Circular 13/tt-Byt/2012: A Guide To The Work Of Anesthesiology-Resuscitation

Original Language Title: Thông tư 13/2012/TT-BYT: Hướng dẫn công tác gây mê - hồi sức

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MINISTRY OF HEALTH
Number: 13 /2012/TT-BYT
THE SOCIALIST REPUBLIC OF VIETNAM.
Independence-Freedom-Happiness
Hanoi, August 20, 2012

IT ' S SMART

Anesthesia Guidance

____________

Base of Protocol 188 /2007/NĐ-CP December 27, 2007 and Decree No. 22 /2010/NĐ-CP March 9, 2010 by the Government stipulated the functions, duties, powers, and organizational structure of the Ministry of Health;

On the recommendation of the Director of the Bureau of Management, healing and the Chief of the Legal Affairs Department;

The Minister of Health issued the Anesthesia Manual.

Chapter I

GENERAL REGULATION

What? 1 -The adjustment range.

This information instructs the function, mission, organizational structure, facilities, equipment, and anesthesia activities in the facilities of the disease, healing of the treatment of surgery, anesthesia, recovery procedures.

What? 2 Explains the word.

In this Information, the words below are understood as follows:

1. Anesthesia is the method of helping people with a different degree of awakness to maintain the stability of living functions while performing surgery (surgery), the procedure.

2. Wake up It ' s the disease that ' s out of the anesthesia.

3. Foreign health is the diagnostic measures, treatment for the outpatient (before, during, after surgery and some procedures) to maintain, stabilize and improve the life functions of the sick.

4. Anesthesia is the implementation of some or all of the activity in pre-anesthesia, anesthesia, anaesthesia, anaesthesia, and anti-pain.

What? 3 Principle applies to law.

Organizations, individuals with activities related to anesthesia work, in addition to carrying out regulations at this Smart, also have to apply the provisions of the Law of Discovery, healing in 2009, the Digital Protocol. 87 /2011/NĐ-CP September 27, 2011 stipulated the details and guidelines of taking some of the provisions of the Law of Discovery, healing, Protocol No. 96 /2011/NĐ-CP October 21, 2011 of the Government rules sanctions on the administrative violation of disease, healing, digital information, and disease. 41/2011/TT-BYT November 14, 2011, of the Ministry of Health of the Health Department of the Ministry of Guide to Behavioral Certification for the Occupational Persons and Licensing Activities on the basis of the disease, healing, other law enforcement texts are related to the examination, healing, and the regulation of the disease. Specialization, engineering in disease, healing.

Chapter II

ORGANIZATIONAL STRUCTURE AND HUMAN RESOURCES

What? 4 Organizational structure.

1. The complete anesthesia department consists of the following parts:

a);

b) Exploring anaesthesia;

c) Surgery;

d) Islam;

Foreign health;

e) Antipain.

2. Special Class Hospital, Class I has to organize a complete anesthesia department according to Regulation 1 Article.

3. Second Class Hospital must organize a anesthesia department with a minimum of 4 parts per regulation at Point a, Point c, Point and Point 1 This Article.

4. Grade III Hospital, Class IV or unclassified without the anesthesia faculty, has to set up a minimum of 2 rules of regulation at Point c and Point 1 This is part of a clinical department performing surgery, procedure.

5. Hospital facilities, treating other diseases other than regulation at Clause 2, Clause 3, and Clause 4 This should be allowed to perform surgery, the procedure must ensure that anesthesia is in accordance with the correct technical regulations prescribed in this Information.

What? 5. The professional titles perform anesthesia-resupability

1. The anesthesia is a doctor who has been trained in anesthesia for 18 months or more and is certified as a law enforcement officer for medical treatment, medical treatment.

2. The anesthesia nursing nurse is a specialist in anesthesia and is certified as a law enforcement officer for medical treatment, medical treatment.

