The procedure for selecting and delivering to a medical sobering-up center for persons who are moderately or severely intoxicated. Aspects of placing persons in a medical sobering station

Are you here: For dismissal

Medical sobering stations are specialized medical institutions under the internal affairs bodies.

Medical sobering stations perform the functions of receiving and sobering up persons detained by police officers for appearing in public places in a state of severe intoxication, offending human dignity and public morality, or who have lost the ability to move independently or navigate the environment, or who may cause harm to others or themselves and provide assistance to them. emergency medical care.

Persons who have committed these offenses may be detained, taken to the police, or to a medical sobering-up center. The adoption of these measures presupposes that police officers have a clear understanding of the legal basis for detention, primarily of the very concepts of intoxication: “severe intoxication” and “a state of intoxication that offends human dignity and public morality.” From which it follows that not every appearance in public places while intoxicated entails administrative liability or placement in a medical sobering-up station.

Persons who are in public places in a “state of intoxication that offends human dignity and public morality” are brought to administrative responsibility, and in a state of “heavy alcoholic intoxication”, in addition, they are placed in a medical sobering-up station.

In accordance with this, the grounds for delivering drunk people to a medical sobering-up center are formulated as follows: “Police squads deliver to medical sobering-up stations persons who are on the streets and other public places in a state of severe intoxication. The concept of “heavy intoxication” defines such a state of an intoxicated person in which he represents a danger to himself and others, and according to medical indicators he is diagnosed with a moderate or severe degree of intoxication.”

Signs of behavior while intoxicated, which indicate a violation of socially accepted rules of behavior and moral norms, are as follows:

Incorrect attitude towards citizens - pestering others, obscene remarks addressed to them, cynical jokes, insults, tactless treatment, etc.;

Indecent (unkempt) appearance – torn, unbuttoned, dirty, wet clothes, shoes, etc.;

Unworthy behavior - shameless actions that violate tact and decency, shouting.

To carry out the tasks assigned to the medical sobering-up station, a squad consisting of an inspector on duty, crews, police officers monitoring persons placed in the wards, and a paramedic is assigned.

Persons who are in a state of intoxication are delivered to a medical sobering-up station, as a rule, by M/V crews consisting of a policeman-driver and two policemen in specially equipped cars with the inscription “Special Medical Service”.

It is prohibited to use M/V crews for purposes other than their intended purpose, incl. to resolve family conflicts and deliver drunken citizens directly from apartments.

To remove drunks from the streets and other public places and deliver them to the M/V, squads of other services and police units involved in maintaining public order, freelance police officers and, in cooperation, members of the DND may be involved.

Crew of M/V, PPSM, OVO, etc. when delivering a person who is in a state of intoxication, takes the necessary measures to prevent harm to his health, ensuring the safety of his belongings, documents and valuables (money, watches, jewelry, etc.).

Before boarding a drunk person into the vehicle, the crew must make sure that the person being delivered does not have any objects that could be used to attack the crew or cause bodily harm to themselves and other citizens. If weapons, drugs or other items indicating the possible involvement of the detainee in the commission of a crime are found, such a person is taken to the duty station of the police department, etc.

It is prohibited to place persons in a medical sobering-up center:

a) who are slightly intoxicated;

b) mentally ill;

c) in a state of acute poisoning or alcoholic psychosis;

d) with skull injuries and other bodily injuries in need of special surgical care;

e) with symptoms of acute and subacute diseases of internal organs;

f) with signs of infectious diseases;

g) military personnel and those called up for military training (transferred to representatives of the military commandant’s office);

h) pregnant women;

i) disabled people with obvious signs of disability;

j) rank and file and commanding officers of the internal affairs department;

k) deputies of all levels;

l) employees of the prosecutor's office, people's judges;

m) heroes of the Soviet Union, Russia, Social. Labor, persons awarded the Order of Glory 3 degrees;

o) foreign citizens enjoying diplomatic immunity;

n) minors (transferred to parents or persons replacing them).

Persons listed in paragraphs “b”, “c”, “d”, “d”, “f”, “h”, “i” should be immediately sent to the appropriate medical institutions; in other cases, the crew chief reports this to the ATS duty officer and acts in accordance with his instructions.

When drunk persons are found on the streets and in other public places, in a severe degree of intoxication, in an unconscious and other helpless state, with symptoms of acute poisoning, drug intoxication, psychosis, with skull injuries and other dangerous bodily injuries, as well as others.

In the event of a clearly severe health condition, an ambulance team is immediately called to the scene.

When delivering drunk people to a van, one of the crew members is required to be in the vehicle and constantly monitor their behavior and condition. If any of the transported persons show signs of a sharp deterioration in their health, an ambulance is called to the location of the vehicle or the patient is transferred to the nearest medical facility of the health authorities.

Persons brought to the police station in a mild state of intoxication are immediately released upon the conclusion of the paramedic or, if they commit an offense, they are subject to referral to the police department to take appropriate administrative measures.

All persons brought to the M/V and their belongings are subject to a thorough search in the presence of witnesses.

In the case of other police units delivering citizens for sobering up, whose valuables and belongings have been searched, they are accepted by the inspector on duty only if there is an inspection protocol (offense protocol).

Persons taken for sobering up in the presence of witnesses are subject to a mandatory medical examination by a paramedic and the attendant, and attention is paid to the condition of the skin (the presence of bruises, abrasions, wounds and other injuries). The skin of the head is especially carefully examined to identify possible traumatic brain injury. Blood pressure must be measured and pulse rate determined.

For persons who have been diagnosed with injuries or illnesses that threaten their lives, as well as for persons who are severely intoxicated, an ambulance team must be called. The decision on this is made by the paramedic and the inspector on duty. Before the ambulance arrives, the paramedic provides first aid. Calls from emergency medical teams and the assistance they provided in M/V conditions are recorded in a medical journal.

Based on the paramedic’s conclusion, the inspector on duty makes a decision to place the person for sobering up.

The results of the medical examination and search of the belongings of the person delivered for sobering up are recorded in a protocol, which is drawn up in triplicate and signed by the paramedic on duty and attesting witnesses.

The behavior of persons placed in M/V is constantly monitored by police officers and a paramedic. If the health condition of anyone sobering up worsens, an ambulance team is immediately called.

After eliminating alcohol intoxication and its consequences (complete sobering up of the person placed in the M/V), the paramedic is obliged to perform a second medical examination and give an opinion on the possibility of discharge from the M/V of the citizen. At the same time, the period of stay of a person in sobering up in any case must be at least 3 hours, but not more than 24.

Extract from the medical center is carried out by the inspector on duty based on the written conclusion of the paramedic. In the period from 01:00 to 05:00, discharge is made only in exceptional cases (business trip, transfer to relatives, etc.) with a corresponding entry in the protocol. In other cases, it should be carried out taking into account the reserve time necessary for the citizen to arrive at work on time.

Upon discharge from the police station, the inspector on duty is obliged to familiarize the citizen with the protocol, explain to him the procedure for paying for maintenance in this institution and return things, documents, money, valuables with the exception of weapons, narcotic substances and other items that were confiscated in the established law order. A copy of the protocol is given to the citizen. The inspector on duty also informs the citizen about which city district internal affairs agency will send the protocol on his offense for taking administrative measures. If the person discharged from the M/V has complaints and statements, the duty officer provides him with a book of complaints and suggestions.

If drunk, unconscious people with symptoms of acute poisoning, drug intoxication, skull injuries and other bodily injuries, as well as other clearly expressed serious health conditions are found on the streets and in other public places, an ambulance is immediately called to the scene. . Delivering such persons to a medical sobering-up center is strictly prohibited.

