Cabinet of Ministers Regulations No. 948 in 2011 December 13 (pr. No 74 16) disaster medical system management rules Issued in accordance with article 9 of the law on medical treatment, the second part i. General questions 1. establish disaster medical system of the organisation.
2. Disaster medical system is the system of civil protection and national security systems.
3. Disaster medical system activates emergency medical situation and emergency public health situations.
4. Emergency medical situation in the medical institution, the municipal administrative territory or the country is in such a case, if immediately available medical resources do not match existing or predicted to the victim or victims.
5. Emergency public health situation is the outbreak of infectious diseases or outbreaks with significant risk and hard to control the spread of potential as well as an event or an event with health threats of biological, chemical or physical factor in population exposure to when the need for public health measures to be enhanced and coordinated action of the participating institutions.
II. Disaster medical system on disaster control 6 medical system is responsible for the organisation of the Ministry of health.
7. the Cabinet of Ministers created the national emergency medical Commission (hereinafter the Commission) to coordinate the health sector institutions in the event of disasters, as well as make decisions in emergency public health situations and emergency medical situation.
8. Disaster medical system plans, manages and coordinates the emergency medical assistance service (hereinafter service).
9. Disaster medical system events in the municipal administrative territory of the Commission and the Department works closely with the municipal civil protection Commission.
10. For disaster medical system organization of medical institution responsible is the hospital's Manager.
11. Emergency medical situation and emergency public health situations according to the rules of membership 4. and 5. the conditions laid down in point: 11.1. medical institution, medical institutions;
11.2. the administrative borders of the municipality – municipal civil protection Commission Chairman;
11.3. the national armed forces regular force unit or in the National Guard-national armed forces Commander or his authorized person;
11.4. the country-the President of the Commission.
III. Disaster medical system resources 12. Emergency medical situation and emergency public health situations involving relief following medical institutions operating and reserve resources: 12.1. service resources;
12.2. the hospital resources that provide emergency medical assistance 24 hrs (hereinafter hospital);
12.3. the national agency "Infektoloģij Center" (hereinafter referred to as the Infektoloģij Centre of Latvia) resources;
12.4. the national blood center resources;
12.5. other medicinal resources of the institutions.
13. the way the medical reserve pirmsslimnīc the emergency medical assistance for emergency medical situation and emergency public health situations. Medical reserve service and shall lay down the procedure for the use of the service.
14. The hospital form the medical backup to ensure medical treatment in emergency medical situations and emergency public health situations. Medical use of reserve creation and order determined by the hospital's Director.
15. If, through the provision of resources referred to in paragraph 12, it is not possible to provide emergency medical situation and emergency public health situations, relief service leverages the State material reserves, other sectoral departments, institutions, as well as economic operators ' resources.
16. Emergency medical situation and the public health relief can attract international assistance in accordance with the laws and regulations on humanitarian assistance and delivery arrangements.
IV. Disaster medical plans 17. to ensure disaster medical system ready to react and provide coordinated emergency medical assistance emergency medical situation and emergency public health situations, develop a national disaster medical plans and hospital disaster medical plans.
18. the Department draw up a national disaster medical plans in cooperation with medical institutions, once a year to actualize and coordinated with other involved departments and institutions.
19. national disaster medical plan approved by the Minister of health.
20. national disaster medical service plan for the year to 1 September, submitted for approval to the Ministry of health.
21. The hospital disaster medical plans coordinated by the service.
22. the disaster medical plans, taking into account the following preparedness and response regimes: 22.1. readiness – received information about the incident or accident which may effect the immediate liquidation of the available medical resources may not be enough. Identify existing and additional resources deployed, as well as test the communication system of preparedness;
22.2. increased preparedness and response-get information about the accident, following the immediate liquidation of the available medical resources are scarce. Launch additional medical resources to disaster medical system;
22.3. the emergency preparedness and response – received information about the incident, which followed the liquidation requires large amounts of additional medical resources. Launches all possible additional resources.
23. national disaster medical plan provides: 23.1. emergency medical situation and emergency public health situations in management and coordination;
23.2. hospital emergency response procedures in medical and emergency public health situations;
23.3. the country used the disaster medical system resources, and location;
23.4. the number of patients who can provide medical assistance in hospitals;
14.6. the companies, institutions and members of the public, crisis management and the Chairman of the Council of Ministers of health information;
14.7. treniņapmācīb organizing plan.