3. Anesthesia Technician is an engineer with a degree in anesthesia and is certified as a law enforcement officer for medical treatment, medical treatment.

4. Nursing the surgical department is a certified nursing home that has been trained in surgical nursing and is granted a certificate of practice by law on the examination of the disease, healing.

What? 6 The human layout.

The manpower of the anesthesia department is deployed in the following parts:

1. Executive: consists of the chief nurse of the faculty and the administrative staff. The number of administrative personnel is due to the director of the facility, which is decided on the basis of a general anesthesia.

2. Exploring in anesthesia: a minimum of 1 (a) anestheologist, 01 (a) nursing home anesthesia, and 01 (a) for their own.

3. Surgery: The manpower for each surgery is a minimum of 1 (a) anestheologist, 01 (a) anestheologist, 01 (a) nursing-duty officer, 01 (a) nursing duty as an outpatient, and 1 (one) for a passport.

4. Islam: A minimum of 1 (a) anestheologist, nursing (the number of nursing depending on the number of beds of the province with a rate of 2 (two) nursing in charge of 5 hospital beds) and 01 (one) a passport.

5. Foreign health: a minimum of 1 (a) anestheologist in charge of 3 beds, 1.5 nursing in charge of 1 hospital beds and 01 (one) assistant.

6. Antipain: a minimum of 1 (a) anestheologist, nursing (the number of nursing depending on the number of beds, the rate of 1 (one) (nursing in charge of 2 beds) and 01 (one) for the treatment.

7. The above titles may work in various departments depending on the actual manpower of the clinic, treating the disease but must be consistent with the certificate of disease, healing.

Chapter III

FUNCTIONS, DUTIES AND POWERS

What? 7. The function and mission of anesthesia department

1. Function:

The anesthesia department is the clinical practice, which has the function of performing anesthesia, during, after surgery and some procedures for the pathology of the patients in accordance with the specifications prescribed at this Smart.

2. Mission:

a) The practice of anesthesia has been approved by the authority of the authority;

b) Training, participation in training, scientific research, direction of line, international cooperation on the field of anesthesia;

c) participate in the management of health economics in the unit;

d) Perform other tasks led by the head of the facility to examine the disease, cure the disease.

What? 8 The mission of the department in the anesthesia department

1. Administrative:

a) Track, statistics, aggregation, reporting on specialized activities;

b) Track, statistics, aggregation, report on the granting, use of equipment, matter of attrification, drugs and chemicals;

c) Human resources and other administrative work in the department.

2. Discover before anesthesia:

a) Exploring anesthesia to prepare the sick before surgery, the procedure;

b) A pre-anesthesiologist anesthesiologist who performed at the clinic before anesthesia, or in surgery, or in the medical school, is subject to the condition of the disease, the condition of the disease, the treatment, and the patient's condition. illness;

c) An anesthesia predates the anaesthesia between 01 and 07 days before the person is undergoing surgery, the procedure (except for the emergency);

d) The pre-anesthesia doctor has the right to ask for an additional test or organization, and must be fully documented in the medical records to perform;

Doctor premeditators have the responsibility to inform and discuss with the person who perform the surgery, the procedure, who will perform anesthesia on the risks, complications that may occur related to anesthesia; explain the risks and benefits associated with it. interested in anesthesia for the sick person or the legal representative of the sick before the signing of a anesthesia, surgery or procedure.

3. Surgery:

a) Preparation of the manpower, table of surgery, equipment, medication, medical supplies of full and ready to perform surgery, the procedure for the sick;

b) Take over, examine the case of the disease, the condition of the disease, and the mandatory preparation conditions to ensure the right person and determine the correct location of the surgical operation, the procedure;

c) Implementing the Anesthesia in accordance with the surgery, procedure with the involvement of anesthesia and anesthesia nursing, the surgical department nurse and other staff at the request of a anesthesia doctor. You know,

d) Perform the controlled bacterial infection.

