Regulations of Shanghai Municipality on Emergency Medical Services
Regulations of Shanghai Municipality on Emergency Medical Services
(May 14, 2020)
Contents
Chapter I General Provisions
Chapter II Pre-hospital Emergency Medical Services
Chapter III Hospital Emergency Medical Services
Chapter IV Social First Aid
Chapter V Safeguard Measures
Chapter VI Legal Liabilities
Chapter VII Supplementary Provisions
Chapter I General Provisions
Article 1
These Regulations are formulated with a view to regulating emergency medical services, maintaining the emergency medical order, improving the emergency medical service system, and achieving the purpose of healing the sick and saving the dying.
Article 2
These Regulations apply to the activities and management of pre-hospital and hospital emergency medical services and social first aid in the administrative areas of this Municipality.
Article 3
Pre-hospital emergency medical services referred to in these Regulations mean medical activities carried out by the emergency center and first aid station (hereinafter referred to as the pre-hospital emergency agency) in accordance with the unified command before sending a patient to a medical institution for treatment, mainly with on-site rescue and in-transit emergency treatment and intensive care.
Hospital emergency medical services referred to in these Regulations mean emergency medical activities provided by the medical institutions with emergency department (hereinafter referred to as the hospital emergency agency) for patients sent by the pre-hospital emergency agency or coming by themselves for treatment.
Social first aid referred to in these Regulations means activities or behavior of social organizations and individuals that promptly rescue the injured and reduce harm using cardiopulmonary resuscitation, hemostatic bandage, fixed handling and other basic operations on medical emergency case or accident injury scene.
Article 4
The municipal and district people’s governments shall strengthen leadership over the emergency medical service work, include the emergency medical service into the national economic and social development planning, establish perfect mechanisms of financial input and operating funds compensation guarantee, form an emergency medical network and service system with perfect plane emergency sites, complete three-dimensional first aid, advanced hardware configuration, orderly pre-hospital and hospital linkage, and guarantee the coordinated development of the emergency medical services and economic society to meet the needs of people’s daily emergency treatment.
Article 5
The municipal health administrative department shall be in charge of emergency medical services within the scope of this Municipality; the district health administrative department shall be responsible for the management of emergency medical services within the corresponding area.
The departments of development & reform, finance, planning and resources, public security, fire protection, construction, economy and informatization, transportation, human resources and social security, education, civil affairs, and culture and tourism shall, in accordance with their respective duties and functions, jointly do a good job relating to emergency medical services.
Article 6
The health administrative department shall organize pre-hospital and hospital emergency agencies to carry out publicity, education and training on first-aid knowledge and skills, and guide the citizens to make reasonable use of emergency medical resources.
Newspapers, television, radio, Internet and other media shall carry out public welfare publicity on first-aid knowledge and skills, advocate the concept of self-help and mutual aid, and give publicity to the spirit of healing the wounded and saving the dying.
Article 7
Citizens shall respect and cooperate with emergency medical services activities carried out by the pre-hospital and hospital emergency agencies, make reasonable, standardized, orderly use of emergency medical resources, and consciously maintain the emergency medical order.
Article 8
Units and individuals are encouraged to donate to pre-hospital and hospital emergency agencies to support the development of emergency treatment services.
Article 9
Pre-hospital emergency services and non-emergency referral services shall be under classification management.
The pre-hospital emergency service is provided with ambulance by the pre-hospital emergency agency.
Non-emergency referral services can be provided by social forces through specialized transit vehicles, and the specific management rules shall be formulated by the Municipal People’s Government.
Chapter II Pre-hospital Emergency Medical Services
Article 10
The municipal health administrative department shall, in conjunction with the municipal planning and resources department, organize the preparation of special planning for construction of pre-hospital emergency facilities, reasonably determine the number and layout of the emergency sites, and upon approval by the Municipal People's Government, include them in the corresponding urban and rural planning.
The municipal planning and resources department and the district people’s government shall set aside the construction-use land for pre-hospital emergency facilities.
