Vaginal examinations during childbirth: an emergency or a precaution? Why and how often should such inspections be carried out?
Emergency room
If labor begins at a woman’s home (and not in the pregnancy pathology department), she is admitted to the emergency room, where she is questioned in detail (they clarify when exactly labor began or the waters broke, whether the woman slept at night, whether she took any medications) . After this, a general examination is carried out: temperature, blood pressure are measured, height is determined, weighing is carried out, the presence of edema and varicose veins, the thickness of subcutaneous fat, etc. are determined.
Then they proceed to an external obstetric examination (the fetal heartbeat is listened to, the external dimensions of the bony pelvis, abdominal circumference, and the height of the uterine fundus are measured). Using palpation (palpation) of the abdomen, the tone of the uterus, the position of the fetus (longitudinal, transverse, oblique), and the presenting part (head or pelvic end) are determined.
In the emergency room, the doctor’s main task is to determine whether labor has actually begun. If the presence of labor or rupture of amniotic fluid is not confirmed, the woman is hospitalized in the pregnancy pathology department. If a woman was admitted with a suspicion of rupture of amniotic fluid, and it was definitely ruled out, the expectant mother does not make any further complaints (of pain, pulling sensations in the lower abdomen), then she can be sent home. If the onset of labor is confirmed, the woman is admitted to the maternity ward. In doubtful cases, hospitalization is carried out in the maternity ward and the patient is constantly monitored there.
In most maternity hospitals, a woman in labor entering the maternity unit is given a cleansing enema. This is done not only for “aesthetic” reasons (so that the contents of the intestine are not released during pushing), but because an overcrowded intestine can interfere with labor and make examination difficult. In addition, an enema promotes the development of labor.
After a cleansing enema, the woman in labor has her genital and pubic hair shaved off, so treatment with a disinfectant solution is more effective. In addition, hair on the labia can interfere with stitches after childbirth. In some maternity hospitals, shaving the genitals is now considered optional; it is enough for the hair to be cut short.
Before entering the maternity ward, the woman showers and puts on sterile underwear.
Vaginal examination during childbirth
In the maternity ward, a vaginal examination is carried out, monitoring the condition of the fetus and assessing the nature of labor.
Upon admission to the maternity ward, a woman is examined in speculum (the cervix and vaginal mucosa are examined using a gynecological speculum), and a vaginal examination is performed. Before the procedure, the genitals are treated with a disinfectant solution. The doctor conducts a gynecological examination wearing sterile gloves, which he puts on after treating his hands (the doctor washes his hands, then treats them with a special disinfectant solution).
Initially, the appearance of the external genitalia is assessed: how are they formed, are there any varicose veins veins, whether there are signs of inflammation or sexually transmitted diseases.When examined in mirrors, the appearance of the vagina and cervix, as well as the nature of the discharge, are assessed.
Frequent vaginal examinations increase the risk of developing infectious complications.
During a manual (manual) examination, the condition of the vagina (wide or narrow, the presence of scar changes), the condition of the cervix (degree of maturity, opening) are assessed. The presence of the amniotic sac is checked (intact or absent); if the amniotic sac is intact, the amount of anterior waters (those waters that are in front of the head) is assessed. If there is little or too much anterior water, it may be necessary to open the amniotic sac, since in these cases the amniotic sac may interfere with labor. Next, the presenting part (head or pelvic end) is diagnosed. When the head is presented, the nature of the insertion is determined (normally the head is bent, the occiput is born first). But the head can be inserted not only from the back of the head, but also from the forehead or face, etc. Incorrect position of the head can cause a discrepancy between the fetal head and the mother’s pelvis. In order to determine the insertion, the sutures and fontanelles are palpated on the head (they serve as landmarks). If the pelvic end is presented, determine the type of pelvic presentation (foot or breech). They talk about leg presentation if the legs are presented, if the legs are bent at the hip joints and the buttocks of the fetus are in front of them, then this is a breech presentation. If both the legs and the buttocks are visible (the baby seems to be squatting), this is called a mixed breech presentation.
During a vaginal examination, the condition of the bone pelvis is necessarily assessed. The doctor tries with his finger to reach the promontory of the sacrum (the most protruding point in the pelvic cavity). If the cape is not reached, then the pelvic capacity is sufficient. If the cape is reached, then there is some narrowing of the pelvis. In addition, the presence of deformities of the pelvic bone is determined. Repeated vaginal examination should be carried out no earlier than after 4 hours, since frequent vaginal examinations increase the risk of developing infectious complications in the vagina. postpartum period. More frequent vaginal examination can be carried out only strictly according to indications: when there is rupture of amniotic fluid, if there has been premature effusion water - at the onset of labor (the appearance of contractions); when bleeding occurs; before anesthesia; in case of deviation from the normal course of labor (suspicion of the development of weakness or incoordination of labor, lack of advancement of the head). The reasons for conducting a vaginal examination must be recorded in the birth history. It is unacceptable to conduct a vaginal examination without clear indications. Multiple vaginal examinations (more than four) during childbirth are an indication for the prescription of antibiotics in the postpartum period.
