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APPEAL

АЛГОРИТМ ОБРАЩЕНИЯ

The procedure for admission of patients to the consultation in the consultative and polyclinic Department

According to the order MZ of the Russian Federation of 15.11.2012, no 918н «On approval of the procedure of rendering medical aid to patients with cardiovascular disease», the direction of the patient to the consultation (treatment) in the cardiology clinic implemented «only after a routine primary health care in outpatient and inpatient health-care institutions at the place of residence».

The decision on the need for referral of the patient for specialized medical care is made by the medical Commission of the medical organization providing primary health care, with the implementation of a minimum of laboratory and instrumental methods of research, in the presence of comorbidities with the involvement, if necessary, of medical specialists of different profiles.

The dispensary provides specialized medical care to patients referred by physicians, cardiologists of Central district hospitals that do not have cardiac departments, or cardiac patients whose diagnosis and treatment is difficult or not effective.

Patients sent for consultation to a cardiology clinic should have a referral from a doctor from the place of residence (signed by the head of the institution, with a stamp, indicating the diagnosis and purpose of the consultation), a passport, a medical insurance policy + a photocopy of the policy and the results of laboratory and instrumental methods of research. At the direction for delivery of the conclusion on medical and sanitary examination it is obligatory to provide survey results: daily monitoring of ECG, Echocardiography, daily monitoring of BP at the diagnosis arterial hypertension (no more than 2 months prescription).

Admission of patients who do not have a referral or medical insurance policy of MHI is carried out on paid services. Disabled people, participants of the great Patriotic war equated to them categories are served out of turn. At the time of consultation, examination of patients in the consultative and polyclinic Department sheets of disability and certificates are not issued.

Recording of patients in the presence of indications for planned hospitalization is carried out by cardiologists of the consultative polyclinic Department of the dispensary. Recording of patients for hospitalization by relatives and patients by phone is not allowed.

Planned hospitalization of patients is carried out on the appointed day with mandatory pre-hospital preparation: with the provision of test results (General blood test, General urine test, feces per I / g, blood glucose, creatinine, — no more than 10 days ago; FLG or R-graphy of the lungs no more than 6 months ago). In the absence of prehospital examination, planned hospitalization is postponed to another date.

Heavy (stretcher) patients for consultation with a cardiologist in the consultative and polyclinic Department of the dispensary are not sent! The provision of medical care to such patients is carried out by prior agreement with the Deputy chief physician for the medical part of GBUZ SK «KKCD» by phone 8(8652) 36-56-89. Delivery of such patients is carried out on sanitary transport accompanied by a medical worker and in the presence of the necessary medical documentation (detailed extract from the medical history or outpatient card with the results of further examination and treatment, the conclusion of the district specialist). The transfer of patients from other hospitals is carried out in consultation only with the chief physician or Deputy chief physician for the medical part!

The procedure for referral to planned hospitalization in the cardiology Department of the dispensary

Regional patients and residents of Stavropol, mainly persons of working age (men up to 60 years and women up to 55 years) are hospitalized in the dispensary. Patients with chronic diseases of the cardiovascular system, as well as inactivated patients (with heart failure above CHF 2 «B» — 3 art.), are subject to hospitalization and treatment in the therapeutic Department at the place of residence.

Invalids and participants of the second world war are hospitalized in a planned manner, in accordance with the Federal law and Resolutions of the Government of the Russian Federation to provide medical care to disabled people of the great Patriotic war and persons equated to them on benefits, out of turn.

Patients, a non-admission in hospitals dispensary:

with rheumatic fever, rheumatic heart disease and other connective tissue;

— with hypertension II-III art. (are consulted before medical examination in the conditions of consultative and polyclinic Department);

— with symptomatic arterial hypertension (are consulted in the consultative-polyclinic Department);

— with vegetative-vascular dystonia without complex rhythm and conduction disorders (subject to treatment and examination in therapeutic departments);

— with neuro-endocrine and anaemic myocardiodystrophy,

— with hypothalamic syndrome,

– in a stable state for the purpose of examination for health examination.

Planned hospitalization of patients is carried out after preliminary consultation of the cardiologist and prehospital preparation. The date of planned hospitalization is agreed with the Deputy chief medical officer. Recording of patients for hospitalization by relatives and patients by phone is not allowed.