So, on May 25, the medical sobering center of the Leninsky District Department of Internal Affairs received a message that a drunk woman was lying at the first entrance at 6 Kazakova Street. Arriving at the scene, the sobering-up center staff determined that she was unconscious. The police called an ambulance. When the ambulance team arrived at the scene, the police officers handed the woman over to the doctors, reported this to the duty officer, and left.

However, there are cases of unjustified placement of citizens in sobering-up stations. So in October 2000, in the Kirovsky district of Samara, citizen I.M. Zinoviev was detained “for trying to drink a bottle of beer on the street.” As a basic analysis of information received from interviewees and media publications shows, such facts have become the “everyday norm” in Samara.

More on topic 2.1. Placement in a medical sobering-up center:

4. Obtaining samples for comparative research and placement in a medical hospital
Mokhov A. A. Medical law (legal regulation of medical activities). Course of lectures: Textbook. - Volgograd: VolSU Publishing House, - 186 pp., 2003
C. Additional principles for conducting medical research combined with the provision of medical care
I.V. Buromsky, V.A. Klevno, G.A. Pashinyan Buromsky I.V., Klevno V.A., Pashinyan G.A.. Forensic medical examination: Terms and concepts: Dictionary for lawyers and forensic experts. - M.: Norma, - 256 pp., 2006
§6.1. Conditions and procedure for transferring residential premises to non-residential premises or non-residential premises to residential premises
§ 6.1 Conditions for transferring residential premises to non-residential premises or non-residential premises to residential premises
§6.2. Refusal to transfer residential premises to non-residential premises or non-residential premises to residential premises
§6.2 Procedure for transferring residential premises to non-residential premises or non-residential premises to residential premises
§6.3 Refusal to transfer residential premises to non-residential premises or non-residential premises to residential premises
Chapter 3. Transfer of residential premises to non-residential premises and non-residential premises to residential premises
3. Transfer of residential premises to non-residential premises and non-residential premises to residential premises
World Medical Association. WORLD MEDICAL ASSOCIATION DECLARATION OF HELSINKI, 1964
§4.1. Living space: concept and types. Purpose and use of residential premises
Chapter 5. Rights and obligations of the owner of residential premises and other citizens living in the premises belonging to him
Chapter 6. TRANSFER OF RESIDENTIAL PREMISES TO NON-RESIDENTIAL PREMISES AND NON-RESIDENTIAL PREMISES TO RESIDENTIAL PREMISES
2. Moving other family members into the living space. Departure from residential premises
§ 1. The concept of living quarters. Types of residential premises and their purpose
§4.2 Purpose of living quarters. Use of residential premises

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Task

Within 24 hours, 20 citizens were delivered to the medical sobering-up station by the police department, of which five were highly intoxicated; one employee of the prosecutor's office; two were under the influence of drugs; three teenagers aged 15-16 years, one of whom is in a state of toxic poisoning; three women are moderately intoxicated.

During the inspection of those brought in, it was established: one citizen, who was intoxicated, had bodily injuries to his head; two men did not work and did not have a permanent place of residence; citizen K. could not explain anything about the discovery of two ampoules with the medicine “morphine” in his possession; citizen I., when checking his records, turned out to be a person on the federal wanted list; Citizen B. was found to have a gas pistol, but B. could not produce permission to keep it.

What should the person on duty at the sobering-up station do in these cases? Name the categories of persons who are not subject to placement in a medical sobering-up center.

Answer: The medical institutions where the police deliver and where persons who are intoxicated in public places are kept until sobering up are understood primarily as medical sobering-up stations. The regulations on the medical sobering-up center at the city regional department of internal affairs and the Instructions for providing medical care to persons taken to medical sobering-up stations were approved by order of the USSR Ministry of Internal Affairs of May 30, 1985 N 106. Order of the Ministry of Internal Affairs of the USSR dated 05.30.1985 N 106 “On approval of the Regulations on the medical sobering-up station at the city regional department of internal affairs and Instructions for the provision of medical care to persons delivered to medical sobering-up stations” (loses force from January 1, 2010 due to the publication of the Order of the Ministry of Internal Affairs of the Russian Federation dated 31.01 .2009 N 71)//SPS Consultant Plus. In accordance with paragraphs. 26, 28-31 of the Regulations on the medical sobering-up center indicate the specifics of delivering certain categories of persons to the sobering-up station: “26. When drunk, unconscious people with symptoms of acute poisoning, drug intoxication, psychosis, skull injuries and other dangerous bodily injuries, as well as other clearly expressed serious health conditions are found on the streets and other public places, an ambulance is immediately called to the scene health care. Delivery of such persons to a medical sobering-up center is strictly prohibited.28. Deputies of the Councils of People's Deputies who are in public places in a moderate or severe degree of intoxication are handed over to representatives of the relevant Councils; military personnel and those called up for training, dressed in uniform or in civilian clothes and having identification documents - to representatives of the military commandant's office; employees of internal affairs bodies, state security and prosecutors - to the relevant representatives; Heroes of the Soviet Union or Socialist Labor, persons awarded the Order "For Service to the Motherland in the Armed Forces of the USSR" of three degrees, Glory of three degrees, Labor Glory of three degrees, are transferred to relatives. If it is impossible to transfer such persons, they are placed on sobering up on a general basis. Women with obvious signs of pregnancy, disabled people with obvious signs of disability are sent to medical institutions.29. Placement of minors in a medical sobering-up center is allowed only in exceptional cases, when it is impossible to establish their identity and place of residence and transfer them to parents (persons replacing them) or representatives of institutions responsible for their upbringing and maintenance, or to a reception center for minors. For each fact delivering a minor in a state of intoxication, it is mandatory to find out whether he was involved in drunkenness by adults and by whom exactly, where he purchased alcoholic beverages, and other necessary data.30. Foreign citizens enjoying diplomatic immunity who are intoxicated are not taken to a medical sobering station and are not placed for sobering up. If such persons are detected, the crew chief reports this to the duty officer of the city regional authority and acts in accordance with his instructions. Foreign citizens who do not enjoy diplomatic immunity, as well as stateless persons, are taken to medical sobering stations on a general basis.31. Persons suspected of committing crimes are not placed in a medical sobering station. They are transferred to the duty department of the city district authority." In accordance with clause 28 of the Regulations on the medical sobering-up station, the prosecutor's office employee is not placed in the sobering-up station, but is transferred to representatives of the prosecutor's office. Minors, if their identity and place of residence are established, are transferred to their parents or in accordance with clause 29 Regulations either to representatives of institutions responsible for their upbringing and maintenance, or to a reception center for minors. In accordance with clauses 26 and 39 of the Regulations, a minor with signs of toxic poisoning is transferred to a medical institution. In accordance with clause 39 of the Regulations: 39 If, during a medical examination, signs of diseases or bodily injuries specified in paragraph 26 of these Regulations, as well as signs of tuberculosis, are detected in the delivered person, patients are immediately transferred to the appropriate medical institution of the health authorities, and with skin and venereal diseases - to a skin and venereal disease dispensary. or another medical institution with written notification (Appendix No. 4). Thus, a citizen with bodily injuries to the head is also transferred to a medical institution. In accordance with paragraph 31 of the Regulations on the medical sobering-up station: Persons suspected of committing crimes are not admitted to a medical sobering-up station fit. They are transferred to the duty station of the city district authority. Thus, citizen I., who, upon checking the records, turns out to be a person on the federal wanted list, is not placed in a medical sobering-up station, but is transferred to the duty station of the city district. In accordance with clause 36 of the Regulations on the medical sobering-up station, when items and items prohibited for storage are found on the delivered items (weapons, drugs, foreign currency, pornography, etc.), these persons, as well as the seized items, are transferred to the relevant internal affairs body for taking action. Thus, citizen K., who could not nothing to explain about the discovery of two ampoules with the medicine “morphine” in his possession, and citizen B., who was found to have a gas pistol, but B. could not present permission to store it, is transferred to the appropriate police department. It should be noted that, in accordance with paragraph 37 of the Regulations, those delivered for sobering up are examined by a paramedic and a duty officer in the presence of witnesses of the same sex as the person delivered. Examination and provision of medical care to persons brought to sobering up is carried out by a paramedic in accordance with the Instructions for providing medical care to persons delivered to medical sobering up centers. In addition, in accordance with paragraphs 40 and 41 of the Regulations, Persons subject to sobering up are placed in wards, when In all this, men are kept separately from women, minors from adults. Foreign citizens are kept in separate wards whenever possible. The behavior of persons placed in a medical sobering-up center is constantly monitored by police officers and a paramedic. If the health condition of anyone in the sobering-up center worsens, an ambulance or emergency medical assistance is immediately called.