The district people’s government shall, in accordance with this Municipality’s special planning for pre-hospital emergency facilities construction, construct facilities relating to pre-hospital emergency agencies.
Article 11
A pre-hospital emergency agency shall, in accordance with the relevant provisions of laws and administrative rules, apply to the municipal and district health administrative departments to handle pre-hospital emergency medical practice registration.
Without the approval of the administrative department of health, no unit or individual may arbitrarily set up a pre-hospital emergency agency to carry out pre-hospital emergency medical services.
Article 12
The municipal health administrative department shall organize to work out norms and quality control standards for pre-hospital emergency medical work and establish the statistical reporting system.
A pre-hospital emergency agency shall establish the corresponding management system in accordance with the norms and quality control standards of pre-hospital emergency medical work, regularly organize first-aid training and assessment, and submit the relevant statistical information to the health administrative department.
Article 13
Employees of pre-hospital emergency agencies shall include emergency physicians, medical emergency command and dispatch personnel, administrative personnel, emergency assistant personnel and medical emergency equipment professional maintenance personnel. The position and staff of the pre-hospital emergency agency shall follow the relevant provisions of the State and this Municipality.
Article 14
The municipal authorities shall determine the reasonable amount of pre-hospital emergency ambulances (hereinafter referred to as ambulances) and equip a certain number of special ambulance vehicles according to the service population, service radius, geographical environment, traffic conditions, business demands and other factors in the region. The specific amount of ambulances shall be set by the municipal health administrative department and approved by the Municipal People’s Government.
The ambulance shall meet the national standards, have obvious emergency medical signs and names set uniformly by the industry, and shall, in accordance with the relevant provisions, have the positioning system, communication equipment and video monitoring system installed, and be equipped with sirens, signal lights, emergency equipment and medicines, and also have the “120” sign pattern painted.
The ambulance shall be used for the special purpose. No unit or individual may use an ambulance to carry out non pre-hospital emergency medical service activities.
Any social vehicle shall not use the “120” logo design.
Article 15
Each ambulance shall have at least one emergency physician, and two emergency assistants including a driver and a stretcher-bearer.
The emergency physician shall be medical graduate and qualified person after pre-hospital emergency medical professional training and continuing education and training.
The emergency assistant shall be qualified after first-aider skills training, mastering the basic knowledge of emergency medical treatment and basic operation skills.
Article 16
The salary and welfare of pre-hospital first-aid personnel shall, according to their job responsibilities, work load, service quality, service effect and other factors, be determined reasonably.
Article 17
This Municipality shall set up the pre-hospital emergency call acceptance, command and dispatch center, offering full-year twenty-four-hour emergency call reception services, making unified acceptance of emergency calls, and reasonable allocation of emergency resources.
The municipal health administrative department, municipal transportation department, and municipal public security traffic management department shall establish a road and traffic information sharing mechanism.
Article 18
The first-aid special telephone number is “120”. The pre-hospital emergency call reception and dispatch center shall, according to the population size and emergency call business volume, set up the corresponding number of "120" telephone line, be staffed with dispatchers to guarantee timely answer the public’s emergency call.
Any unit and individual can dial “120” hotline only in the event of an emergency and in need of emergency medical services; no false emergency call nor harassment to the "120" hotline shall be permitted.
“120” call acceptance, command and dispatch center and the “110” and “119” command centers shall improve the linkage coordination mechanism.
Article 19
A pre-hospital emergency call reception and dispatch center, after receiving emergency call information, shall immediately classify and register the emergency call information, make preliminary assessment of the patient’s condition, and send the ambulance dispatch instruction. When necessary, the on-site emergency rescue guidance may be given to the emergency caller.
Article 20
The pre-hospital emergency personnel in carrying out emergency tasks, shall wear a unified pre-hospital emergency medical logo, and carry the corresponding emergency medicine and equipment facilities.
The pre-hospital emergency personnel, arriving to the scene according to the dispatch instructions, shall take appropriate first-aid measures based on the patient's condition. For patients who need to be sent to a hospital emergency agency for rescue, the pre-hospital emergency personnel shall notify the hospital emergency agency to prepare for rescue treatment.
