Article 4 Health administrative departments at all levels shall strengthen the guidance and monitoring of emergency departments in hospitals, and hospitals shall strengthen the establishment and management of emergency departments to improve the level of emergency treatment and ensure medical safety.
Chapter II Setup and Operation
Article 5 The emergency department shall meet the requirements of places, equipment, equipment and medicines that are suitable for the level, functions and responsibilities of the hospital, so as to ensure the timely and effective development of emergency specialty.
Article 6 The emergency department should be located in an area that is convenient for patients to reach the hospital quickly, and close to various auxiliary reflex departments.
The entrance to the emergency department should be delayed, and wheelchair and flat car barrier-free access, ambulance access and special parking spaces should be set up; If necessary, emergency patients and ambulances can be set up separately.
Article 7 The emergency department shall set up medical area and security area, including triage, consultation room, treatment room, treatment room, rescue room and observation room, and emergency operating room and emergency intensive care unit can be set up according to needs; The support area includes registration, various auxiliary departments, pharmacies, charging and security departments.
Reasonable planning of medical area and security area is conducive to extending the radius of emergency response and rescue.
Eighth emergency departments should have obvious road signs and signs to facilitate and guide patients to seek medical treatment. The signs of emergency green passage in the hospital should be clear and obvious, and the services of emergency related departments can be continuously unblocked.
Article 9 The emergency department should be bright and ventilated, with a wide waiting area, convenient and slow treatment process, and the building pattern and equipment should meet the threshold of hospital infection management. Pediatric emergency should provide suitable medical environment for children according to their characteristics.
Article 10 The emergency room of the emergency department should be close to the emergency entrance, and a certain number of emergency beds should be set up, each with an area of 14- 16 square meters. The rescue room should be equipped with complete first-aid drugs and instruments, as well as rescue equipment such as cardiopulmonary resuscitation and monitoring, and should be in standby form, and should have the function of emergency surgery if necessary.
Eleventh emergency department should set up observation beds according to the patient flow and professional characteristics, and treat patients who need hospitalization observation. The number of observation beds should be 2-3% of the number of hospital beds. The observation time of patients shall not exceed 72 hours.
Twelfth emergency department should be equipped with special paging (telephone, pager, intercom) installation. Hospitals in need can establish an emergency clinical information system to provide timely information for medical, nursing, infection control, medical technology, assurance and other departments.
Chapter III Personnel Equipment
Thirteenth emergency department should be equipped with a sufficient number of medical personnel, after special training, master the basic theory, basic knowledge and basic operation technology of emergency medicine, and have independent professional ability.
Fourteenth emergency departments should have relatively fixed emergency doctors, and the number of on-the-job doctors is not less than 75%, and the doctor structure is reasonable.
Emergency physicians should have more than 2 years of clinical professional experience, be able to independently master the common basic skills of first aid in internal medicine and surgery, master the basic techniques of cardiopulmonary resuscitation, tracheal intubation, deep vein puncture, arterial puncture, defibrillation, ventilator application and trauma first aid, and receive emergency technical retraining regularly, with an interval of 2 years as appropriate.
Fifteenth emergency department should have relatively fixed emergency nurses, and not less than 75% of the nurses on the job, and the nurse structure echelon is reasonable.
Emergency nurses should have more than 2 years' professional experience in clinical nursing. Through standardized training and assessment, they should master the first-aid nursing technology of emergency and critically ill patients, often see the coordination of first-aid operation technology and the connotation and process of emergency nursing specialty, and regularly carry out continuous training and first-aid technical training, with an interval of 2 years as appropriate.
Article 16 Emergency departments are mainly emergency doctors and emergency nurses. Hospitals with more emergency patients should also arrange doctors and nurses from obstetrics and gynecology, pediatrics, ophthalmology and otolaryngology to participate in emergency treatment.
Article 17 The director of the emergency department shall be a physician with intermediate or above professional technical qualifications in emergency medicine and more than 5 years of clinical professional experience in emergency medicine; The director of the emergency department of a tertiary hospital shall be a physician with intermediate or above professional technical qualifications in emergency medicine and more than 8 years of clinical professional experience in emergency medicine.
The director of emergency department is a medical, teaching, scientific research, prevention and administrative profession of undergraduate course, and is the first responsible person for the quality of diagnosis and treatment, patient safety management and continuous improvement.
Article 18 The head nurse in the emergency department shall be a person who has the qualification of a nurse or above and has been engaged in emergency clinical nursing for 5 years. The head nurse in the emergency department of a tertiary hospital shall be a person who has the qualification of a nurse or above and has been engaged in emergency clinical nursing for 8 years.
As a nursing management major of undergraduate students, head nurses are the first responsible person for nursing quality of undergraduate students.
Nineteenth emergency departments can be equipped with administrative management, security and other personnel according to actual needs.
Chapter IV Department Management
Twentieth emergency departments should establish and strictly abide by the implementation of various rules and regulations, job responsibilities and related medical technical standards and operating procedures to ensure the quality of medical services and medical safety.
Twenty-first emergency system, not for any reason to refuse or shirk emergency patients.
Twenty-second hospitals should establish a system to ensure that relevant personnel participate in first aid and consultation in time.
Twenty-third emergency department should be based on the outpatient and emergency medical professional system and diagnosis and treatment norms, in the regular time to complete the outpatient and emergency diagnosis and treatment, to ensure the timeliness of emergency treatment.
Twenty-fourth emergency triage system, establish triage order and triage standard, distinguish triage according to symptoms, and give priority to patients who may endanger life safety.
(1) Patients who need cardiopulmonary resuscitation or are dying: resuscitate and rescue immediately;
(2) Emergency critical patients: they should be evaluated and given first aid within 5 ~ 10 minutes;
(3) Emergency patients with relatively fixed vital signs: emergency treatment should be given within 30 minutes to 1 hour.