24. the Service shall have the right to request and receive from the local authorities and the authorities of the country of treatment information for disaster medical development and updating of the plan.
25. Hospital disaster medical plan is responsible for drawing up the hospital's Manager. Hospital disaster medical plans with staff, other concerned departments and institutions and not less frequently than once a year to actualize.
26. According to the hospital provided health care services and the types of risks foreseen disaster medical plan States: 26.1. alarm and notification procedures in the hospital;
26.2. the emergency medical situation management hospital;
26.3. the hospital operational management group composition and tasks;
26.4. the staff response procedures;
26.5. iesaistāmo resources and their management;
16.5. the number of patients who can provide medical assistance;
16.6. patient flow diagram;
26.8. movement of vehicles;
26.9. cooperation arrangements with other medical institutions that may be involved in emergency medical situations and emergency public health situations and rehabilitation;
26.10. cooperation arrangements and agreements with other departments and bodies involved;
26.11. the municipal civil protection arrangements for forwarding information to the Commission;
26.12. the victim and their family information procedures and modalities for cooperation with the media;
26.13. the measures for the protection of people in emergency medical situations and public health effects of the winding-up period;
26.14. the head of the hospital's approved list of medical reserve;
26.15. treniņapmācīb organizing plan.
V. procedures for service notify emergency medical situation and formation, as well as threats of emergency public health situations 27. Ensure early identification of emergency medical situation and emergency public health situations of threats and ensure the establishment of the necessary coordination of medical assistance and treatment, persons in accordance with the medical institution reporting arrangements specified in the terms of service: 27.1. all immediately 24/7 by phone or walkie-talkie by backing up the information by fax or electronically to the following cases: If the disaster or not 27.1.1. case of five victims (deceased) and more who need medical help;

27.1.2. If, after seeking medical treatment five victims (deceased) and more professionally and there is a reasonable suspicion that the health damage caused by direct exposure of the same chemical and physical agents, or if the health risks associated with food, drinking water, medication use, atmospheric air or other environmental factors;
27.1.3. If acute health damage caused by radiation, first diagnosed with acute radiation sickness is there a professionally substantiated suspicion of acute radiation diseases;
27.1.4. If symptoms, patient survey data, or other information leads to the suspicion of a biological or chemical agent dissemination;
27.1.5. If there is a risk that an emergency medical situation and emergency public health situations, the estimated number of victims (victims) could be so great that immediately available medical resources is not enough appropriate medical assistance;
27.1.6. If the hospital is hit by the devastating effects of the factors are there such threats;
27.1.7. If infection, poisoning, drug-induced complications (side effects) or injury not stacionēt or died a foreigner;
27.1.8. If registered two patients and more that are hospitalized or have died of complications caused by certain drugs (side effects), or there is suspicion;
27.2. at the request of a service.
28. the treatment of persons, providing operational information on this provision of paragraph 27 of the cases referred to, the following: 28.1. hospital's name and address;
28.2. the nature of the event, date, location, type and extent of hazard;
28.3. the victim (victims) and the number of fatalities, age, health damage, the General clinical condition;
28.4. to provide medical assistance, hospitalisation of victims (victims) need other treatment facilities, in addition to necessary assistance (technicians, equipment);
28.5. additional information (including the event development forecast);
28.6. the report preparer name, title and phone number, as well as treatment services manager or the responsible supervising physician's name, title and phone number.
VI. the procedures for emergency response in a medical situation 29. operational control centre of the service provides emergency medical situation. The Director of the service, if necessary, establish emergency management group that provides emergency medical situation management.
30. Following the receipt of the information about imminent or existing emergency medical situation professional: 30.1. evaluate the information received and identify the available medical resources;
30.2. activates disaster medical system under the national disaster medical plan;
30.3. inform the President of the Commission.