4.

a) to accept and evaluate the condition of the sick;

b) Treatment, positive treatment to help the sick people quickly awaken;

c) Treatment for post-surgical pain, procedure;

d) Track, detection, complication of complications, abnormal if there is to the person who is sick;

) assess the condition of the disease to move back to the department of foreign affairs or move to other related faculties.

5. Foreign health:

a) Take over the sick person from the provincial department or from other parts moving in;

b) Track, diagnosis, positive treatment and comprehensive care of the disease;

c) Assessment of the condition of the disease to move on the clinical or other department or to the hospital, the hospital.

6. Antipain:

a) Discovery, counseling, anti-pain treatment for pre-surgical patients, following surgery and other acute and post-surgery cases;

b) Before the implementation of the anti-pain technique must inform, explaining to the sick person or the legal representative of the disease of the disease, the antipain method will perform;

c) Follow, execute the complications, the undesirable effect if there is a method, the anti-pain technique.

7. In addition to carrying out the prescribed tasks, parts of the anesthesia department have to perform other tasks according to the division of the dean.

What? 9 The mission and the power of the chief anesthesia.

Carrying out the duties, the powers of the dean, the chief clinical dean for the prescribed and the duties, the specific powers are as follows:

1. Management operating the activity of anesthesia department; organization for the constituent parts of the department of coordination working effectively, quality assurance and responsibility before the head of the medical examination, healing of the activity of the department;

2. Build a management plan, use the manpower, equipment, drugs and supplies of the department to present the head of the medical examination facility, cure the disease and execute the plan after being approved.

3. Deliver anesthesia, nursing, and other staff involved in the procedure;

4. The organization follows, taking care of the sick from the reception until the delivery of the clinical department;

5. Report the operational results of the anesthesia department according to the regulation of the head of the disease examination facility, healing;

6. The organization performs the control of the hospital and the labor safety.

7. perform quality management work at the department and participate in the quality of hospital quality management.

What? 10 The mission and the authority of the doctor anesthesia.

Performing functions, general tasks according to the assignment of the dean, in each of the functional physicians, the specific task is as follows:

1. The doctor ' s mission at the pre-anesthesia clinic

a) Examination of the process, judging, and giving a maze of anesthesia to the sick;

b) The full record of the content according to the pre-anesthesia sample and attachments according to the patient's medical records;

c) Request for the surgeon for the suspended surgery, the procedure when not sufficiently safe for the sufferer and must be recorded at the medical records. If you can't agree with the surgeon, you must report to the chief of the department.

d) Explain the anesthesia method of pathology, guidance, counseling for the sick and the family of the sick person, to make the pre-anesthesia requirements;

Participation and scientific research, updating professional knowledge, engaging in training, direction of the line, and foreign aid education when assigned.

2. The doctor ' s mission at the operation:

a) The organization is responsible for the expert in anesthesia, according to the division of the Dean.

b) In case of excess of professional capacity or having an accident occurs in time to report the chief of the department;

c) The foreman, examining, reminding doctors, nursing, medical staff and other subjects (if a doctor at the site for permission) is present in the operating room; ensuring control of the bacterial infection in the operating room;

d) Check out the sick person, the anesthesia case record-back before and after the surgery; the documents must be fully documented, accurate and honest;

There's always a presence in anesthesia for the sick, except for the anesthesia doctor who replaced it after a full hand.