The patients’ family members and other persons on the site shall have the obligation to assist the pre-hospital emergency personnel to do the relevant work and provide convenience.
Article 21
The pre-hospital emergency personnel who cannot enter the house to give on-site first-aid treatment because of failing to contact the emergency patient caller may report to the police and fire department immediately, requesting assistance to enter the scene. The public security, fire protection and other departments shall promptly rush to the scene to give assistance.
Article 22
Apart from referral services provided by the pre-hospital emergency agency for the emergency patient, the pre-hospital emergency agency shall, in the principle of going nearby for the urgent case and meeting the need of professional treatment, decide to send the patient to the corresponding hospital emergency agency for treatment. If the patients or their families require to be sent to other medical institutions, the pre-hospital emergency physician shall notify them of the possible risks, and require their confirmation by signature.
The patient who has one of the following circumstances shall be sent to the corresponding hospital emergency agency for treatment at the discretion of the pre-hospital emergency physician
1. The condition is critical with a risk of life;
2. A suspected emergent infectious disease or severe mental disorders; or
3. As may be specially provided for by laws and administrative regulations.
Article 23
The pre-hospital emergency personnel in sending patients to the hospital emergency agency shall keep close observation of patients’ condition, monitor vital signs, give timely treatment, inquire of the patients or their family members about the medical history and keep relevant record.
Article 24
In respect to the patients who have behavior harmful to public security or have suspected crimes or need protective measures to be provided according to law, the pre-hospital emergency personnel shall notify the local public security organ or the relevant professional institutions while providing emergency medical services, and the public security organs or relevant professional institutions shall take corresponding measures.
Article 25
The pre-hospital emergency agency shall do a good job in recording such information as emergency call acceptance, on-site rescue, in-transit treatment and monitoring.
The pre-hospital emergency medical records shall be managed and kept in accordance with the relevant provisions of medical institutions on the management of medical records. The pre-hospital emergency agency’s emergency call telephone recording and vehicle dispatch record data shall be stored at least for two years.
Article 26
A three-dimensional pre-hospital emergency network on land and water and in the air with a wide range shall be established and improved in this Municipality and with the increase in government support to achieve the land, water and air rescue integration.
Article 27
As for emergency treatment in the major or especially major contingencies, when necessary, upon professional judgment of patients on the site made by emergency medical experts, the pre-hospital emergency agency shall make referral to the relevant medical institutions for treatment.
Article 28
The pre-hospital emergency agency shall, in accordance with the requirements of the municipal and district people's governments or the requirements of the emergency preplan, do a good job in preparations of pre-hospital emergency medical services for large-scale mass activities.
Chapter III Hospital Emergency Medical Services
Article 29
The municipal and district health administrative departments shall formulate the planning for allocation of hospital emergency medical resources, perfect the distribution of hospital emergency medical resources within the corresponding administrative area, and strengthen the guidance and supervision of the hospital emergency agency.
The municipal and district health administrative departments shall establish and improve the relevant critical case professional emergency network and strengthen the regional designated rescue work.
Article 30
The municipal public health administrative department shall, according to the functional orientation of the hospital emergency agency, formulate the construction standards and management norms for emergency departments in the hospital. The higher-level competent department and unit of the hospital emergency agency shall, in accordance with the construction standards and management norms, strengthen the construction of emergency departments, and accept the guidance and supervision of the municipal health administrative department.
Article 31
The Grade 2 and above comprehensive medical institutions and specialized hospitals determined by the health administrative department shall, in accordance with the construction standards and management norms, set up emergency departments, strengthen the emergency discipline building and daily management and improve the ability of hospital emergency medical services. Without the approval of the health administrative department, emergency departments may not be closed or stopped.
The hospital emergency agency shall be encouraged to carry out the integration construction of emergency departments and intensive care units.
Article 32
The hospital emergency agency shall, in accordance with the relevant standards, staff emergency departments with personnel with emergency medical knowledge and basic operation skills, and strengthen training for the emergency department personnel.