Task

Sidorov, a resident of Berezniki, Perm Territory, while in Perm, applied to the regional police department with a request to issue him a permit to purchase a rifled hunting rifle at the Okhotnik store. At the same time, he presented a hunting license issued by the voluntary society of hunters in Berezniki a year ago.

Will Sidorov's application be granted? Prepare a response to his statement.

The application of citizen Sidorov will be left without satisfaction, since on the basis of Article 13 of the Federal Law “On Weapons” dated December 13, 1996. Citizens of the Russian Federation who are duly granted the right to hunt have the right to purchase hunting firearms with a rifled barrel, provided that they are engaged in professional activities related to hunting or have owned a smooth-bore long-barreled hunting firearm for at least five years. And from the conditions of the problem it follows that citizen Sidorov does not have a long-barreled smooth-bore weapon or a hunting license giving him the right to hunt.

Practical task: make a layout of the documentation necessary to open a permit system object:

Code of the Russian Federation on Administrative Offenses of December 30, 2001 N 195-FZ (as amended on April 25, July 25, October 30, 31, December 31, 2002, June 30, July 4, November 11, December 8, 23 2003, May 9, July 26, 28, August 20, October 25, December 28, 30, 2004, March 7, 21, April 22, May 9, June 18, July 2, 21, 22, September 27, December 5, 19, 26, 27, 31, 2005, January 5, February 2, March 3, 16, April 15, 29, May 8, June 3, July 3, 18, 26, 27, October 16, 3, November 5, 4, 18, 29, 30 December 2006, February 9, March 29, April 9, 20, May 7, 10, June 22, 19, July 24, 2, October 18, 8, November 27, 1 , December 6, 2007, March 3, April 29, May 13, 16, July 14, 22, November 8, 3, 22, 25, 26, December 30, 2008, February 9, May 7, 3, 28, June 29, July 17, 19, 24, 2009)

Medical sobering stations are specialized medical institutions under the internal affairs bodies.

Signs of behavior while intoxicated, which indicate a violation of socially accepted rules of behavior and moral norms, are as follows:

1. incorrect attitude towards citizens - pestering others, obscene remarks addressed to them, cynical jokes, insults, tactless treatment, etc.;
2. obscene (unkempt) appearance - torn, unbuttoned, dirty, wet clothes, shoes, etc.;
3. unworthy behavior - shameless actions that violate tact and decency, shouting.

Persons in a state of intoxication are delivered to a medical sobering station, as a rule, by M/V crews consisting of a policeman-driver and two policemen in specially equipped cars with the inscription “Special Medical Service”.

It is prohibited to use M/V crews for purposes other than their intended purpose, including for resolving family conflicts and delivering drunk citizens directly from apartments.

To remove drunks from the streets and other public places and deliver them to the M/V, squads of other services and police units involved in the protection of public order, freelance police officers and, in the order of interaction, members of the DND. Crew of the M/V, PPSM, OVO may be involved. etc. when delivering a person who is in a state of intoxication, takes the necessary measures to prevent harm to his health, ensuring the safety of his belongings, documents and valuables (money, watches, jewelry, etc.).

Before boarding a drunk person into the vehicle, the crew must make sure that the person being delivered does not have any objects that could be used to attack the crew or cause bodily harm to themselves and other citizens. If weapons, drugs and other items indicating the possible involvement of the detainee in the commission of a crime are found, such a person is taken to the duty station of the police department, etc.

It is prohibited to place persons in a medical sobering-up center:

1. mildly intoxicated;
2. mentally ill;
3. in a state of acute poisoning or alcoholic psychosis;
4. with skull injuries and other bodily injuries in need of special surgical care;
5. with symptoms of acute and subacute diseases of internal organs;
6. with signs of infectious diseases;
7. military personnel and those called up for military training (transferred to representatives of the military commandant’s office);
8. pregnant women;
9. disabled people with obvious signs of disability;
10. ordinary and commanding personnel of the internal affairs department;
11. deputies of all levels;
12. employees of the prosecutor's office, people's judges;
13. heroes of the Soviet Union, Russia, Social. Labor, persons awarded the Order of Glory 3 degrees;
14. foreign citizens enjoying diplomatic immunity;
15. minors (transferred to parents or persons replacing them).

Persons listed in paragraphs 2, 3, 4, 5, 6, 7 should be immediately sent to the appropriate medical institutions; in other cases, the crew chief reports this to the ATS duty officer and acts in accordance with his instructions.

All persons brought to the M/V and their belongings are subject to a thorough search in the presence of witnesses.

Based on the paramedic’s conclusion, the inspector on duty makes a decision to place the person for sobering up.

The behavior of persons placed in M/V is constantly monitored by police officers and a paramedic. If the health condition of anyone sobering up worsens, an ambulance team is immediately called.

When discharged from the police station, the inspector on duty is obliged to familiarize the citizen with the protocol, explain to him the procedure for payment for maintenance in this institution and return things, documents, money, valuables against receipt, with the exception of weapons, narcotic substances and other items that are confiscated in accordance with the law. ok. A copy of the protocol is given to the citizen. The inspector on duty also informs the citizen about which city district internal affairs agency will send the protocol on his offense for taking administrative measures. If the person discharged from the M/V has complaints and statements, the duty officer provides him with a book of complaints and suggestions.

Recently I happened to encounter the “honesty” of our valiant police. And not just anywhere, but in a sobering-up station. No, it wasn’t me who got there at all. My neighbor visited there, and for some reason he gave me my phone number for communication.