Twenty-fifth hospitals should formulate rescue procedures and disposal plans for critical diseases to ensure the key measures for emergency rescue and the support and cooperation of relevant medical departments.
Twenty-sixth emergency medical personnel must write medical documents for emergency patients and patients under observation in accordance with the relevant rules of medical record writing, ensure that every emergency patient has a medical record, and record the whole process of diagnosis and treatment and the whereabouts of patients.
Twenty-seventh hospitals should establish systems and mechanisms to ensure that patients who need to be hospitalized after emergency are given priority in receiving wards in time, and relevant clinical departments shall not refuse to shirk.
Twenty-eighth hospitals should establish a system and mechanism to strengthen the quality control and management of the emergency department, and the emergency department should designate full-time (part-time) staff as undergraduate medical quality and safety management.
Article 29 In case of major rescue in the emergency department, especially in case of sudden accidents or mass disasters, the emergency department shall report to the relevant departments of the hospital in a timely manner according to the regulations, and the hospital shall start corresponding disposal orders according to the situation.
Thirtieth emergency department should follow the threshold of "Hospital Infection Management Measures" and relevant laws and regulations, strengthen hospital infection management, strictly implement standardized prevention and hand hygiene standards, and isolate patients with special infections.
Thirty-first hospitals and medical management departments should designate full-time and part-time personnel as emergency department managers to direct and coordinate the export of critical rescue and emergency patients.
Chapter V Supervision and Administration
Thirty-second health administrative departments may set up emergency medical quality control centers or other relevant organizations to conduct quality assessment and self-examination of emergency departments of medical institutions within their jurisdiction.
Thirty-third medical institutions shall cooperate with the administrative department of health and its entrusted emergency medical quality control center or other organizations to reflect and guide the emergency department, and shall not refuse or obstruct or provide false information.
Thirty-fourth health administrative departments at all levels shall timely report or publish the quality and safety management of emergency departments of medical institutions.
Chapter VI Supplementary Provisions
Thirty-fifth medical institutions that do not have the conditions can set up emergency rooms, and set up and manage them with reference to this standard.
Article 36 The Ministry of Health shall be responsible for the interpretation of this standard.
Article 37 This standard shall be implemented as of the date of promulgation.
Attachment 1
Specification for equipment and drug configuration in emergency department
1. Instruments and equipment: electrocardiograph, pacemaker/defibrillator, cardiac resuscitation machine; Ventilator, portable ultrasonic instrument, ECG monitor, aspirator, oxygen supply equipment, gastric lavage machine; Bedside x-ray machine, etc.
Second, first-aid instruments: usually first-aid moving and handling instruments, various basic surgical instruments.
Third, first-aid drugs: central nervous system stimulants; Antihypertensive drugs, cardiotonic drugs, diuretics and dehydrating drugs; Antiarrhythmic drugs; Vasodilator; Sedative; Painkillers and antipyretics; Hemostatic agent; Antidotes, antiasthmatic drugs, drugs for correcting acid-base imbalance of water and electrolyte, various intravenous infusions, some anesthetics, antibiotics, hormone drugs, various dressings, dressing fixing materials, etc.
Annex 2
Emergency department medical personnel configuration table
Emergency volume (daily average person-time) Rescue volume (daily average person-time) Number of hospital bed visits for several consecutive days Doctor (person) Head nurse (person) Nurse (person) Care worker (person)
≤ 100 4 10 12 12~ 14 1 25~30 2
10 1~200 8 15~20 20 18~2 1 2 40~50 2
20 1~300 12 2 1~30 25 24~26 2 50~60 3
30 1~400 16 3 1~40 30 27~28 3 60~70 3
40 1~500 20 3 1~40 30 29~30 3 70~80 4
≥ 500 20 365 438+0 ~ 40 30 365 438+0 ~ 40 380 4 above
Annex 3
Technology and technical threshold of emergency doctors and nurses
First, emergency doctors should master the first aid technology and technology.
1. independently handle various emergencies (such as high fever, chest pain, dyspnea, hemoptysis, acute abdomen, upper gastrointestinal bleeding, jaundice, hematuria, convulsions, dizziness, headache, etc.). );
2. Master ECG to distinguish ventricular fibrillation, wide QRS tachycardia, atrioventricular block and severe bradycardia;
3. Master cardiopulmonary cerebral resuscitation, awakening, and rescue and treatment of various shocks;
4. Master the initial diagnosis and treatment standards of trauma;
5. Master the preliminary diagnosis and treatment of heart failure and respiratory failure;
6. Give appropriate rescue and treatment to the acute and critical diseases that have not been diagnosed for the time being;
7. Can carry out airway opening technology, electric defibrillation, emergency pacing, thrombolysis, deep vein catheterization, arterial puncture, thoracic puncture, abdominal puncture, pericardiocentesis, lumbar puncture, closed thoracic drainage, intubation, gastric lavage and placement of esophageal three-lumen tube;
8. Skillfully use infusion pumps, ventilators, various physiological monitors, blood glucose meters and analyze blood gas reports.
Second, emergency nurses should master the first aid technology and technology.
1. Master the professional connotation and process of emergency nursing and conduct emergency triage;
2. Master the standards of hospital infection prevention and control in emergency room;
3. Master the emergency care of critically ill patients;
4. Master the emergency care of trauma patients;
5. Master the monitoring technology and emergency nursing operation technology of emergency critically ill patients;
6. Master the management of emergency rescue equipment, articles and medicines;
7. Master the key points and communication methods of psychological care for emergency patients;
8. Master the emergency treatment of emergencies and group injuries. This is about urgently answering a speech about competing for the head nurse in the emergency department. 79 1