Observation
To assess the development of labor, at least every hour, the doctor or midwife evaluates the frequency, strength and duration of contractions. To do this, the doctor places his hand on the woman’s stomach and records the time. Normally, over time, contractions become more frequent, increasing in strength and duration.
Normally, over time, contractions become more frequent, increasing in strength and duration.
Using an external examination, the location of the presenting part of the fetus in relation to the pelvis is determined approximately every 2 hours. The presenting part can be palpated completely or partially above the entrance to the pelvis (above the pubis). If the presenting part is located in a narrow part of the small pelvis or on the pelvic floor, that is, the fetus has already moved significantly “toward the exit,” then during external examination it cannot be palpated through the anterior abdominal wall.
In addition, the woman’s condition is assessed. Temperature and pressure are periodically measured, and the pulse is calculated (these manipulations can be carried out by a midwife). All data is entered into the birth history.
Fetal assessment
No less carefully than the condition of the mother, you need to monitor the condition of the fetus.
Every 20-30 minutes, the doctor listens to the fetal heartbeat using an obstetric stethoscope (wooden tube). Be sure to wait for the contraction to assess how the fetal heartbeat changes during and after the contraction.
The fetal heartbeat is recorded at least 1-2 times using a special device - a cardiotocograph (fetal monitor). The expectant mother, lying on her side or on her back, has a special sensor attached to her stomach, with the help of which a graph of the fetal heartbeat is recorded on a paper tape - a cardiotocogram (CTG). In some cases, recording of the fetal heartbeat using a cardiotocograph is carried out continuously throughout the entire birth. This is necessary in the following cases:
- with severe gestosis in the mother (preeclampsia is a condition associated with pregnancy, the main symptoms of which are swelling, increased blood pressure and the appearance of protein in the urine);
- during labor stimulation (stimulation of labor after the onset of labor with the help of medications) or labor induction (when labor is induced artificially);
- in case of premature or post-term pregnancy;
- at multiple pregnancy;
- if there are severe chronic diseases at mother's ( diabetes, cardiovascular pathology);
- during epidural anesthesia (since it is possible that a woman’s blood pressure may decrease and, as a consequence, malnutrition of the fetus);
- with delayed fetal development;
- if, when listening with an obstetric stethoscope, a disturbance in the fetal heartbeat is detected.
The advantage of continuous heartbeat recording is constant control depending on the condition of the fetus, the defect is its inconvenience for the woman, restriction of her freedom and physical activity.
In some cases, the cardiotocograph has 2 sensors, one of which records the fetal heartbeat, and the second records uterine contractions. This is convenient because you can see how your heartbeat changes during a contraction.
Amniotic fluid
The appearance of the amniotic fluid after its release must be assessed. Normally, the water should be light and transparent. If the waters are colored green color, this indicates hypoxia ( oxygen starvation) fetus (the green color of the water is due to the fact that during hypoxia, premature excretion of meconium occurs - the original stool of the fetus, which colors amniotic fluid). In this case, constant monitoring of the fetal heartbeat is necessary. Waters can be colored yellow if there is a Rh conflict - the color of the water is explained by the fact that during a Rh conflict, blood cells are destroyed and the pigment bilirubin is released from them.
On the birth table
Once the cervix is fully dilated and the second stage of labor (the pushing period) has begun, everything should be ready to deliver the baby. Delivery is carried out on a special birth table (in some maternity hospitals there are special beds that transform into a birth table).
The woman is transferred to the birthing table after the head has erupted (the head appears in the genital slit during contractions and does not disappear after contractions). During childbirth, the mother in labor is provided with a benefit called “perineal protection.” It is aimed at ensuring that the head cuts into the genital slit with its smallest size; for this it must be bent as much as possible (the baby’s chin must be pressed to the chest). Therefore, until the maximum flexion of the head, the midwife delays its advancement. In case of breech presentation, the benefit is aimed at ensuring that the fetus’s buttocks are born first and that the leg does not fall out. To do this, delaying the progress of the fetus, the doctor forces it to “sit down,” as it were.
When providing manual assistance, monitor the condition of the perineum. If there is a threat of its rupture (palening of the skin, the appearance of cracks), it is necessary to make a dissection of the perineum - an episiotomy, since the incision heals better than a rupture.
At the same time, the doctor listens to the fetal heartbeat after each attempt. If the fetal heartbeat worsens, it is necessary to end labor as soon as possible. To do this, an episiotomy is performed; in rare cases, obstetric forceps are used.
