Addition to the Open Letter of Mykola Kurianov, presented on May 31 2012
I have to inform you about events, which took place during my duty on May 30, 2012.
That evening our crew N102 went after the call N1311 to one of the houses on Heroiv of Dnipra Str., to a person, which had fallen out from the window.
Been arrived to that place at 21:03, we found a casualty man, 58 years old, in grave condition. Estimated the situation, defining vital signs (more particular is written in the Card of an ambulance crew`s dispatch N1311 from 30.05.2012), taken anamnesis, we located the patient into the ambulance vehicle GAZ-32214 (govern.N362-72KA), (which must not be used during our work because of shabbiness, emergency condition of stretchers, absence of attachments for bottles on the ceiling etc.). Also our team didn’t have intubation tools, appropriate apparatuses’ for artificial breathing and devices of connection etc.
We continued examination there and started intensive treatment: connected cardio monitor of defibrillator, catheterized peripheral vein (connected the system for i/v infusion of solutions, started to infuse Isotonic Sodium Chloride and Dexamethasone 12 mg), set laryngeal mask and started ALV with a help of breathing bag. We went to Kyiv City Hospital of Emergency Medical Services near at 21:20.
Risking our lives, we were going overspeed and missing the rules of road racing in this too old vehicle. Nearly on the half of our way condition of the patient deteriorated and we had to conduct the reanimation. I performed defibrillation and compression of the chest, a paramedic made and gave solutions, and first aider performed ALV. During this actions condition of the patient varied from better to worse. In general we performed few defibrillations, and made injection of Adrenaline (2mg).
After arrival at KCHEMS nearly at 21:35 our crew departed the patient into the Emergency Room (the route there is complicated by 2 rectangular turns and narrow doors) in the condition of clinical death. In the ER was only another ambulance crew with their own patient. After a few minutes reanimation team started to gather. They had done intubation by endotracheal tube, connected ALV machine. They asked us to stop reanimation actions at 21:45, put 10 ECG electrodes (4 from extremities and 6 from pectoral), fixed isoline and announced death at 21:50.
I heard wrongful charges about myself, that tracheal intubation and catheterization of central vein weren’t prepared.
After this we were recommended to transport the body to Kyiv City Bureau of Forensic Medical Examination N2 through the police department, what has been done.
Moreover, I had worked in crew N115 on June 2 and 3 without having such important instruments as defibrillator, laryngoscope, endotracheal tube, airducters, breathing bag, glucometer, aspirator etc. This enables me to perform my duties properly. I take away responsibility from myself (I’ve already said about this in the written form to my management at April 4, 2012) about the deterioration of the patients’ condition, which can happen because of bad equipment of crew and hard vibration into the old ambulance vehicle. It is a violation of Ministry of Health Order N500 “On measures of improvement of emergency medical services in Ukraine”.
Management of Kyiv City Station of Emergency Medical Services (Vershigora A.V. and Bojko L.I.) has officially answered me on May 16, 2012, N542 “Crews of EMS are completed by all kinds of necessary equipment, which allow to provide EMS completely on prehospital stage .” However this is not true.
After the accident in Marganets town, government has emphasized on better performing of technical observation of vehicles and changing of old. Why doesn’t it include medical transport?
Also I’m testifying about the weakness of equipment in ER in KCHEMS and the difficult route to get there.
Not only the competent institutions, but NGOs and Media as well should take part in an estimation of equipment of EMS, because material and technical maintenance of EMS is critically bad.