e) Coordinate closely with the faculties and persons who perform surgery, the relevant procedure to complete the work well, implement the operation of surgery, track and care for the person first, during and after surgery;

g) Participate in surgery, procedure, examination, and preparation of the pre-anesthesia for evaluation, interpretation, may add tests or treatment, invite the seminar if needed, create anesthesia planning;

h) Rediscovering the sick person at the department of the department for a period of 1-7 days before the operation, the planned procedure. Perform prior examination, during or after emergency surgery depending on the emergency nature of the foreign intervention intervention;

i) The division, which oversees the specialized activities of anesthesia nursing;

l) Check out the anesthesia and the anesthesia that the anestrophic nursing-resuction prepared before. We have to reexamine the medical records of the name, the patient's surgical location. Performing hard techniques such as opening up the gas, which leads the pleural membrane, poking the central vein, causing the region, placing the endothelum in full amounts;

l) Test before blood transfusion and blood preparations prescribed at the Code of Blood transfusion issued with Decision No. 06 /QĐ-BYT on 19 January 2007 by the Minister of Health;

m) A anesthesia doctor at the same time is responsible for the maximum anesthesia of 2 (2) table at the same time as the necessary intervention and the pathology of anesthesia has always been present to monitor the sick. Special cases in charge at the same time more than 2 (two) of the table must be unanimous and are responsible for the responsibility of the chief anesthesia.

n) In the event of complications, severe calamus must report Dean and focus the hospital, helping each other in terms of manpower, means and medicine;

o) In the case of emergency treatment that can coordinate with the surgeon, the anesthesia nurse performs a direct command in the operating room, and then has to be fully documented in the prescribed medical records;

p) It is responsible for anesthesia until the pathology of the pathology of the anesthesia and the anesthesia, anesthesia, anesthesia. Responsible for the medical transfer of the patient out of the operating room, from the department back to the department of foreign affairs, department of department, or hospital. When the person is at high risk (unstable circulation, respiratory failure, which is supporting respiration through the internal tube or through the open tube, which is using a vascuitologist or other severe condition) must have the manpower to have sufficient qualifications to coordinate the transport. You're sick to get your hands on the ground.

3. The doctor ' s mission at the provincial department:

a) To accept and evaluate the condition of the disease that has just moved in to have the appropriate designation;

b) Do the techniques, the antipain method for the sick;

c) Track, detection, complication of complications and abnormus to the sick;

d) Command the Provincial Defense Nursing Officer performs treatment and care for the patient;

) Identifying the sick person eligible to make a decision to move back to the department of foreign affairs, department of boarding, outpatient treatment, or discharged from the hospital;

e) Coordinate with another doctor to dispose of the severely ill person who needs to restore the recovery department.

4. Doctors ' mission at the department of foreign affairs:

a) Coordinate with other parts to decide on the reception and transfer of the disease;

b) Track, diagnosis, treatment and execution of specialized procedures in accordance with regulations;

c) The report, please the chief of the department in special cases, needs to invite the seminar to have the appropriate handling decision;

d) Table the pathology and the command between the working shifts must be full, correct and have a handbook, record records, and check the medical records before transferring the sick person or for the hospital.

5. Doctors ' mission at the anti-pain division

a) Exploring, counseling the pain for the person before and after the surgery;

b) The announcement, explaining to the sick person or the agent of the sick or both in terms of the technique, the method will perform;

c) The organization performs anti-pain measures;

d) Monitoring results;

Tracking, dealing with complications, the undesirable effect of the anti-pain method.

What? 11. The mission and the powers of the chief nursing officer of the anesthesia department

The mission and the powers of the chief executive are executed by regulation at Annex IV of the Digital Information. 07 /2011/TT-BYT January 26, 2011, the Minister of Health's Guide to Health Care for the Care of the Patient in the Hospital.

What? 12 . The mission and the powers of nursing nursing-resusking and physical

The mission and the jurisdiction of Anesthesia Nursing and Nursing are carried out by regulation at Digital News. 07 /2011/TT-BYT January 26, 2011 of the Ministry of Health instructs nursing to care for the patient in the hospital; Decision No. 1. 41/2005/QĐ-BNV April 22, 2005 of the Ministry of the Interior on the Board of Litigation of Health Litigation, Nursing; Digital News. 23 /2009/TT-BYT December 1, 2009, of the Ministry of Health, the Board of Health of the Ministry of Health of the Faculty of Medicine. In addition, anesthesia nursing-resusking and passport has a number of specific tasks and powers as follows:

1. Anesthesia Nursing at the anaesthesia clinic

a) Preparing to fill the equipment, the means for the doctor to examine the anesthesia;

b) After an anesthesia foresee, it must complement the full amount of attriation in the number of regulations, the preservation of the instruments, the receiving and the full hand, the clear record in the book book.