Article 33
The hospital emergency agency shall establish rules and regulations for emergency rescue and emergency consultation, and the emergency response joint action mechanism, and clarify job responsibilities and operational procedures. The hospital emergency personnel shall comply with the rules and regulations and technical specifications, and shall ensure the quality of medical services and medical safety.
Article 34
The municipal health administrative department shall formulate and improve emergency classification treatment standards and clarify objectives and measures of the emergency classification treatment.
The hospital emergency agency shall, based on the standards of classification treatment, work out its execution system, and make it known to the public to guide emergency patients to flow in reasonable direction, make classification according to the patient’s disease severity and determine the treatment priorities. Emergency patients and their families shall follow the emergency classification criteria and arrangements of the medical personnel, and receive orderly treatment in accordance with the standards and procedures of the hospital emergency agency.
Article 35
The hospital emergency agency and the pre-hospital emergency agency shall jointly establish a working link mechanism, standardize the transfer process, and realize information exchange and business collaboration as required by the emergency classification treatment standards.
The hospital emergency agency shall keep easy access unimpeded, and, upon receiving the notice of pre-hospital emergency personnel to prepare for giving emergency treatment to critically ill patients, promptly do well the treatment preparations.
After the pre-hospital emergency personnel sent patients to the hospital emergency agency, the hospital emergency agency personnel concerned shall go through the formalities in writing with the pre-hospital emergency personnel for the transfer of patients, and may not refuse or excuse for any reason, or make undue occupancy of ambulance facilities and equipment. The municipal and district health administrative departments and the higher-level competent department of the hospital emergency agency shall strengthen the supervision and examination of the taking-over of the hospital emergency agency.
Article 36
The hospital emergency agency shall exercise the first diagnosis responsibility system, and shall not refuse or excuse for emergency patients; critically ill patients shall be treated according to the principle of first timely treatment and later payment of medical expenses.
In respect to a patient in special need of referral to other hospital emergency agency for treatment, the hospital emergency agency that has made the first diagnosis shall make judgment, and contact and make sure the hospital emergency agency that is to accept the patient in compliance with the signs of referral.
Article 37
The hospital emergency agency shall, based on the patient's condition needs, give treatment, make referral or diversion. Patients who need hospitalization for continuing treatment after emergency department treatment shall promptly be transferred to the hospital ward for treatment by the hospital emergency agency; patients in stable condition after emergency department treatment, without the need to continue the emergency treatment and in compliance with the discharge or referral standards shall timely handle discharge formalities or be referred to the relevant medical institution or rehabilitation institution to continue treatment and rehabilitation.
Article 38
The municipal and district health administrative departments shall improve the medical rehabilitation and nursing service system, and make smooth patients’ two-way referral channels.
The Grade 3 medical institutions and related medical, rehabilitation, elderly care and old-age institutions shall be encouraged to carry out business cooperation and two-way referral.
Article 39
The municipal health insurance department shall, by the medical insurance payment policy tilt, guide the patients in stable condition after emergency treatment to go to the relevant medical institution to continue treatment and rehabilitation.
In respect to the patients who comply with the discharge or referral standards but still stay in the hospital emergency agency without any reason, occupying emergency resources, the municipal health administrative department shall, in accordance with the relevant provisions, provide the information to the public credit information service platform of this Municipality as a bad credit information record.
Article 40
A linkage training mechanism shall be set up in this Municipality for hospital and pre-hospital emergency physicians and for hospital emergency physicians and related department physicians, and it is necessary to organize relevant professional doctors to work at the pre-hospital emergency agency or the emergency department.
Article 41
The superior competent department and unit of the hospital emergency agency shall, based on the functional orientation, emergency scale and medical service quality, make reasonable assessment indicators; awards after assessment shall be tilted to the emergency department.
Medical institutions shall tilt towards medical staff of emergency departments in the personal performance appraisal, the promotion of professional titles and appointment, and strengthen the emergency discipline construction and personnel training.
