One hundred and nineteen years guarding our health: the history of the Moscow Ambulance Service

One hundred and nineteen years guarding our health: the history of the Moscow Ambulance Service
28 April, ambulance service employees will celebrate their professional holiday. This service was launched in Moscow 119 years ago. Today, the city’s ambulance service is the largest in Eastern Europe: its brigades attend to 12,000 calls a day...

Reception desks at police stations and first ambulance carriages

In the 19th century, people, injured in accidents were usually picked up by policemen, firemen, or sometimes by carriage drivers, and then simply brought to local police stations. A medical check on the spot was out of the question: moreover, badly-injured people had to wait several hours to receive medical attention.

Ambulance carriages arrived on Moscow’s streets only in 1898. According to a decree issued by the chief of the police Dmitry Trepov, on April 28 the two original ambulance desks were opened at Sushchyovsky and Sretensky police stations. For the first time, ambulance employees were given separate rooms where they were on duty round o’clock. Medical help was given to people injured in accidents or to drunken people found unconscious in the street.  At each desk there was a carriage equipped with medicines, medical instruments and material for dressing wounds.  A physician, a paramedic and a nurse responded to medical calls.

A year later, three more ambulance desks were opened at Lefortovsky, Tagansky, and Yakimansky police stations. In 1900, the sixth desk was organised at the Prechistinskoye fire depot. In 1902, the seventh desk, Presnensky, was opened.

The design of the city’s first ambulance carriage was entrusted to the physician Vladimir Pomortsov in 1912. The carriage could serve as an ambulance and a mobile infirmary in times of war. And this is how the history of the national sanitary transport began.

From the first desk to a network

In 1919, the Board of the Medical and Sanitary Department of the Moscow soviet of workers ' deputies issued a decree: “To organise an ambulance station in Moscow. First and foremost, to organise medical help in case of accidents at plants and factories, and then in the streets and public places. For this purpose, the head of an ambulance station position is to be created, who will be responsible for arranging emergency medical care; to service these stations, 15 doctors should be employed, among which there must be surgeons, physicians and gynaecologist-surgeons, then nurses and other staff." Vladimir Pomortsov was selected to become the first head of the new ambulance station. In 1920, he was replaced by Grigory Gerstein, a doctor from the Sheremetyev hospital, where the station had the same rights as department. In 1923, the service was headed by Alexander  Puchkov, whose name the station bears today.

Moscow grew, and it became clear that ambulance stations were needed in different areas of the city. Currently, the capital's ambulance service is the largest in Eastern Europe, encompassing 56 substations and employing nearly ten thousand people.

Eight minutes

On any given day, the Alexander  Puchkov Ambulance Station receives 16,000 calls, its team make 12,000 visits. Each specialist of the Unified City’s Call Centre, which can be reached by dialing 103, receives about 350 calls a day.

Despite the large number of calls, ambulance teams now reach patients even more quickly than before. Last year, the average time of arrival to house calls (related to health issues) was 13.1 minutes. In situations when a person's life was at risk (for instance, in case of heart attacks, strokes, etc.), an ambulance reached its destination within an average of 11 minutes. In order to reach traffic accidents, ambulance brigades spend on average eight minutes — this figure is better than in London, Berlin, or Toronto.

This is greatly facilitated by an updated vehicle fleet, which is the largest and most modern among similar organisations in the country. Since its establishment in 1919, the fleet has grown to 3,400 vehicles while the number of employees to 6,500 people.

Patients needing emergency medical care are taken to hospital by air. In such cases three light class hospital helicopters are sent to the place of the accident. The average journey time from the receipt of a command to take off is 11—15 minutes. Then, it takes about seven minutes to bring the injured to hospital. Helicopters arrive not only in case of accidents but also in cases when patients have suffered strokes, heart attacks, or severe bleeding. The helicopters are equipped with a ventilator, defibrillator, an incubator to transport the newborns, a spinal shield, oxygen cylinders and other vital equipment.

 

 

Over a thousand brigades

Moscow’s Ambulance Service employees visit patients not only at home, in offices or public places, but also in hospitals. For example, a children's cardiac team attends to patients in maternity hospitals, when a newborn is suspected to have a heart defect. There are also neonatal, neurosurgical, vascular, ophthalmic teams. In total, there are 898 general profile brigades, 21 intensive care (resuscitation) teams, 61 pediatric teams, 20 psychotherapeutic brigades, and 18 advisory teams.

Moscow specialists share their experience with colleagues in the regions and abroad. For instance, in the Kirov Region an information system was installed, which was developed at the Puchkov Ambulance Station. In 2016-2017, the station was visited by delegations from the Kaluga Region, Krasnodar and Khabarovsk territories, as well as delegations from the Sakha Republic. A cooperation agreement is about to be signed between Moscow doctors and their Crimea colleagues. Recently, the station has hosted guests from Iran, who praised the city doctors’ new technology. This includes, for example, tablets, which were given to each team. The tablets allow ambulance employees to access information from patients’ medical records. Already on its way, an ambulance team can learn whether a patient has allergies, or suffers from chronic or other diseases.