31. the emergency medical situation consequences does the following: 19.3. sent to the location service for emergency medical teams and means doctor of management;
31.2. If necessary, the location of the event is sent to a medical support unit;
19.4. If needed, send the service professionals to hospitals, which hospitalized victims (deceased);
19.5. coordinate the victim (victims) hospitalization;
31.5. Decides on the deployment of medical reserve service;
19.6. If necessary, determine specific urgent call service procedures, limit the daily call service, without prejudice to emergency medical care to people in life-threatening situations;
19.7. preparing a request for disaster medical system resources and the involvement of the State material reserves;
19.8. inform the Foreign Ministry if the disease, poisoning, drug-induced complications (side effects) or injury not stacionēt or died a foreigner.
VII. response of the service arrangements for emergency public health situations 32. Following receipt of the information on emergency public health situations of threat or create service: 32.1. evaluate the information received and identify the available medical resources;
32.2. If necessary, activate the disaster medical system under the national disaster medical plan;
32.3. inform the President of the Commission.
33. the emergency public health situations: 33.1. inform the European Union of Biological and chemical terrorism emergency warning and response system (Rapid alert system for Biological, Chemical and radio-Nuclear agents-RAS-BICH) about the incident;
33.2. the public health protection measures with the European Commission's Environment Directorate-General of health, consumer and Health Department, if the threat is a threat to citizens of other countries;
33.3. inform the World Health Organization's international public health focal point for public health risks that can lead to exceptional international importance to public health, and international health regulations in the cases specified under the public health protection measures;
20.8. for emergency public health situations or circumstances, which may cause exceptional international importance to public health, the Ministry of Foreign Affairs announces the preventive foreign diplomatic and consular information.
VIII. Emergency medical assistance coordination and emergency medical situation management on site 34. On site come the first emergency medical assistance team (doctor or Physician Assistant) shall perform the duties of a doctor of management.
35. Management doctor (doctor or Physician Assistant) in running the rescue work under the guidance of the supervisor and arrange the sorting, as well as the victims, coordinate and manage emergency medical assistance to victims, directly participating in emergency medical care.
36. If necessary, emergency medical assistance, the Organization of the event instead of taking over the management of the service designated doctor (the doctor).
37. Management doctor (doctor or Physician Assistant) is a distinguishing mark (vest or other distinguishing mark) with the word "management" doctor ".
38. Emergency medical teams staff work outside the danger zone of the site.
39. medical evacuation of victims, coordinated by the regional center of the service's senior duty doctor (Dispatcher), if necessary involving the operational management of the Service Center.
40. If necessary, the victim (victims) medical evacuation service involved in the national armed forces or the national border guard aircraft logistics support means (vehicles, machinery, fuel, equipment, vessels) and personnel, as well as other sectoral departments, institutions and resources of economic operators.
41. If necessary, the Department shall designate a responsible person on site coordination with the media.
IX. Emergency medical assistance coordination and emergency medical situations in managing hospital 42. Information about emergency medical situation, hospital admissions department keep-medical staff: 42.1. information on the event type, location, time, and number of victims;
26.2. to act in accordance with the hospital's disaster medical plan.
43. The hospital disaster plan in the medical officer shall adopt and repeal decision on preparedness and response regime, as well as decide on the hospital's core management group convened.
44. The hospital's core management group's main tasks: ensuring hospital 44.1. work under the hospital's disaster medical plan;
44.2. to inform about the operational management group activities;
27.5. contact other hospitals to which, if necessary, could bring victims (saslimušo);
27.6. to ensure the exchange of information with the operational service of the regional center for senior duty doctor (Controller);
27.7. to take a decision on the hospital's existing medical reserve and use of medical devices in emergency medical care and treatment;
27.7. to take a decision on the need to attract additional resources and inform the service;
44.7. to take a decision on the involvement of the competent authority the hospital security and policing;
27.8. organize the provision of information to victims, the victim (victims) nationals and, if necessary, the media.