Chapter IV Social First Aid
Article 42
Any citizen who finds a patient in need of emergency treatment shall promptly make an emergency call on "120" hotline, and may carry out emergency aid under the guidance of emergency command and dispatch personnel and can also give rescue according to the scene situation to provide convenience for first aid.
Citizens with first aid skills shall be encouraged to give emergency on-site rescue to critically ill patients.
At the place where there is automatic external defibrillator and other emergency equipment, the trained person can use the automatic external defibrillator and other emergency equipment for emergency rescue.
An emergency rescue behavior shall be protected by law, and damage to the patient shall not be subjected to legal responsibility according to the law.
This Municipality’s social organizations shall be encouraged to support and guide citizens to take part in on-site rescue through the form of commercial insurance, awards and so on.
Article 43
The following places and units shall be equipped with the necessary first aid equipment, drugs and be staffed with personnel with knowledge and skills of the use of first aid equipment:
1. rail transport stations and the airport, bus stations, port terminals and other transportation hubs;
2. schools, stadiums, gyms, exhibition halls, cultural and entertainment venues, hotels, shopping malls, scenic spots (points) and other crowded places; and
3. construction site of large construction enterprises, large industrial enterprises.
The places and units where conditions permit are encouraged to be equipped with automatic external defibrillators.
Article 44
The municipal health administrative department and the municipal Red Cross society shall organize the preparation of training materials of first-aid knowledge and skills and organize all kinds of training on first-aid knowledge and skills.
Volunteer organizations and other social organizations are encouraged to carry out first-aid knowledge and skills training, improve citizens’ emergency awareness and skills of self-rescue and mutual aid.
Article 45
Public security personnel, firefighters and public transport drivers and attendants, school teachers, security guards, tour guides and AED users shall take part in the first-aid knowledge and skills training launched by the Red Cross society, pre-hospital emergency agency and other organizations with training ability.
Article 46
The Red Cross society, pre-hospital emergency agency and other medical institutions shall carry out the popularization of first-aid knowledge, and organize citizens to participate in social first-aid training.
State organs, enterprises and public institutions and social organizations shall organize personnel to participate in the popularization of first-aid knowledge and skills training.
Schools at all levels and of all kinds shall set up first-aid knowledge and skills courses, and organize students to carry out first-aid knowledge and skills training.
The residents' committees and the villagers' committees shall cooperate in the popularization of first-aid knowledge and skills.
Chapter V Safeguard Measures
Article 47
The municipal and district people’s governments can take such ways as the purchase of public services, etc., to support and encourage social forces to participate in emergency medical services. Social forces that participate in emergency medical services, shall obey the unified organization and management of the health administrative department.
Article 48
The municipal health administrative department shall, in conjunction with the municipal human resources and social security, education and other departments, work out safeguard measures in line with the characteristics of emergency industry for personnel training and discipline team building and others.
Article 49
The public security traffic management department shall ensure the passing priority of the ambulance in first-aid task, and shall make timely guidance when the ambulance runs into the traffic congestion. In front of the pre-hospital and hospital emergency agencies, as well as in the road section within thirty meters from the front of the location above said, no parking shall be permitted except for ambulances.
Article 50
An ambulance in carrying out an emergency task can use the alarm sirens and signal lights; on the premise of ensuring the safety of road traffic, the ambulance shall not be subjected to restrictions of driving route, direction, speed and traffic signals.
Article 51
When an ambulance carries out an emergency task, other vehicles and pedestrians shall give way and shall not impede the passage of ambulances.
The vehicles and pedestrians breaking the traffic rules due to giving way to an ambulance in an emergency task shall be exempted from administrative punishment. In respect to any vehicle and pedestrian that do not give way as required to an ambulance in the emergency task, the pre-hospital emergency agency may record the fixed evidence by video of a vehicle or pedestrian hindering the passage of the ambulance. The public security organ shall give punishment according to law by the above evidence.
Article 52
The ambulance in emergency task shall be exempted from tolls and parking fees.