So, they called me, introduced themselves and said that so-and-so was in a medical sobering-up center in the glorious city of Ivanteevka, and that they needed to come and pick him up. How my neighbor got to this city, I had no idea, but he is a good person, so I decided to go after him after all. I was warned, “Just take some money with you. You will need to pay a fine and our services.” "How many?" – I asked. 650 rubles - answered the good comrade policeman. I called a taxi and went. Since I don’t often come across the police, and I’ve never ended up in a sobering-up center, I didn’t have answers to the questions that arose along the way. And only then, having arrived home, I decided to check the legality of the actions of the valiant police. Strange things began immediately. Firstly, when I went there and said that I had come to pick up so-and-so, for some reason they asked me to wait outside. To be honest, I was even scared for my neighbor’s condition, because why make me wait on the street if there is nothing to hide? And outside, meanwhile, it was not the month of May at all. But while I was standing there waiting, I had a feeling question #1: On what basis are they taken to a sobering-up center? Well, firstly, obviously, on the basis of the Code of Administrative Offenses, where Article 20.21 states that appearing on the streets, stadiums, squares, parks, in a public vehicle, or in other public places in a state of intoxication that offends human dignity and public morality shall entail the imposition of an administrative fine in the amount of one hundred to five hundred rubles or administrative arrest for a term of up to fifteen days. That is, it is prohibited to be on the street in this form. Secondly, based on Article 1 of the Law of the Russian Federation of April 18, 1991 N 1026-1 “On the Police” (hereinafter referred to as Law N 1026-1), the police are classified as part of the system of state executive authorities called upon to protect the life, health, rights and freedoms of citizens , property and interests of society from criminal and other attacks and vested with the right to use coercive measures. And in accordance with paragraph 11 of Article 11 of Law N 1026-1, in order to fulfill the duties assigned to it, the police are given, in particular, the right to deliver to medical institutions or duty units of internal affairs bodies and keep them in them until they sober up, persons who are in public places in a state of intoxication and having lost the ability to move independently or navigate the environment, or who can cause harm to others or themselves. Thus, if a citizen walks down the street in a state of alcoholic intoxication, he may well be taken to a sobering-up center or the local police station. Another question is that the degree of alcohol intoxication varies. And, unfortunately, each policeman determines it independently in his own subjective opinion. So, I stood in the cold for about 10 minutes until they called me inside to fill out the documents. They sat me down on a chair, gave me a pen and put the protocol in front of me. The protocol indicated the reasons for the arrest, an inventory of the property available during the arrest, the amount for the services of a sobering-up center, and similar circumstances. And I had to sign all this. And immediately I had a bunch of questions that I asked. Question No. 2: Do they have the right to take money for services? Based on the text of Article 35 of Law No. 1026-1, funding for the police is carried out from the federal budget, budgets of the constituent entities of the Russian Federation, local budgets and other revenues. That is, the law establishes four sources of funding for the police:

federal budget;
budgets of the constituent entities of the Russian Federation;
local budgets;
other income.

In this case, medical sobering up centers, charging for the services provided, receive funding from other revenues, which in itself is legitimate. According to Letter of the Ministry of Finance of Russia dated April 26, 2006 N 02-05-03/989, until the issue of transferring responsibilities for managing the work of medical sobering stations to the Ministry of Health and Social Development of the Russian Federation is decided, the amounts collected from citizens for staying in a medical sobering center are administered by the Ministry of Internal Affairs of Russia " . And although the medical sobering up center is a budgetary organization, due to insufficient budget funding, it is financed, among other things, from funds received from citizens for their stay in the medical sobering up center. Question No. 3: For what services? The main activities of a medical sobering-up center are:

delivery of drunken persons to a medical sobering station;
medical examination and assistance to those taken to a sobering-up center,
placement of persons subject to sobering up in wards,
monitoring them by police and medical personnel,
maintenance of delivered persons until complete sobering, etc.

The law carefully avoids the wording “medical” when talking about the services of sobering stations. Is a medical examination considered a medical service? It probably still counts. Is a citizen in a sobering-up station a patient? Let's remember the rights of the patient (patient rights - active link). Articles 32 and 33 of the “Fundamentals of the Legislation of the Russian Federation on the Protection of Citizens’ Health” stipulate that a necessary precondition for medical intervention is the informed voluntary consent of the citizen. And only if the citizen is unconscious, then the decision on medical intervention is made by his attending physician. However, sobering-up centers do not have the status of a medical institution, a license to engage in medical activities, or a requirement to have a medical worker with a higher education on staff. In this case, who conducts the medical examination? And most importantly, on what basis? And the following follows from all of the above:

If the citizen is conscious, then the medical examination should be carried out only with his consent;
If a citizen is unconscious, he must be provided with emergency medical care;
The decision on such assistance should be made by the attending physician, which means that the person should be taken not to a sobering center, but to a hospital;
According to Article 39 of the “Fundamentals of the legislation of the Russian Federation on the protection of the health of citizens”, emergency medical care Emergency medical care for citizens of the Russian Federation and other persons located on its territory is provided for free.

However, in addition to medical examination and assistance, other services are also provided in the sobering center. Therefore, of course, the fee is still charged legally. But not for the medical services themselves, but for maintenance, observation, and the like. Now its size varies, but within 100 rubles. Question No. 4. Inventory of property This is a separate story altogether. According to the protocol, my friend had no money with him. It’s surprising, because it’s somehow strange to go to a neighboring city without money. And the fact that he drank all the money away is also unlikely, because he had to pay it back for something. That is, I am more than sure that he had money (at least 100 rubles) with him until the moment of the “inspection”. Next are two mobile phones, which were also included in the inventory, and a chain with a cross. That's it, nothing else was listed in the inventory. Moreover, the policeman who helped me fill out the documents actively insisted that I sign the inventory. In the “Received” column. The dialogue goes something like this:

- Sign here “Received.” - So I haven’t received anything yet. - So we’ll give you everything now. - How do I know that he had only what is written here? - So, how could it be otherwise? We recorded what we seized! - Well, I haven’t received this yet! - So we’ll give you everything now! Okay, I think they’ll give everything back according to the inventory anyway, I’ll sign it. And what is not in the inventory, I don’t know. Signed. Then I was distracted by signing other documents for the medical examination. But in general, the signature in the “received” column, even if you just think logically, needs to be placed after receipt. When you really “got” everything. But the police have their own logic. And it’s difficult to go against her, especially in such situations. Although you have to, you have to go. This is a violation of our rights. Then it was more fun. I was offered to pay a fine and sobering-up center services. They named the amount 650 rubles. It was only on the way back in the taxi that I realized that 500 rubles as a fine and 100 rubles for services could not possibly equal 650 rubles. But that was already in the taxi. And when paying, I stopped at another point. They didn’t want to give me any document that I paid for anything. The policeman looked at me with honest eyes and said that they did not provide checks or receipts. “How can this be?”, I ask, “After all, I must have a document proving that the fine has been paid? Otherwise, you can later say that I didn’t pay anything. And if the service is provided and I pay for it, I am also entitled to some kind of document.” But the policeman honestly stuck to his line that they do not issue receipts. I realized that it was useless to argue, that it was time for me to demand the extradition of the one who was generally the goal of this entire epic, and to go home. The taxi stood outside the windows, and you had to pay for the waiting time later. In general, I gave these 650 rubles. And then they asked me to wait outside again while they brought my neighbor out to me. Question No. 5: Who determines the size of the fine? Indeed, the Code of Administrative Offenses provides for a fine of 100 to 500 rubles or arrest for 15 days for appearing in public places in a state of intoxication that offends human dignity and public morality. Who determines the punishment? Based on the text of Article 28.6 of the Code of Administrative Offenses, a fine can be imposed and collected at the place where the administrative offense was committed. At the same time, this article says that if a fine is collected on the spot, then a protocol is not drawn up. But then what kind of protocol did I sign? In general, I still don’t understand this system. But let's get back to the fine. If the offender agrees with the amount of the fine, then he pays it. If you do not agree, then the issue of the amount of the fine will be decided in court. But in our case, we agreed with the amount of the fine, but what about the receipt? in the case where a fine for an administrative offense is collected on the spot, it says that a decree-receipt is issued. It states:

date of issue;
position, surname, initials of the official who imposed the administrative penalty;
last name, first name, patronymic, year and place of birth, place of work and place of residence or place of stay of the person brought to administrative responsibility;
an article providing for administrative liability for this offense;
time and place of commission of the administrative offense;
the amount of the administrative fine imposed;
information about the recipient of the fine, required in accordance with the rules for filling out settlement documents for the transfer of the amount of an administrative fine,
address of the authority whose official issued the order-receipt.

