Recently, a ** has once again aroused heated discussions. ** It shows that after two 120 emergency personnel came to the door, the family asked them to carry the patient downstairs, and the staff said that they had lumbar disc disease and could not help carry the patient downstairs, and said that they "did not have this obligation". An argument ensued, and the patient questioned, "Can I still do this job if I have lumbar disc disease?" 120 emergency personnel replied, "If I can carry it, I will help you carry it", "We are doctors, not stretchers".
The result of the handling is: the hospital and the relevant staff apologized to the familyTwo hospital staff members have been suspendedThe family now understands it.
The staff of the Health Commission of Heihe City, Heilongjiang Province, where the incident occurred, respondedFirst responders do not have an obligation to carry patientsThe dispute is mainly due to the lack of stretcher personnel in ambulances, and the city is currently promoting the allocation of stretcher personnel in medical institutions.
Why are first responders suspended when they are not obligated to carry patients? Some netizens jokingly said: "If you can't solve the patient's family, you may not be able to solve a few people wearing white coats." ”
The doctor is not obligated to carry the stretcher
However, the hospital needs to be staffed
According to Article 20 of the Measures of the People's Republic of China for the Administration of Pre-hospital Emergency Medical Care, inMedical ambulance workers can engage in related paramedical work, including:Transporting and escorting patients, but note that this refers to:Ancillary work。And the scope of medical ambulance personnel mentioned here is very large, it is a general term, and there is no clear provision on whether doctors and ** have the responsibility and obligation to carry patients.
The Beijing Municipal Regulations on Pre-hospital Emergency Medical Services, which has been implemented by Beijing, clearly stipulates the job responsibilities of "stretcher bearer". It is pointed out that each pre-hospital ambulance should be fully equipped including driver, doctor, **Stretcher bearerand other first responders, who have the ability to provide lifting services for patients in need.
In reality, stretchers are rarely available
It's all the doctors
Although it is stipulated that hospitals need to equip ambulances with stretchers, in reality, few hospitals can be fully equipped, and doctors are basically in charge.
The staff of Nenjiang People's Hospital responded to the incident, saying: "The hospital is indeed not equipped with a stretcher, in principle, the doctor can take a hand, but at that time, the emergency doctor suffered from a herniated lumbar disc, and the patient needed a special stretcher, equipment and training. When the patient's family calls 120 Ambulance**, they can explain the patient's condition and the requirements for transportation, and the hospital will dispatch appropriate personnel and equipment to treat the patient according to the situation. ”
Because of the particularity of patients, it is necessary to have a certain degree of professionalism in the lifting personnel, but the pre-hospital emergency work is intensive, high-risk, and low-income, and it is difficult to attract and retain medical personnel. Stretcher bearers are non-regular workers, and the shortage and turnover of personnel are even more serious. According to the special (municipal) financial expenditure performance evaluation report on the construction of 120 pre-hospital emergency systems in Shanghai in 2017, from the perspective of personnel management, the stability of the first aid (stretcher) team is the lowest among the three types of first-aid personnel: first-aid (stretcher) personnel, emergency doctors, and ambulance drivers.
Therefore, in most cases, it is the emergency doctor who is with the car to help carry the patient.
Behind the incident is the issue of ambulance operating costs
How much does an ambulance cost?
At present, an ambulance needs to be equipped with 1 driver, 1 doctor, 1 **, as well as 1 staff member of the relevant supporting dispatch room and 1 dispatcher of the emergency center. In other words, 1 120** will transfer at least 5 staff members. In 2016, the average direct cost of an ambulance in Beijing was close to 1,500 yuan, including labor costs, motor vehicle operation and maintenance costs, and depreciation of medical equipment, while the average charge for each trip was 180 yuan.
The staff of the Heihe Municipal Health Commission said that due to the vast and sparsely populated area of Heihe City, the current setting of its first-aid station relies on local hospitals, "as far as the social service system is concerned, the first-aid station is a public welfare, it itself is not profitable, if the first does not bear the cost of hiring (stretcher), the hospital also needs a lot of money to hire personnel every year." ”
The specific charging standards for ambulances in various provinces and cities across the country are different, and the charges are mainly divided into two parts: ambulance fees and pre-hospital first aid fees.
Ambulance fee
The ambulance fare generally includes a fixed usage fee plus a kilometer fee for one trip, and if there is a waiting for the bus (usually more than half an hour), there will be a fixed amount of waiting fee.
Pre-hospital emergency expenses
The cost of pre-hospital emergency care will be charged according to the different examinations, medicines, and consumables covered by ordinary first aid and rescue in accordance with the regulations of the Price Bureau.
Some cities will be listed separatelyStretcher feeCarry out a fee,Depending on the elevator room or staircase room, different floors also have different charges
In Shanghai, for example, the most basic cost of a trip includes an ambulance fee (30 yuan), a charge per kilometer from the fourth kilometer (7 yuan) and a pre-hospital emergency fee (60 yuan). In general, in Shanghai, if it is not very far from the hospital and you get on the bus in time, the general charge will be controlled within 150 yuan.
And in the United States, according to the U.S. Accountability Bureau, the service fee for ambulances ranges from $224 to $2,204 per trip, which is equivalent to 14,000 yuan. In Los Angeles, the average cost of an ambulance is about US$1,200, which is equivalent to about 8,000 yuan.
In the UK, if you call an ambulance three times, the total cost is 513 pounds, which is equivalent to about 5,059 yuan. Moreover, the cost of the ambulance is not covered by the UK's universal health insurance and is entirely borne by the patient.
In contrast,China's 120 service and medical system are more reasonable from the perspective of **
And if you want to solve this problem once and for all,It is necessary for relevant management departments and hospitals to increase investment and increase the scientific and reasonable allocation of first aid personnel, especially stretchers。Before that, doctors and patients' families need to understand each other, family members can ask neighbors to help before the ambulance arrives, and 120 can also understand the patient's condition in detail and adjust the emergency personnel reasonably. Only when doctors and patients work together can patients be better cared for.