2. The anesthesia nursing home at the surgical department

a) The anesthesia nursing-resucution performed some of the tasks of the anesthesia, but must meet the conditions, in accordance with the ability of expertise, to be accepted and responsible for the head of the body of the disease, to treat the disease. It's the head of the dean's offer. The anesthesia nursing only some of the doctors ' tasks anesthesia-when in science, the doctor has no anesthesia.

b) bear the direct direction of the anesthesia of anesthesia;

c) Notice the anesthesia doctor and nursing the chief of the department when there is a problem to resolve;

d) Preparing drugs, anesthesia vehicles, test names, age people, and surgical positions, peripheral transmission, blood tests, blood group tests, pathology monitoring, patient records, anesthesia, and other documents related to the disease. The surgical procedure, the procedure.

Test before blood transfusion and blood preparations prescribed at the Code of Blood issued with Decision No. 06 /QĐ-BYT on 19 January 2007 by Minister of Health;

e) In the event of an emergency without or without a anesthesia doctor, the anesthesia, the anesthesia, is required to take the necessary resusability measures, and quickly require a doctor and a colleague to assist.

g) Perform a direct command and a full record of the medical records when required by the doctor during the operation;

h) Each of the anesthesia-resucotion is only allowed for a table in the same time or extra for another 1 in the event of a lack of manpower and has to be induced by a neurosurgeon, the procedure for the procedure.

3. Nursing as a tool for tooling and nursing duties:

a) General mission:

-Prepare and test the instruments, facilities, medications that respond to each operation;

-Check out the patient, the patient, the surgery, the surgical position and the pre-surgical procedure.

-Combine the combination of gauze, needles, and surgical instruments before and after surgery for each surgery to avoid an allergic reaction in the patient's body. The counting check must be stored in the case file and must have the signature of the chief surgeon, nursing the duty of the instrument and nursing duties as a perimeter duty;

-Execute the incision and sanitation for the sick after surgery, the procedure.

b) The nursing officer for the instrument task:

-Help the surgeon perform the surgery, prepare and arrange the full instrument, give the instrument to the right surgeon and match the timing of the surgery;

-Processing of surgical equipment, medical equipment and consumerate supplies used for surgery by the procedure of the surgical department;

-Didn't take it out without the consent of the surgeon.

c) The nursing operator on the outer perimeter:

-Coordinate with surgical procedures to place the patient's posture, placing the relay of the electric knife, protecting the patient's hands.

-The addition of surgical instruments, consumable supplies, and other means for surgery;

-Support the surgical crew and the anesthesia to control tools such as electric knives, suction machines, endoscopes, anti-vibration machines;

-Full of records, precisely the consumable materials used for surgery as well as the number of residual, amount of damage;

-Help transport people to bed or stretcher;

-Blood or blood processing when required, when the field is directly handed over to the nursing or anestrophic doctor.

4. Nursing at the provincial department:

a) Track of the sick, detection and processing of the first aid of the complications of the patient within the scope of the disease, the full preparation of the hospital bed, the equipment, the supplies of the disease, to be ready to receive the patient after the surgery;

b) Annex to the anesthesia doctor during visits and treatment of sick people in the provincial department;

c) Assessment of the condition of the disease according to regulatory scales;

d) Track and fully documented, accurate, honest honesty of the sick person, the execution of the command on the tracking board and the profile for the nursing home.