This document is drawn up in two copies and signed by the official who imposed the administrative punishment and the person brought to administrative responsibility. Thus, they still had to give me a receipt for paying the fine. And I roughly understand why the policeman did not want to give me this document. What is striking is the impudence and honest eyes with which they proved to me that receipts were not issued at all. Although I quite persistently asked to be given at least some document about paying the fine. So, I stood and waited for my neighbor to be brought out to me. And finally he appeared. Cheerful, happy, he almost kissed the policemen goodbye, wishing them all the best. The policemen also smiled and said goodbye to him as if they were family. We safely loaded into the taxi that had been waiting all this time and went home. While we were driving, the neighbor inspected his pockets to see if everything was in place. And then it dawned on me that no one gave me the items according to the inventory. They were given to the owner. But I signed the protocol. And they promised to give me the things according to the inventory. Meanwhile, the neighbor was missing a “Swiss” knife, which he always keeps in his inner pocket. Maybe lost? But who knows now... Thus, the kind policemen from the sobering-up center in Ivanteevka, even to my untrained eye, clearly committed more violations than my neighbor, appearing heavily “drunk” on the street:

They charged me 50 rubles more than they should have (maybe they just don’t know how to count?);
They did not give me any document either to pay the fine or to pay for the services of the sobering-up center;
Despite the fact that it was I who signed the inventory, the items were not returned to me. Although in this case, I think it was necessary to return them both in front of me and the owner. And require a signature after the property is issued.
And finally, it is unlikely that the law stipulates that the person waiting should wait on the street when the “sober up” person is brought in.

And all this politely and with a smile. Well, at least it could be worse... The moral of this fable is this: Citizens, the new year and ten days of New Year holidays are coming. If you have drunk so much that your appearance and behavior may offend human dignity, then sit at home or take a taxi. Why do you and your loved ones need extra stress?

, “Instructions for providing medical care to persons delivered to medical sobering stations” (approved by Order of the Ministry of Internal Affairs of the USSR dated May 30, 1985 N 106) (extract)

Revision dated 07/01/1991 - Valid

POSITION
ABOUT THE MEDICAL SOBERIATION CENTER AT THE DEPARTMENT OF INTERNAL AFFAIRS OF THE EXECUTIVE COMMITTEE OF THE CITY, DISTRICT COUNCIL OF PEOPLE'S DEPUTIES

<*>In the future - city regional authority.

II. ORGANIZATION OF WORK OF A MEDICAL SOBERIATION CENTER

11. To carry out the tasks assigned to the medical sobering-up station, a squad consisting of an inspector on duty, the crews of the medical sobering-up station, police officers monitoring persons placed in the wards, and a paramedic is assigned.

12. To remove drunken persons from the streets and other public places, medical sobering-up crews consisting of a policeman-driver and two policemen in specially equipped cars with the inscription “Special Medical Service” are appointed.

13. The personnel of the medical sobering-up station must be dressed in the prescribed uniform, have service IDs, service books, whistles, and police drivers, in addition, driver’s licenses, technical tickets and waybills. The medical detoxification unit serves without service weapons.

15. The crew of the medical sobering-up station must work in search mode, with periodic stops and foot patrols in the route area. The squad is obliged to prevent and suppress crimes and other offenses, take measures to detain the persons who committed them, and provide the necessary assistance to other employees of internal affairs bodies and people's vigilantes in the fight against violations of law and order.

16. Instruction of the squad is carried out in accordance with the requirements of the Charter of the patrol service of the Soviet police by the leaders of the medical sobering-up center or city regional agency.

17. The work schedule of the medical sobering-up station is established by the head of the city regional agency, taking into account the state of public order in the service area in agreement with the leadership of the Ministry of Internal Affairs, the Main Internal Affairs Directorate, the Department of Internal Affairs and the executive committee of the city (district) Council of People's Deputies.

III. PROCEDURE FOR SELECTION AND DELIVERY TO A MEDICAL SOBRING-UP CENTER OF PERSONS WHO ARE MODERATELY OR SEVERELY INVOLVED BY ALCOHOL

18. Persons who are in a state of intoxication on the streets, squares, parks, train stations, airports and other public places are taken to a medical sobering-up station if their appearance offends human dignity and public morality or if they have lost the ability to move independently or could cause harm to others or to yourself.

19. Delivery of intoxicated persons to a medical sobering-up center is carried out, as a rule, by its crews in Special Medical Service vehicles.

It is prohibited to use the crews of medical sobering-up stations for purposes other than their intended purpose, including to resolve family conflicts and deliver drunken citizens directly from apartments.

To remove drunks from the streets and other public places and deliver them to medical sobering stations, squads of other services and police units involved in maintaining public order, freelance police officers and, in cooperation, members of voluntary people's squads may be involved.

20. When delivering a person in a state of intoxication, the crew of a medical sobering-up station takes the necessary measures to prevent harm to his health, ensuring the safety of his belongings, documents and valuables (money, watches, jewelry, etc.).

21. Before boarding a drunk person into a car, the crew must make sure that the person being delivered does not have any objects that could be used to attack the crew or cause bodily harm to themselves and other citizens. Such items are confiscated from a drunken person on the basis of Art. Art. - Code of the RSFSR on Administrative Offenses and the corresponding articles of the Codes of the Union Republics. If weapons, drugs, foreign currency and other items indicating the possible involvement of the detainee in the commission of a crime are found, such a person is delivered to the city district agency.

22. Persons who are to be taken to a medical sobering-up center, but are unable to move independently, are transferred to a special medical service vehicle on a stretcher. Other persons are provided with the necessary assistance when getting into the vehicle. Inside the car, they are seated on benches and secured with seat belts.

23. If a squad leaves a car to perform functions of picking up drunks, the police driver is obliged to take anti-theft measures and ensure constant surveillance of the persons in the cabin.

24. During the delivery of drunk people to a medical sobering-up station, one of the crew members must be in the car and constantly monitor their behavior and condition. If any of the transported persons show signs of a sharp deterioration in their health, emergency medical assistance is called to the location of the vehicle or the patient is transferred to the nearest medical facility of the health authorities.

25. It is prohibited to deliver drunken citizens to medical sobering stations on scooters and motorcycles, dump trucks, as well as other vehicles not intended for transporting people.

26. If drunk, unconscious persons with symptoms of acute poisoning, drug intoxication, psychosis, with skull injuries and other dangerous bodily injuries, as well as with other clearly expressed serious health conditions are found on the streets and other public places, the squad is immediately called to emergency medical care place. Taking such persons to a medical sobering station is strictly prohibited.

27. If a fire occurs in a Special Medical Service vehicle, the crew is obliged first of all to remove the persons in the cabin and take measures to eliminate it using the available primary fire extinguishing means, if necessary, call the fire department. The crew chief should report the incident to the duty officer at the medical sobering station. To provide assistance to persons injured during a fire, call an ambulance.

28. Deputies of the Councils of People's Deputies who are in public places in a moderate or severe degree of intoxication are handed over to representatives of the relevant Councils; military personnel and those called up for training, dressed in uniform or in civilian clothes and having identification documents - to representatives of the military commandant's office; employees of internal affairs bodies, state security and prosecutors - to the relevant representatives; Heroes of the Soviet Union or Socialist Labor, persons awarded the Order "For Service to the Motherland in the Armed Forces of the USSR" of three degrees, Glory of three degrees, Labor Glory of three degrees, are transferred to relatives. If it is impossible to transfer such persons, they are placed on sobering up on a general basis. Women with obvious signs of pregnancy, disabled people with obvious signs of disability are sent to medical institutions.

29. Placement of minors in a medical sobering-up center is allowed only in exceptional cases when it is impossible to establish their identity and place of residence and transfer them to parents (persons replacing them) or representatives of institutions responsible for their upbringing and maintenance, or to a reception center for minors.

For each case of bringing a minor in a state of intoxication, it is mandatory to find out whether he was involved in drunkenness by adults and by whom exactly, where he purchased alcoholic beverages, and other necessary data.