X. arrangements for the Centre of Latvia's Infektoloģij report on dangerous infectious diseases and diseases with other block infectious diseases 45. early identification of threats To public health or emergency medical situation, caused by infectious diseases, including dangerous infectious diseases and other biological agents, medical person immediately by telephone and in writing, notify the Centre of the Latvian Infektoloģij the duty epidemiologists in any time of the day in the following cases: 45.1. of every professional event of serious doubts about the human disease with dangerous infectious disease;

45.2. If there is a case for the block with three and more patients that open simultaneously, or incubation time, if there is reasonable suspicion of a professional event, the epidemiological relationship, with the following diagnoses: 45.2.1. botulism;
45.2.2. brucellosis;
45.2.3. diphtheria and diphtheria carrying the agent;
45.2.4. tick-borne encephalitis (if the infection occurred in the alimentār path);
45.2.5. E. coli 157 and other Enterohaemorrhagic e. coli induced by infection;
45.2.6. Hunt virus infection (haemorrhagic fever with renal syndrome);
45.2.7. Legionnaires ' disease;
45.2.8. leptospirosis;
45.2.9. malaria;
45.2.10. meningococcal infection;
45.2.11. ornithosis (psittacosis);
45.2.12. Q fever and other riketsioz;
45.2.13. trichinosis;
45.2.14. tularemia;
typhoid and paratyphoid fever in 45.2.15.;
45.3. where is stacked with five or more disease sufferers detected simultaneously, or incubation time, if reasonable suspicion is a professional about this case with an epidemiological link, the following diagnoses: 45.3.1. Hepatitis A;
45.3.2. yersiniosis;
45.3.3. salmonellosis;
Shigellosis; 45.3.4.
45.3.5. food toksikoinfekcij, except for botulism, other specified and unspecified etiology of acute intestinal infections;
45.3.6. measles;
45.3.7. mumps;
45.3.8. rubella;
45.3.9. whooping cough;
45.3.10. influenza (outside the influenza epidemic);
45.3.11. viral etiology of meningitis, encephalitis, myelitis, meningoencephalitis, acute kardīt;
45.3.12. uncertain etiology of severe acute infectious diseases with five patients and more, put in a hospital;
45.3.13. the two and the more the vaccination induced complications (side effects) if the professional sound, these complications are related.
46. the treatment of persons, providing operational information on this provision, paragraph 45 of the cases referred to, the following: 46.1. dangerous infectious disease case-patient's name, age, sex, place of residence (address), workplace or educational institution;
46.2. the block in case of disease, the diseased and dead;
46.3. the initial diagnosis of the patient, the patient's general condition, the main clinical symptoms and disease severity progress;
46.4. the date and time of the disease;
46.5. the date on which the deceased approached medical attention;
46.6. diagnosis date and time;
stacionēšan, 29.0. date and time;
29.1. the epidemiological health history: 46.8.1. possible contamination;
46.8.2. the most likely source of infection and transmission factor (if known);
46.8.3. dangerous infectious diseases in the case of the date when you last visited the workplace or educational institution;
46.8.4. the first pretepidēmij measures taken and other important information, including the service of assistance and infektolog the need for consultation;
46.8.5. the vaccination in the case of complications caused by the vaccination date, time, name of the vaccination, the vaccine name, manufacturer and series;
46.9. message preparer name, title, institution, address, and phone number.
XI. the response of the Centre of Infektoloģij, receiving information about dangerous infectious diseases and diseases with other block infectious diseases 47. Infektoloģij Center, receiving information about possible danger to public health or illness caused by infectious diseases, including dangerous infectious diseases and other biological agents, activated by the Latvian Centre of Infektoloģij on-hand resources and coordinate the measures to be taken in accordance with the operating procedures approved by the Director.