5. Foreign Health Department Nursing:

a) To receive, monitor the pathology, detect and process the emergency of the first step of the patient's complications within the scope of the disease, prepare the full bed of the disease, the equipment, the supplies, the supplies to be ready to pick up the patient after the surgery;

b) Track and full documented, accurate, honest honesty of the sick person, the execution of the ordinance on the tracking board and records for nursing;

c) The immediate report to the doctor and nursing the head when the sick person has abnormal or has difficulty in carrying out the ordinance, taking care of the sick;

d) Preparing and providing nutrition to the patient by the doctor ' s designation and adhering to the established nursing care plan.

6. The anesthesia nursing home in the anti-pain division:

Tracking, effective assessment of pain relief on the disease, when abnormal behavior needs to report directly to the doctor to handle.

7.

a) For the regulation of hygiene, the antimicrobial of the anesthesia, the pathology of the hospital.

b) The department of the department of the department and the appearance of the anesthesia department according to the division;

c) Management of fabric;

d) Collum, classify, transport and dispose of waste by regulation.

Chapter IV

FACILITIES, EQUIPMENT OF THE ANESTHESIA DEPARTMENT

What? 13 General requirements for infrastructure

The work and design solution of the Department of Anesthesia Conducted by Point 5.8.2 A 5 Department of Anesthesia Surgical of TCXDVN 365: 2007 "General Hospital-Design Guide" issued by Decision No. 18 /2007/QD-BXD May 15, 2007, of the Minister of Construction.

What? 14 Equipment, drugs and supplies.

1. Surgery Department:

a) The minimum surgical division must have 02 (two) operating room.

b) Each operating room must secure the device pages as follows:

-Enough equipment, technical facilities and anesthesia-in-the-in-the-line of the surgical portfolio that fits the surgical portfolio, the procedure has been granted authoritative authority;

-A multi-purpose surgical table.

-Surgical desk, tricks.

-The surgical kit is consistent.

-oxygen systems, compressed air, vacuum cleaners;

-A respiration machine has a vapour vessel for respiratory anesthesia (preferable to the use of an anesthesia system);

-A 5-digital monitor (heart, non-invasive blood pressure, SpO2, breathing rhythm, temperature) or machine with multiple parameters including invasive blood pressure measurement, EtCO2, anesthesia analysis and other intensive blood exploration for some people with severe illness or disease. Intensive surgery.

-A minimum of 1 injection of electrical injection activated.

-Matter of attriation and respiratory emergency and circulate.

-The means of warming and spreading fast;

-The way to heat the sick.

c) The general utility for the surgery consists of a vibration machine, a hard-managed internal set, a mask mask, a soft brontic endoscope;

d) The areas that require anesthesia (outside the operating area) must also have equipment, medications, supplies of attriment, anesthesia, anesthesia, respiratory emergency, and circulate.

2. The department revived:

a) The provincial department is located adjacent to the surgical department, which has a minimum hospital number of 1.5 times the number of tables of surgery;

b) The pages of office equipment;

c) Medical devices:

-Medical gas (oxygen, compressed air);

-Machine.

-The machine monitors the heart and measures the blood pressure;

-SO2 tracking device;

-It's a thermometer.

-The way to heat the sick;

-The means of warmth and blood.

-The ventilated machine, the tools to deliver the airway.

-The defibrillator.

-Equipment to carry out pain relief measures;

-The medicine and the consumable supplies are needed.

3. Department of Foreign Affairs:

The department of foreign affairs must secure some of the following requirements:

-There's enough room to control multiple poses with non-optical underwear for an X-ray in bed;

-Every bed has a multi-digital monitor, ventilator, transmator, and injection pump, medical supplies (2 oxygen sockets, 1 pneumological drive, 2 vacuum cleaners). Encouraging each chamber to have only one hospital bed, with proper design;

-chamber isolation chamber and isolation chamber of the infection in case of need;

-A certain amount of medicine, matter of attriation,

-The vehicles as the magic in bed: the defibrillator, the pacer, the X-ray machine in bed, monitor and the ventilator;

-The way to heat the sick;

-The means of warmth and blood.