30. Foreign citizens enjoying diplomatic immunity who are intoxicated are not taken to a medical sobering station and are not placed for sobering up. If such persons are detected, the crew chief reports this to the duty officer of the city regional authority and acts in accordance with his instructions. Foreign citizens who do not enjoy diplomatic immunity, as well as stateless persons, are taken to medical sobering stations on a general basis.

31. Persons suspected of committing crimes are not placed in a medical sobering station. They are transferred to the duty department of the city regional authority.

IV. ADMISSION OF THOSE DELIVERED TO A MEDICAL SOBERIATION FACILITY, CONDITIONS OF THEIR CONTENT AND DISCHARGE AFTER SOBERIATION

32. Persons brought to a medical sobering-up station in a state of intoxication are brought to the duty station by the squad, and those who are unable to move independently are carried on stretchers.

33. All persons taken to a medical sobering-up center are registered in a special journal (Appendix No. 1)<*>based on identification documents, as well as an oral statement from the delivering employees or citizens.

<*>No attachments are provided.

34. The duty officer, in the correct uniform, invites the person being delivered to remove his outer clothing down to his underwear for a medical examination.

If you refuse or are unable to fulfill this requirement yourself, undressing is carried out forcibly.

Clothes and other things delivered are carefully examined in the presence of witnesses to identify weapons, documents, valuables, etc.

Witnesses can be vigilantes or other citizens invited for this purpose.

35. All belongings of persons undergoing sobering up are stored in individual cabinets, and documents, money and other valuables are stored in metal boxes (safes) in separate cells or in bags.

36. If items and items prohibited for storage are found on the delivered items (weapons, drugs, foreign currency, pornography, etc.), these persons, as well as the seized items, are transferred to the relevant internal affairs body for action.

37. Those brought in for sobering up are examined by a paramedic and a duty officer in the presence of witnesses of the same sex as the person delivered. Examination and provision of medical care to persons taken to sobering up is carried out by a paramedic in accordance with the Instructions for providing medical care to persons taken to medical sobering up centers.

38. The results of the medical examination and search of the belongings of the person taken for sobering up are recorded in the protocol (Appendix 2), which is a document of strict accountability and has a typographical imprint of the serial number.

The protocol is drawn up in two copies and signed by the duty officer, paramedic and attesting witness. The first copy with the card (Appendix No. 3) is sent by the city district authority to resolve the issue of bringing the person to administrative responsibility or transferring materials to the public for consideration, the second remains in the medical sobering-up station.

39. If, during a medical examination, signs of diseases or bodily injuries specified in paragraph 26 of these Regulations, as well as signs of tuberculosis, are detected in the delivered person, patients are immediately transferred to the appropriate medical institution of the health authorities, and with skin and venereal diseases - to the skin and venereal disease dispensary or other medical institution with written notification (Appendix No. 4).

40. Persons subject to sobering up are placed in wards, with men kept separately from women, minors from adults. Foreign citizens are kept in separate rooms whenever possible.

41. The behavior of persons placed in a medical sobering-up center is constantly monitored by police officers and a paramedic. If the health condition of anyone in the sobering-up center worsens, an ambulance or emergency medical assistance is immediately called.

42. Point deleted. (as amended by Order of the Ministry of Internal Affairs of the USSR dated July 1, 1991 N 223)

43. The identity of a person taken to a medical sobering-up center must be reliably established. If he does not have identification documents, measures are taken to comprehensively verify the information he has provided about himself (the capabilities of the address bureau, passport office (desk), human resources department at the named place of work, information of relatives, acquaintances, etc. are used). When examining such a person, his special features (scars, tattoos, birthmarks, dentures, etc.) must be especially carefully recorded in the protocol.

If necessary, information on these persons is checked through employees of the relevant internal affairs agency.

Citizens arriving from other cities and towns are checked at their place of temporary residence (in hotels, sanatoriums, boarding houses, hostels, etc.). Detainees whose identity has not been established by the measures taken, with the permission of the officer on duty at the city regional internal affairs agency, are sent to the reception center for checks in the prescribed manner.

Foreign citizens are checked with the help of the city district authority on duty through departments, departments, foreign tourism agencies, educational institutions, organizations in which they worked, as well as consular missions.

44. After complete sobering up of a person placed in a medical sobering up center, the paramedic is obliged to perform a second medical examination and give an opinion on the possibility of his discharge. In this case, the period of stay of a person for sobering up in any case must be at least three hours, but not exceed one day.

45. When establishing the identity, place of work and residence of a citizen after his sobering up and registration of the relevant materials, he must be discharged from the medical sobering up center. Check-out from 01:00 to 05:00 is carried out only in exceptional cases (business trip, transfer to relatives, etc.). In other cases, it should be carried out taking into account the reserve time necessary for the citizen to arrive at work on time.

46. When a citizen is discharged from a medical sobering-up center, the duty officer explains to him the procedure for payment for maintenance in this institution and returns, against a receipt in the protocol, the things, documents, money, valuables seized for storage, with the exception of weapons, narcotic substances and other items that are seized in accordance with the law. ok.

The duty officer offers the citizen to pay for maintenance in the amount established by the decision of the relevant authority. The person who paid is given a receipt, and if it is impossible to pay on the spot, he is given a copy of the invoice of the established form (Appendix No. 6).

The duty officer also informs the citizen about which city district agency will send the protocol on the offense committed by him for taking administrative measures.

47. The duty officer, at the request of a person discharged from a medical sobering-up center, issues a certificate of stay in this institution (Appendix No. 7), and if he has complaints and statements, presents a book of complaints and suggestions.

INSTRUCTIONS
FOR PROVIDING MEDICAL CARE TO PERSONS TRANSFERRED TO MEDICAL SOBRING-UP CENTERS

(as amended by Order of the Ministry of Internal Affairs of the USSR dated July 1, 1991 N 223)

(Extract)

1. Persons taken to a medical sobering-up center are subject to a medical examination, which consists of:

A thorough examination of the condition of the skin;

Determination of frequency and other characteristics of the pulse;

Blood pressure measurements;

Listening to the heart and lungs;

Abdominal palpation;

Definitions of mental and neurological status.

2. Based on a study of the mental, neurological, and somatic state of persons taken to a sobering-up center, the paramedic determines the presence of alcohol or drug intoxication, various poisonings, injuries, diseases of internal organs (Appendices No. 1, 2, 3, 4) and provides the necessary medical care (Appendix No. 5).

3. For persons who have been diagnosed with injuries or diseases that threaten their lives (Appendix No. 1), an ambulance is called. The decision on this is made by the paramedic on duty and the inspector on duty. Before the ambulance arrives, the paramedic provides pre-hospital medical care. Calls from emergency medical teams and the assistance they provided in a sobering-up center are recorded by a paramedic in a medical journal (Appendix No. 6)<*>.

<*>Appendix No. 6 is not provided.

4. If a person does not have medical contraindications for placement in sobering up, the paramedic determines the degree of his alcohol intoxication and makes a decision on the possibility of placing this person in sobering up, which he reports to the inspector on duty. The presence of signs of a hangover is not an indication for sobering up.

5. If necessary, after completing the medical examination, the paramedic, together with the workers of the sobering-up center, carries out sanitary treatment of the delivered person, which includes wiping and disinfecting his belongings. Only warm water is used for sanitation. After completion of sanitary processing, those delivered are sent to the wards and placed on beds (beds).

6. The medical assistant of the sobering-up center regularly makes the rounds of the wards, monitors the health of those sobering up and, if necessary, provides them with assistance.