48. If a dangerous infectious disease and illness with the block other infectious diseases, as well as to public health caused by the case of a biological agent, Infektoloģij Centre of Latvia shall take the following measures: 29.9. ensure operational information, evaluation and further provision under the Latvian Center of Infektoloģij arrangements, including the provision of information services;
48.2. If necessary, set up a working group for emergency public health measures to control the situation and to coordinate and establish a professional team to check out the location of the event;
48.3. provides information the State, municipal authorities and non-governmental organizations on emergency public health situations and elimination issues;
30.1. provide consultative assistance and requests from the other institutions the information necessary for the Latvian Infektoloģij the Mission of the Centre;
30.1. the epidemiological investigation, collect and analyse information on dangerous infectious diseases and disease clusters with other infectious diseases, public health scares caused by cases of biological agent, in the course of development of such threats, as well as biological factors, assessed the impact of the risk to human health;
30.2. prepare and, upon request, provide to other institutions concerned information on the specific situation of infectious disease-causing potential effects on human health;
30.3. If necessary, evaluate the epidemiological situation and provides recommendations for laboratory examination;
30.3. determine population increased risk groups, risk objects and areas;
30.4. providing recommendations to citizens and institutions concerned about contaminated drinking water, food, household items and other environmental decontamination or destruction of the object;
48.10. If necessary, in cooperation with the health inspection and food and veterinary services carried out in the affected places and objects, as well as epidemiological assessment of hygiene;
48.11. determine the specific infectious diseases and specific prevention measures;
48.12. If necessary, organise the disinfection and disinsectisation instructs and pest extermination measures the outbreak of communicable diseases;
48.13. appropriate competency determine the priority public health measures;
48.14. predicts the development of the epidemiological situation and determine short and long term emergency measures, as well as the necessary personnel for this purpose and materiāltehnisko resources;
48.15. evaluate the results of the laboratory examinations in relation to the impact on the health of the population;
48.16. According to competence and provides information to the media;
48.17. prepare concrete proposals and recommendations for the population and the institutions involved, if found dangerous infectious diseases and disease clusters with other infectious diseases, as well as to public health caused by the case of biological agents, and to provide an analytical assessment of the situation;
48.18. participates in the biological effects of terrorism in the management of public health: 48.18.1. epidemiological investigation, including collecting detailed information about contacts;
48.18.2. inform the family doctors and for medical observation of contact;
48.18.3. arranging the scene disinfection;
48.18.4. prepare recommendations on public health in a given situation;
48.18.5. inform the European Commission and the European Centre for disease control and Prevention Center, using the early warning and response system (Early Warning and response system-ewrs) for public health the people of other countries, report on epidemiological control and prevention measures and, if necessary, consult this field;
48.19. inform the Foreign Ministry, where a dangerous infectious disease ill foreigner or block disease with other infectious diseases has suffered a foreigner;
48.20. ensure infection agent, including dangerous infectious disease agents, laboratory identification (major and supporting) using third-level biosecurity laboratory resources;
48.21. ensure patients isolation and treatment.
XII. Emergency medical assistance in the coordination of dangerous infectious diseases cases 49. in patients suspected of being infected with dangerous infectious diseases, professional emergency medical assistance team leader: 30.5. ensure protection of workers using protective clothing appropriate to the situation and protective equipment;
30.6. patients with isolated and emergency medical assistance;
30.6. isolating people who had contact with the patient;
49. the report to the regional center of the service Chief duty doctor (Controller) and the Latvian Centre for the Infektoloģij duty epidemiologists;
30.8. organizes the other emergency measures, including pretepidēmij, inform the patient and contact on infectious disease of roads, the necessary safeguards and individual prevention measures according to the specific circumstances of the infection outbreak, if necessary, consult with the Centre of the Latvian Infektoloģij epidemiologists;
30.8. provide patients hospitalized in taking measures to prevent the contamination of other people the patient during transfer;

49.7. on arrival at the Infektoloģij Centre of Latvia or another hospital's infectious disease Department, perform the supervising staff instructions for operating the vehicle disinfection, medical emergency medical teams staff sanitary treatment, isolation, medical observation and other individual prevention measures.
50. the regional centre senior duty doctor: 50.1. controls and directs emergency medical team personnel actions in accordance with Infektoloģij Center specialist;
50.2. report according to the service's operational reporting arrangements.
XIII. action by the Inspectorate of health public health event, associated with the handling of natural disasters or 51. Health inspection, you receive information about the public health risks associated with the handling of natural disasters or (chemical or physical factors), take the following measures: 51.1. collect and analyse information on public health development and evaluate chemical and physical factors influence risk to human health;
51.2. evaluate the risks of the hygienic situation of affected objects and provide recommendations for carrying out of laboratory studies to decide on the consequences of the measures, the population safe living and working environments, as well as, if necessary, take drinking water samples;
51.3. If necessary, evaluate the hygiene and household conditions of population, short-term accommodation for asylum or escape.
52. the health inspectorate shall prepare and provide an analytical assessment of the specific proposals and recommendations to the public, local authorities and institutions concerned about public health, its consequences liquidation measures are effective, as well as, if necessary, to ensure the preparation and presentation of information to the media.
Prime Minister v. Minister of health I dombrovsky. Cricket»