-It's an anti-pain.

-The ultrasound machine and the fast-test vehicles in the bed;

-For the medical recovery department of the Grade I hospital and the special category adds the following instruments: the tools to balance the disease, the kidneys, the pacers, the pacer, the heart-based ultrasound machine, the central monitor system.

-Tool wash and disinfection;

-Equipment reserve.

-The pharmacy and medical supplies drain.

-The area is prepared for the sick.

-The place of the reception of the sick.

-The working rooms of the medical staff, the bedroom, the dining room, the costume, the toilet.

4. The anti-pain division:

Depending on the conditions and treatments of pain, the basis of the disease, the treatment must have basic equipment such as follows:

a) The medicine, the equipment and the supplies to fight the pain and execute the complications;

b)

c) The contact media of the sick with the medical staff.

5. The prefated search department:

a) The facilities that meet the standard of the general disease clinic;

b) The medical equipment, medication, consumable supplies required to respond to a specialist anesthesia, resuscour.

6. Administrative divisions:

a) The layout of the delivery room, the area of reception of the sick, the staff room, the room;

b) The offices are required by the office.

Chapter V.

THE RESPONSIBILITY FOR COORDINATION BETWEEN THE ANESTHESIA DEPARTMENT WITH THE UNITS INVOLVED.

What? 15 Coordination with the external systems

1. The faculties of the Foreign Relations are responsible:

-Configure a medical record, visit and do the tests or procedures needed to diagnose and specify the surgical method.

-The organization takes the patient with a planned operation to the anesthesia department to examine the surgery. The case of a severe illness or emergency is informed of the anesthesia to send a doctor to the clinic.

-Surgical planning and communication with anesthesia-fully retrofit information: the name of the sick, the age, the gender, the number of cells, the diagnosis, the methodology and the surgical time, they name the surgeons, the number of tracking records (if management is on the way). Computer systems.

-The surgeon is responsible for tracking, visiting, coordinating the regimen of treatment and dealing with the abnormties associated with the surgery performed on the patient.

2. anesthesia in charge of responsibility:

-Explore the sick before the surgery, ordered the additional treatment before the surgery (if necessary);

-The anesthesia is consistent with every single patient.

-Preferable surgery schedule in accordance with the condition of the pathogen.

-Coordinate with the relevant faculties to set up the appropriate anesthesia and surgical procedure;

-The anesthesia, the anesthesia, was given the right to deny the anesthesia in case of disobeying the principle above and the case of a safety threat in anesthesia and responsible for his decision.

3. When there is no consistency between the surgeon and the anesthesia doctor-resuslate and while the surgery needs to hold the prescribed diagnosis.

4. In the case of emergency emergency, the decisions, the ordinance can be exchanged directly and finely completed in writing after the emergency of the patient. Important decisions are required to have a third witness to ensure the objective.

What? 16. Coordinate with relevant faculties in hospital

1. Make sure to respond to the anesthesia requirement of the surgical procedure;

2. Coordinate closely with the reception and transfer of the disease;

3. Coordinate with relevant faculties to explain, advise the sick;

4. In the case of a person who has a severe illness in anesthesia, it has to be coordinated with the relevant faculties for emergency treatment, treatment of the sick in time. At the same time, it is required to inform the sick person or the legal representative of the sick person about the current condition of the disease.

What? 17 Coordinating transport, foreign aid.

1. When there is a requirement for anesthesia support, the chief of the department is responsible for sending staff in the department with the appropriate qualifications to participate in.

2. The severely ill person must be carried out the appropriate escort, tracking and treatment measures during the transport process.