7. The paramedic makes an entry in the medical journal about the provision of medical care; it also describes the state of health of the person being sobered up before and after the provision of medical care, indicating the time of examinations.

9. The time frame for sobering up is set by the paramedic based on the condition of the person being sobered up, but should not exceed 24 hours.

10. When it is established that persons who have undergone sobering up have no signs of intoxication, the paramedic reports to the inspector on duty at the sobering up center about the possibility of their discharge.

Head injuries

First of all, everyone taken to a sobering-up center must have their head thoroughly examined. In areas of detected skin damage, cut the hair short and carry out initial treatment of the wounds. It should be kept in mind that with a concussion, there may be no external signs. Those brought in with suspected intracranial trauma should be carefully transported on a stretcher.

Bruises and concussions

Depending on the severity of the bruise or concussion, they are accompanied by stupefaction and loss of consciousness lasting from several minutes or hours to several days, repeated vomiting, slowing of the pulse, uneven breathing, increased blood pressure, constriction of the pupils, weakening or absence of their reaction to light, anisocoria, nystagmus, meningeal symptoms (stiffness of the neck muscles), pathological reflexes of Babinsky, Oppenheim, Rossolimo.

Cracks and fractures of the skull bones and hemorrhages under the lining of the brain

For fractures of the bones of the base of the skull, the diagnostic criterion is bleeding from the ears, less often from the nose (blood clots, ichor). Later, a characteristic hematoma of the bridge of the nose and in the area of the eye sockets appears (symptom of “glasses”).

With fractures of the cranial vault, after several hours of relative well-being from the moment of injury, phenomena of brain compression develop: bursting headaches, a slow, tense pulse, and sometimes hemiparesis. Blackout of consciousness increases, then stupor develops with transition to coma, ending in death.

With subarachnoid hemorrhages, the following are observed: sudden headache, vomiting, loss of consciousness, stiff neck, pathological reflexes, increased body temperature.

Brain hemorrhage

It occurs suddenly, usually in connection with nervous experiences, physical stress, and is more common in older people. The patient falls as if struck, loses consciousness, and does not respond to external stimuli, including severe pain. The face is red with a bluish-purple tint, breathing is labored, hoarse, the pulse is rare and tense. Vomiting and involuntary urination (less often defecation) occur. Focal symptoms are characteristic: dilation of the pupils on the side of the hemorrhage, the “sail” symptom - hypotonia of the mouth muscles on the side of paralysis, noticeable when breathing; atony of the muscles of the arm and leg on the side opposite to the hemorrhage (the raised arm falls “like a whip”), pathological reflexes of Babinsky, Oppenheim, Rossolimo.

Internal organ injuries

Intoxicated people have reduced pain sensitivity, and therefore injuries may not be recognized in time if they are not accompanied by skin damage. Therefore, a thorough external examination of persons left for sobering up is necessary. After removing their clothes, the abdomen, chest, arms, and legs are carefully examined. With internal bleeding, due to rupture of internal organs, the patient experiences severe pallor, weakness, rapid thread-like pulse, shallow breathing, and tension in the abdominal muscles.

Myocardial infarction

It manifests itself as severe pain behind the sternum, radiating to the arms, shoulders, and shoulder blades. In cases where the intoxicated person is conscious and complains of pain in the heart and behind the sternum, alertness is necessary regarding a possible heart attack.

The further course of an unrecognized myocardial infarction causes collapse (loss of consciousness, severe pallor, weakness, rapid pulse, a sharp decrease in blood pressure, muffled heart sounds). Often, people who have a myocardial infarction after drinking even small doses of alcohol can be mistaken for being in a state of severe intoxication.

Therefore, if a myocardial infarction is suspected, the patient must be given nitroglycerin, call a cardiac emergency medical team and administer an anesthetic before its arrival.

Comatose states

Diabetic coma occurs in people suffering from diabetes. Signs: smell of acetone from the breath, deep noisy breathing, pale, dry, cold skin, dry lips and tongue, pointed facial features.

Uremic coma occurs due to kidney disease with insufficiency of their functions. Its signs are: ammonia odor from the mouth, vomiting, narrow pupils, dry skin, twitching of body muscles.

Hepatic coma occurs in liver cirrhosis. Symptoms: bad breath, reminiscent of the smell of rotten leaves, yellowness of the skin, vomiting blood.

Poisoning with various drugs. Poisoning with morphine, substances with morphine-like effects (opium, codeine, dionine, etc.)

After taking a toxic dose of the drug, short-term excitement occurs, followed by stupor and then coma, which is characterized by extremely rare breathing, sometimes periodic like Cheyne-Stokes (after a pause, first weak breaths, then increasingly deeper, fading again, turning into a pause), and sharp constriction of the pupils. The mucous membranes and skin are cyanotic, and there are often rashes on the skin. There is no smell of alcohol from the breath.

Poisoning with hashish (anasha, plan, marijuana)

In some cases, the use of hashish can be combined with the consumption of alcoholic beverages, and there is an odor of alcohol on the breath. The state of drug intoxication is characterized by euphoria, foolishness, increased appetite, sometimes sexual disinhibition, and distorted perception of the environment. Subsequently, dissatisfaction, anxiety, concern increases, rapid heartbeat, cold sweat, weakness, impaired coordination of movements, and sleep sets in. Acute psychotic disorders may occur, accompanied by changes in consciousness, disorientation in the environment, and psychomotor agitation.

Poisoning with hypnotics (barbituric acid derivatives and others)

Barbitus intoxication is characterized by a sharp impairment of motor skills: a shaky gait, slurred, slurred speech. As barbiturate intoxication increases, a blackout occurs, a soporous, then comatose state reminiscent of morphine poisoning (narrow pupils, rare breathing, severe salivation, recessed tongue).

Poisoning with atropine, cyclodol and other atropine-like substances (smoking asthmatol or mixing it with alcoholic drinks)

10 - 20 minutes after taking these drugs, a sharp motor and speech excitation is observed (the intoxicated person shouts out separate incoherent words, looks for something, catches non-existent insects; movements are uncoordinated). The pupils, in contrast to poisoning with morphine and sleeping pills, are sharply dilated, do not react to light, the skin is red, dry, hot, the mucous membranes are dry, the lips are covered with crusts. Breathing is rapid, pulse is rapid, up to 120 beats per minute. They are not oriented in the environment, do not answer questions, and resist inspection.

The listed signs of drug intoxication may increase after some time in the sobering station. Therefore, the paramedic on duty should re-examine all persons left in a sobering-up station in a state of drug intoxication, because following excitement, they may develop a coma, which must be treated with drugs that stimulate breathing and cardiac activity.

Special Conditions

People who have suffered epileptic seizures, heat and sunstroke, or short-term cerebrovascular accidents may be mistaken for intoxicated people. At the same time, the smell of alcohol from the mouth should not disorient the paramedic in assessing these conditions. The clinical picture is dominated by symptoms of disorders of the cardiovascular system: weak, frequent pulse, sometimes arrhythmic, decreased blood pressure, shallow breathing, etc.

Appendix No. 2
to the Instructions

CLINICAL FEATURES OF DEGREES OF ALCOHOL INFUNCIATION

A mild degree of intoxication is characterized by hyperemia of the skin, increased heart rate, breathing, and talkativeness. Speech becomes loud, movements are jerky and sweeping. Attention is quickly distracted, the pace of thinking accelerates, and inconsistency and superficiality prevail. Along with increased motor activity, there is a violation of fine coordination movements. The emotional state in a mild degree of intoxication is changeable. Fun can come under the influence of an insignificant reason, easily give way to irritability, resentment, and then again be replaced by the previous state. After various periods of time from the onset of intoxication, high mood is gradually replaced by lethargy and indifference. Motor activity gives way to relaxation, thinking becomes slower. The state of fatigue increases, and the desire to sleep appears. After a mild degree of intoxication, the memory of the entire period of intoxication is retained.