Referral for planned inpatient treatment is made by a cardiologist of the consultative polyclinic Department, in some cases, the Deputy chief medical officer.

Hospitalization of planned patients in the hospital dispensary is carried out:

in the cardiology Department No. 1 and No. 2 from 11.00 to 12.00;

— to the Department of surgical treatment of complex arrhythmias and DISEASES from 13.00 to 15.00;

in the day hospital from 10.00 to 12.00.

Re-hospitalization of patients in the hospital is possible only in case of deterioration and when there is no effect of treatment in the hospital at the place of residence.

Patients sent for hospitalization must have a passport, an extended medical insurance policy, previous medical documentation. In the absence of a medical insurance policy, hospitalization and treatment in hospitals is carried out on paid services.

Planned hospitalization of foreign patients is carried out only in coordination with the chief physician, taking into account the consultation of the cardiologist of the consultative-polyclinic Department, in accordance with the Territorial program of State guarantees.

Planned patients before hospitalization must necessarily undergo a preliminary examination. The list of necessary additional laboratory and instrumental examinations is issued by the cardiologist to the patient on hands with recommendations on treatment at the prehospital stage. The results of prehospital training on the day of hospitalization are attached to the referral. In the absence of a preliminary examination, planned hospitalization is postponed to another date.

Planned hospitalization of patients in the x-ray surgical Department is carried out by arrhythmologists in coordination with the head of the Department and the Deputy chief medical officer.

In the day hospital, patients examined with a verified diagnosis are hospitalized, without fail after pre-hospital preparation.

In the absence of the recommended follow-up examination on the day of admission to the planned hospitalization of patients, the minimum mandatory laboratory follow-up examination is carried out on a paid basis.

Heavy (stretcher) patients, patients are not clear in the diagnostic plan are sent to the cardiology clinic only after prior approval with the administration of the dispensary. Delivery of such patients is carried out on sanitary transport accompanied by a medical worker and in the presence of the necessary medical documentation (detailed extract from the medical history or outpatient card with the results of further examination and treatment, the conclusion of the district specialist).

The transfer of patients from other hospitals is agreed only with the chief physician or Deputy chief medical officer.

Hospitalization of all patients with cardiac arrhythmia and conduction disorders for emergency indications is carried out by the ambulance station team around the clock or through the sanaviation line.

Patients brought to our dispensary for emergency indications are examined by the duty doctor of the emergency room, if necessary by the resuscitator of the dispensary and, if there are indications, are hospitalized in the appropriate Department.

In the absence of urgent indications, the issues of planned hospitalization are solved in each case by a cardiologist of the consultative polyclinic Department with the preliminary approval of the Deputy chief physician for the medical part.

All patients who have applied for admission to the consultative and polyclinic Department or self-referral to the emergency Department, in the presence of emergency indications, are hospitalized.

Emergency hospitalization is carried out according to the indications and on the basis of the recommended standards of medical care for patients, mainly with the following diseases and conditions:

— acute cardiac arrhythmias and conduction without acute myocardial infarction;

— severe sinus bradycardia, bradiarrhythmia with a heart rate of less than 50 beats per minute;

— paroxysmal supraventricular tachycardia;

— paroxysmal ventricular tachycardia;

— first-time atrial fibrillation,

— first-time atrial flutter;

– patients with disorders of the er, was on the ECG, accompanied by hemodynamic changes.

Patients suffering from chronic heart rhythm disorders who are not subject to emergency admission to our hospital:

— patients suffering from chronic atrial fibrillation, without an increase in heart rate, without an increase in symptoms of heart failure; with stable hemodynamics;

— patients suffering from chronic atrial fibrillation with a moderate increase in heart rate and heart failure phenomena, successfully stopped at the prehospital stage;

– patients with permanent closures of the legs of bundle branch block on ECG.

— patients with long-existing ventricular extrasystole, without increasing its number and symptoms;

— patients with paroxysmal supraventricular tachycardia, successfully stopped at the prehospital stage, without significant hemodynamic disorders;

— patients suffering from chronic atrial fibrillation, with a moderate increase in the incidence of ser (having concomitant pathology in the terminal or decompensated stage).

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