3. When the heavy foreign pathologist needs to move the line, the anesthesia doctor in charge of the person with the task:

a) Please comment on the chief anesthesia for the transfer of the disease to another line (if necessary);

b) Notice the legal representative of the sick person the risks, the benefits of the transfer of the line and must be accepted by the person in writing (the legal representative of the patient who agrees to move the line to the hospital);

c) Notice the move to prepare for the recipient of the sick;

d) Check the condition of the disease before the transfer, prepare to be prepared by the vehicle to monitor and grant the patient in the transport process. Do not move the line when the sick person is dying or is at high risk of death during transport;

The division makes the necessary procedures, fully documented in the transfer records.

4. The anesthesia doctor receives the person who is transferred to the task:

a) Preparing to be ready for medication, medical equipment, vehicles, and manpower to take on the appropriate emergency measures;

b) Ask for the chief anesthesia for the resusability of the execution, the emergency of the sick (if necessary);

c) Subsection for the employee guiding the escort and the legal representative of the sick person to carry out the required hospitalization procedures;

d) The written notice for the hospital has the person with the disease to know the outcome of treatment and the problems that need to be taken out of the experience.

Chapter VI

THE ORGANIZATION.

What? 18 -Assignment.

1. The Director of the Bureau of Management, curing maintenance, coordination with relevant units in the direction, organization, and examination of this information for the facilities of the disease, healing.

2. Director of the provincial Department of Health, the central city of the department, the Chief Health Officer of the Ministry of Health, the industry is responsible for directing, organizing and examining the implementation of this Information on the basis of the examination, the treatment of the jurisdiction.

3. The director of the medical examination facility, healing is allowed to perform surgery, which has anesthesia-induced recruitment, manpower, investment, infrastructure upgrades, and medical equipment to meet regulatory conditions at this Smart. before 1 January 2018.

What? 19 Guarantee the source of the anesthesia.

1. The head of the Chair of Science and Training, in collaboration with the Director of the Bureau of Management, curing diseases and related units to build a training in anesthesia training, the granting of authority to approve and direct the colleges, colleges, and universities. The medical school and the facilities that specialize in training medicine, the organization of the training of the type, the training in anesthesia.

2. The head of the presiding officer of the presiding officer, in coordination with the Director of the Bureau of Management, curing diseases and related units to build the regime, the policy of ensuring the source of human resources in anesthesia for the facilities of the disease, healing according to regulation, the grant. The authority to approve.

3. Hospital director with anesthesia department and training center, director of a continuous training organization, appointment and certification for nursing as an instrument mission, an outpatient, and an operating room for the operating room.

What? 20 Only the line.

The director of the disease facility, which is responsible for carrying out the responsibility for directing the pathology of anesthesia at the Decision No. 4026 /QĐ-BYT on October 20, 2010, of the Ministry of Health enacted the assignment of the direction of the line of conduct in the direction of the line. The area of discovery, healing.

What? 21 Coordinating with the Vietnam anesthesia.

The Bureau, the Department of Health, the Department of Health, the functional base, the tasked task of coordinating with the Vietnam-Vietnam anesthesia in the staff, consulting with the Minister of Health on the Ministry of Health, Policy and Development Plan to specialize in anesthesia. In particular, the training of human resources in order to meet the growing needs of the disease, the healing of the people.

Chapter VII.

EXECUTION CLAUSE

What? 22 The reference terms

The case where the text of the passport in this message is replaced or modified, applies to the alternate text or the revised text, the plugin.

What? 23 The effect of execution.

1. This message came into effect on 10 October 2012.

2. Repeal: Clause 12 on the Department of Anesthesia Surgery under Section V of Public Works Regulation, paragraph 31 on Chief of Anesthesia Surgical and Section 53 of Anesthesia Doctors in Part II Part II Rules of duty, authority, personal responsibility determinate at the Board of Hospital by Decision No. 1895 /1997/BYT-QE September 19, 1997, of the Minister of Health since the date of this date is effective.

In the course of implementation if there is difficulty, entangrium, localities, units that reflect promptly on the Ministry of Health (Bureau of Management, cure) to be guided and resolved.

KT. MINISTER.
Chief.

(signed)

Nguyen Thi