Legal aspects, responsibilities and possibilities of providing emergency medical care by a district pediatrician at the patient’s home

The authors raise an issue of job responsibilities of a district paediatrician in case of a home visit, as well as of the standards for packing first-aid kits and emergency medical care kits. The provisions of the applicable legal acts are provided. The proceedings of international conventions on primary medical care for children, current federal clinical guidelines, paediatric medical care standards and procedures, orders of the Ministry of Health of the Russian Federation were analysed. We paid attention to the experience of foreign countries, as well as the regions of the Russian Federation in providing emergency medical care to the paediatric population. A survey among local paediatricians was conducted: 30 district paediatricians (10 persons from each of three children’s outpatient departments in different districts of St. Petersburg) answered questions on the algorithm for activities during home visit if emergency care was required. The results of the survey and analysis of the applicable legal acts showed that the district paediatrician is responsible for the life and health of his/her patients. However, there is no single standard regulating the responsibilities to provide emergency care to the child by the district pediatrician during home visit, and the volume of this care has not been established. Urgent conditions require immediate medical care right when they are detected by a paediatrician on call, until an ambulance team arrives. In conclusion, the authors determined that the creation of unified algorithms for emergency medical care to be provided by a paediatrician on call encompasses a number of medical, ethical and legal aspects. The development of this document is certainly a necessity and requires a balanced, judicious approach.

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