194

a)      Emeregency medical help and home treatment

b)      Health care centre operating on third shift, national holidays and Sundays

c)      Emergency dental care centre

Work objective: Implements the necessary diagnostic and therapeutic actions to eliminate any immediate life or health threat. Offers medical services and treatment at patients’ home (homecare).  Offers medical assistance on third shift, Sundays and national holidays as well as emergent dental services.

Management approaches and methods: Cooperation between department leaders and experts ensures a successful implementation of the work duties and facilitates improvements in the working process.

Emergency Center

History

The first hospital emergency medical examinations date back to World War II when private doctors with chariots were used as a means of transport.

The first aid station was created for the first time after the war within the latter city polyclinic with two shifting doctors. On July 1, 1956, it was created as a particular station of  Medical Emergency Aid  with four teams. In 1962, radio stations were introduced in sanitary vehicles. In 1970, PHI Skopje “Skopje Health Center” was established and Medical Emergency Assistance was integrated into it as a working unit with its location at Polyclinic Bucharest ,where it remains on this day.

In 2001, the Service expanded to establish a dispatch center,  Base-Jane Sandanski within Jane Sandanski polyclinic and Base-Chair within the Clinical Polyclinic.

The purpose of creating Bases is:

• Improve the speed of intervention, which means the maximum cutback of the time needed to reach and provide assistance to the sick or injured from the moment the call is received;
• Significant reductions in the cost of daily work, mainly by reducing empty mileage and reducing fuel consumption;
• Establishing a whole area coverage of the city with teams in the field.

In 2007, the fourth base -Cento was established within the Chento Polyclinic, making a whole coverage of the city according to the city’s distribution and coverage of the highway.

Borders between points are not strictly defined and calls are made on the team’s emergency scale from the nearest point if the teams from that point are in an interview. From 2006 to 2008, complete replacements of old sanitary vehicles have been replaced with new ones, employees receive uniforms with a special service definition, a training department is being built and a new parking space is being built for sanitary vehicles.

At present the Service is organized with:

1. Karposh Base: Dispatch Center
2. Base- Jane Sandanski, Base -Cair, Base- Chento
3. Emergency Ambulance
4. Department for Education and Complementary Training
5. Home visit and recovery unit
6. Verification of death

The health services provided are:

– First and Second Emergency Interventions

– transportation to the city, state and abroad

– medical guarantees of manifestations with different character

TRIAGE DISPATCHER CENTER – Kaprosh base

The dispatch center is a coordinating part in which all calls are accepted at the city level of Skopje, distributed to teams depending on which part of the city the call is and from which Base will the team intervene. In this way, there is a unique coordination and full visibility of the teams, and if teams from a point are already in intervention, the closest crew from the neighboring point will be sent.

he dispatch center consists of:

• The part of receiving calls
• Part for the distribution of calls to teams on the ground

In the part for the receiving calls there are four telephone lines through which all the calls in the city of Skopje are taken, recordings that record the conversations, and two doctors who in a short conversation with the caller use the unanswered questions and according to the data taken from the nature of the disease or vomiting, make a decision for further action.

The options are as follows:

• The call is acknowledged as a need for emergency medical intervention, second-degree emergency intervention, and a diagnosis or a brief description of the symptoms or injuries under which the emergency rate is determined, generals are marked, the exact location indicator and the time of admission of the call. If the call is not for an emergency, the caller is directed to the nearest physician, a home visit or a night care service. Appropriate advice is provided. The frequency and variety of calls is such that it requires a lot of concentration, experience and skills for verbal communication and knowledge of symptoms indicating urgency. Because of the great responsibility, this position can only be fulfilled with those physicians who have worked in the field for at least three years.

Frequently Asked Questions:

• Is the person conscious?
• How do they breathe (normally, hard, drowsy, not breathing at all)
• What are the symptoms?
• Is there pain and where?
• When did the problems begin? How long have they lasted?
• At what age is the person?
• Do they suffer from any other illness, which therapy do they take if they take it?

In addition to these questions, additional questions may also be asked.

Questions are asked in order to transfer to the team the kind of intervention to be interfered and whether there should be special medical equipment besides the standard medical device.

If the call is received, the correct address, phone number on how contact can be made in case of difficulty finding the address should be clarified. With the arrival of the team, the doctor’s advice is handled on the phone and brochures, and the health documentation of the patient is prepared.All received calls are delivered to the call allocation section where two dispatchers work and they are submitted to the teams by location depending which team is the closest. Call Disconnection involves working with a large number of data or with individual call elements and using the available teams in the optimal way. Dispatchers are medical workers who have long-standing field experience, know the city and have the ability to quickly use the data provided in favor of appropriate team placement.The process of receiving and transmitting the call may take seconds to minutes depending on the applicant.

Medical Teams

Field medical teams consist of a doctor, a nurse / technician and a driver.

During 24 hours, 365 days of emergency medical aid are provided by eight to nine teams on the territory of the city of Skopje. In general, two of the teams are located at the Jane Sandanski and Cair points, a Cento crew point, and four teams at the Karpos service base, however the team schedule depends on the need of the city and can be changed during the shift. If needed, the number of crews increases. Each sanitary vehicle of NSHM Service (medical emergency assistance) is equipped with standard medical equipment for emergency medical care. The Medical Emergency Service carries out medical transport for patients in the city, at home and abroad, according to a medical indicator or patient’s request.For transfers to the city is registered at number 194, and at home or abroad with the main nurse.

Medical insurance

The service provides medical delivery of gatherings and manifestations of different character (sport, cultural, political). Security is carried out at the request of the organizer of the manifestations or meetings and must be reported at least two days before the event.

phone

Tel.02-3064-249

Tel./fax 02-3072-321

Home treatment unit

Home care, is exercised to the insured person when hospital treatment is not necessary, with the recommendation of the specialist doctor.The unit is located at the base of Karposh and registration is done through telephones.

– 3061-258, 3064-465

Verification of death

The death certificate and the issuance of death certificates are in the Home Treatment Unit field. Certificates are given on the facilities of the Home Treatment Unit.