Article 53
The patients and their families shall comply with arrangements of the pre-hospital and hospital emergency agencies, shall not interfere with emergency medical services or the emergency medical order, and shall not assault or insult emergency medical personnel.
The public security organ shall, in accordance with the law and in a timely manner, prevent and deal with the persons who have behavior set out in the preceding paragraph.
Article 54
The municipal price competent department shall, according to the factors of emergency medical service activities cost and residents’ income level, set emergency medical service activities fees, and can make adjustment according to the level of economic and social development. Charges and adjustments shall be published in a timely manner to the public.
Article 55
In respect to wandering and begging persons eligible for aid, the first-aid medical treatment costs shall follow the relevant provisions of the State and this Municipality.
In respect to emergency treatment expenses of patients in critical condition in the administrative area of this Municipality who are in need of emergency treatment and eligible for aid, medical institutions may, in accordance with the relevant provisions of the State and this Municipality, apply for payment from the emergency rescue fund for diseases.
Article 56
The emergency medical information system platform shall be established in this Municipality to conduct dynamic monitoring of this Municipality’s pre-hospital and hospital emergency resources and realize the instant sharing of pre-hospital and hospital emergency resources information.
Article 57
The municipal and district health administrative departments shall establish the emergency medical specialists’ database to respond to contingencies.
This Municipality’s Grade 3 hospitals where conditions permit shall establish an emergency medical rescue team to participate in emergency medical work in major or especially major emergencies.
Chapter VI Legal Liability
Article 58
For violations of the provisions of these Regulations, where laws and administrative rules have provisions on disposition, such provisions shall apply.
Article 59
For carrying out pre-hospital emergency medical services without authorization in violation of the provisions of Article 11 of these Regulations, the health administrative department shall order to make correction and impose a fine of not less than 10,000 yuan but not more than 30,000 yuan; if the case is serious, a fine of not less than 30,000 yuan but not more than100, 000 yuan shall be imposed.
Article 60
For the use of ambulance to carry out non-pre-hospital emergency medical service activities in violation of the provisions of Article 14 Paragraph 3 of these Regulations, the health administrative department shall order to make correction, and impose a fine of not less than 1,000 yuan but not more than 10,000 yuan; if the case is serious, a fine of not less than 10,000yuan but not more than 50,000 yuan shall be imposed. The expenses incurred from the use of ambulance to carry out non-pre-hospital emergency medical services shall be borne by the relevant person held responsible.
Article 61
For a social vehicle using “120” logo in violation of the provision of Article 14 Paragraph 4 of these Regulations, the health administrative department shall order to make correction, and impose a fine of not less than10,000 yuan but not more than 30,000 yuan; if the case is serious, a fine of not less than 30,000 yuan but not more than 100,000yuan shall be imposed.
Article 62
For false emergency calls or harassment to the “120” telephone in violation of the provision of Paragraph 2, Article 18 of these Regulations, the public security department shall give punishment according to law for violation of public security administration.
Article 63
If a hospital emergency agency refuses or shuffles the taking over of a patient or occupies the ambulance facilities and equipment without any reasons in violation of the provision of Paragraph 3, Article 35 of these Regulations, the health administrative department shall give a warning; if the case is serious, a fine of not less than 10,000 yuan but not more than 30,000 yuan shall be imposed.
Article 64
If the health administrative department and its staff have one of the following acts in violation of these Regulations and cause adverse consequences, the corresponding unit or supervisory authorities shall give a warning or demerit according to law to the person in charge held directly responsible and other persons held directly responsible; if the cases is serious, the wrongdoer shall be given a serious demerit or demotion; if the case is more serious, the wrongdoer shall be dismissed:
1. The pre-hospital emergency medical work standards and quality control standards are not formulated in a timely manner;
2. The duty and responsibility for guarantee of emergency medical services is not performed in accordance with the law; or
3. The supervision and inspection is not carried out according to law.
Chapter VII Supplementary Provisions
Article 65
The medical institution carrying out pre-hospital emergency medical services may take reference to the implementation of these Regulations.
Article 66
These Regulations shall be effective as of November 1, 2016.