The average degree of intoxication is characterized by more severe changes in behavior. Movements are uncertain. The possibility of performing relatively simple coordination actions is reduced. Speech becomes slurred and loud, because... the threshold of auditory perception increases. Slowing down the associative process makes it impossible to select or replace a difficult word. There are frequent repetitions of the same thing. Ideas are formed with difficulty, and their content is monotonous. Attention switches slowly, only under the influence of any strong stimuli. The ability to critically evaluate the actions of both one’s own and those around them is sharply reduced. This contributes to the emergence of various kinds of conflicts, which are aggravated by the intoxicated person’s overestimation of his own personality, as well as the easily occurring disinhibition of drives and desires, making it easier to realize them. As intoxication deepens, behavior is increasingly determined by random, fragmentary ideas and impressions. Intoxication turns into deep sleep. Memories of events, both recent and distant, are vague.

A severe degree of intoxication is expressed by gross disturbances in the orientation of the intoxicated person in the surrounding environment. Does not understand the meaning of the questions asked; speech consists of separate words. Cannot move independently. The skin is pale, moist, cold. The pupils are dilated and react sluggishly to light. The pulse is frequent, weak filling, blood pressure is low. Breathing is shallow and slow. Reduced response to pain and temperature stimuli. As intoxication increases, stupor may develop, then coma.

Appendix No. 3
to the Instructions

TABLE OF DIFFERENTIAL CHARACTERISTICS OF DEGREES OF ALCOHOL INFUNCIATION

N p/p	List of signs	Lightweight	Average	Heavy	Coma
1	2	3	4	5	6
1	Consciousness	Not violated	Not violated	Disrupted to medium stun	To a deep degree of deafness
2	Attention	Attracted freely	Difficult to attract	Not involved	Not available to contact
3	Speech	Clear	Lubricated	Mumbling, shouting of individual words	Silent
4	Behavior	Revival	Excitation	Depression, drowsiness	Indifferent
5	Pupils	Regular	Expanded	Significantly dilated, sluggishly responsive to light	Extremely widened or extremely narrowed, poorly responsive to light
6	Nystagmus	Absent	Absent	Easy	Clearly expressed
7	Pain reaction	Distinct	Weakened	Significantly weakened	Absent
8	Reaction to ammonia	Distinct	Slightly weakened	Significantly weakened	Absent
9	Tendon reflexes	Regular	Slight decline	Significant reduction	Complete absence
10	Muscle tone	Ordinary	Promoted	Reduced	Hypotension
11	Coordination of movements	Violations are barely noticeable	Violations expressed	Deeply impaired, unable to stand on his feet	Lies passively
	Coordination tests (drawing figures, fastening buttons, picking up coins and matches from the floor, Romberg's pose)	Performs unclearly	Gross violation	Doesn't perform	Lies passively
12	Skin	Hyperemic	Severe hypertension or pallor	Pale, damp, cold	Hyperemic with a cyanotic tint or pale, cold
13	Pulse	Increased speed	Significantly increased	Frequent weak filling	Significantly increased speed, tense
14
16	Hiccups	Absent	Possible	Distinct	Not marked
17	Nausea, vomiting	Absent	Possible	Noted	Happens often
18	Involuntary urination	Absent	Very rarely	Noted	It is noted that defecation is also possible

Appendix No. 4
to the Instructions

ALCOHOL WITHDRAWAL (HANGover) SYNDROME. ALCOHOLIC PSYCHOSES

Alcohol withdrawal (hangover) syndrome is characterized by vasomotor and autonomic disorders. Severe headache, dizziness, weakness, fatigue, muscle pain, excruciating thirst, unpleasant taste in the mouth, sweating, chills, trembling of the whole body, pain in the heart, rapid heartbeat.

In more severe cases of hangover syndrome, one of the leading symptoms of chronic alcoholism, symptoms of emotional disorders (tension, depression, irritability, anger) arise against the background of autonomic disorders. Sometimes a depressed mood with a feeling of melancholy, hopelessness, and in some cases suicidal tendencies come to the fore.

As the symptoms of hangover syndrome worsen, sleep disturbance with unpleasant dreams, feelings of fear, horror, hallucinations, and signs of incipient delirium tremens are observed.

Alcoholic psychoses occur in stages II and III of alcoholism. Acute alcoholic psychoses include delirium tremens, alcoholic hallucinations, and alcoholic paranoid.

In practice, delirium tremens is more common, characterized by impaired orientation in place, time, environment, frightening visual hallucinations, and general psychomotor agitation.

In the initial stage of this psychosis, there is a loss of orientation in subtleties while maintaining orientation in general, symptoms of increased suggestibility, sleep disorders, fragmentary visual, auditory and tactile hallucinations, illusions, delusions, elements of clouding of consciousness, and a state of confusion.

In the advanced stage of delirium tremens there is a twilight disorder of consciousness. In severe cases of this psychotic condition, seizures may develop, so steps must be taken to prevent possible injury.

Appendix No. 5
to the Instructions

FIRST MEDICAL CARE FOR ACUTE ALCOHOL POISONING

In case of acute alcohol poisoning, the first step is to perform gastric lavage. If the person admitted for sobering up is conscious and no life-threatening diseases have been identified, then he is asked to drink 1 - 1.5 liters of warm water and induce vomiting by irritating the wall of the pharynx, repeating this until the vomit stops smelling of alcohol.

If the state of intoxication does not allow the person sobering up to drink the required amount of water on their own, then gastric lavage is carried out through a tube, but in the absence of a cough and gag reflex it is not performed due to the danger of aspiration with vomit.

For the purpose of alkalization, 0.5 g of baking soda is given every 15 to 20 minutes for an hour. To maintain the activity of the cardiovascular system and breathing, injections of caffeine, camphor, cordiamine, carazol, lobeline, cititone, ephedrine (2 ml each), inhalation of oxygen, and ammonia vapor are given. In severe cases, 10 - 15 ml of 0.5% unithiol solution, 1 ml of 1% mesatone solution, 1 ml of 0.1% adrenaline solution are administered intravenously.

During deep narcotic sleep (in severe intoxication), the tongue may sink, therefore, to prevent severe consequences, it is necessary to insert an air duct into the respiratory tract.

Drug-induced sleep can progress to stupor or coma. If such conditions occur, emergency assistance is required. The patient is placed in a horizontal position with legs raised; he needs to be warmed (blanket, heating pads). Oxygen is given, drugs are introduced to stimulate breathing and the activity of the cardiovascular system.

In cases where the symptoms of cardiovascular failure increase (cyanosis of the mucous membranes, thready pulse, weakening of heart sounds, breathing, convulsive twitching of the muscles of the arms and legs), in addition to the listed drugs, cardiac glucosides are administered (0.5 ml of 0.05% solution of strophanthin in 20 ml of 40% glucose solution intravenously slowly).

If a cerebral stroke is suspected, the patient must be kept at rest, zufillin (10 ml of a 2.4% solution in 20 ml of a 40% glucose solution) administered intravenously slowly, and ice is applied to the head.

During convulsive seizures, it is necessary to protect the head from injury. To do this, you need to support your head by placing a pillow or blanket under it. To prevent tongue bite, a spatula or spoon wrapped in gauze or a mouth retractor is inserted between the patient’s teeth. After a seizure, inject intramuscularly 10 ml of a 25% solution of magnesium sulfate or in an enema 15 - 20 ml of a 6% solution of chloral hydrate. In all cases of severe acute alcohol intoxication and repeated convulsive seizures, it is necessary to call an ambulance.

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