During the birthing process, the doctor or midwife tells the woman in labor when she needs to push, and when, on the contrary, she needs to “breathe” through the pushing. This depends on the location of the presenting part and the speed of its advancement. It is important to listen carefully to medical personnel to avoid rupture and injury to the fetus.
After birth, the baby is placed on the mother's stomach and applied to the breast (if his condition allows). The umbilical cord is cut, then the baby is examined by a pediatrician.
After the baby arrives
After the birth of the fetus, the succession period begins. This is the shortest period of labor, but during it there is a danger of bleeding from the uterus.
The doctor observes the appearance of signs of separation of the placenta - the woman may feel a weak contraction; when the woman breathes deeply, the umbilical cord section does not retract, the fundus of the uterus rises higher and deviates to the right. Only after separation can the placenta be removed from the genital tract if it is not born on its own. Pulling the unseparated placenta by the umbilical cord or squeezing it through the anterior abdominal wall is not used, as this is dangerous due to bleeding.
Suture of tears is usually performed under local anesthesia.
Faster separation of the placenta and better contraction of the uterus is facilitated by putting the baby to the breast immediately after birth. This is explained by the fact that when the nipple is irritated, the hormone oxytocin is released, which has a contractile effect on the uterus.
After the birth of the placenta, it must be examined; the doctor must make sure that the placenta is intact, because if the placenta lobule is retained in the uterus, bleeding may occur. Therefore, if a defect in the placental tissue is suspected, a manual examination of the uterine cavity is performed against the background of anesthesia.
Examination of the birth canal
After childbirth, the birth canal must be examined for ruptures. To do this, special spoon-shaped speculums are inserted into the vagina. First, the doctor examines the cervix. To do this, the cervix is taken with special clamps, and the doctor walks around its perimeter, interlocking the clamps. In this case, the woman may feel a pulling sensation in the lower abdomen. If there are cervical ruptures, they are sutured; no anesthesia is required, since there are no pain receptors in the cervix. Then the vagina and perineum are examined. If there are tears, they are sutured.
Suture of ruptures is usually carried out under local anesthesia (novocaine is injected into the area of the rupture or the genitals are sprayed with lidocaine spray). If manual separation of the placenta or examination of the uterine cavity was carried out under intravenous anesthesia, then the examination and suturing are also carried out under intravenous anesthesia (the woman is removed from anesthesia only after completion of the examination of the birth canal). If there was an epidural anesthesia, then an additional dose of pain relief is administered through a special catheter left in the epidural space from the time of birth. After the examination, the birth canal is treated with a disinfectant solution.
The amount of bloody discharge must be assessed. At the exit from the vagina, a tray is placed where everyone gathers bloody issues, the blood remaining on napkins and diapers is also taken into account. Normal blood loss is 250 ml, up to 400-500 ml is acceptable. Large blood loss may indicate hypotonia (relaxation) of the uterus, retained parts of the placenta, or an unsutured rupture.
Two hours after birth
The early postpartum period includes the first 2 hours after birth. During this period, various complications may occur: bleeding from the uterus, the formation of a hematoma (an accumulation of blood in a confined space). Hematomas can cause compression of surrounding tissues, a feeling of fullness, in addition, they are a sign of an unsutured rupture, bleeding from which may continue, and after some time the hematomas may fester. Periodically (every 15-20 minutes), a doctor or midwife approaches the young mother and evaluates the contraction of the uterus (for this, the uterus is palpated through the anterior abdominal wall), the nature of the discharge and the condition of the perineum. After two hours, if everything is normal, the woman and baby are transferred to the postpartum ward.
Doctors always try to reduce the number of examinations and medical manipulations during childbirth to a minimum in order to allow childbirth to proceed as naturally as possible and to allow the woman to focus on this most important process in life and to feel her leading role in the birth of the child.
Elena Kudryavtseva,
obstetrician-gynecologist,
Ural Institute of Motherhood
and infancy, Ekaterinburg
Dmitry-54
Conclusion:
Must undergo technical inspection at the following intervals:
3 years after graduation.
5 years after graduation.
Does not comply with Federal Law:
Every TWENTY-FOUR MONTHS in relation to the following vehicles, from the year of manufacture of which THREE TO SEVEN YEARS have passed, including the year of their manufacture (except for the vehicles specified in paragraphs 1 and 3 of this part)...
What's not to your liking? From 3 to 5 years 24 months? What about 5 to 7 years? IMHO, also 24!
Vladimir-61
If the technical inspection was carried out regularly, then we consider
There is no need to pass this year.
Please tell me, the car is a 2010, the technical inspection ends in March 2016, is the vehicle subject to technical inspection for 24 months?
It all depends on what diagnostic card is available. It indicates the validity period. If there is no DC, then you need to get one, and then, depending on the production date of the vehicle, you will be given a card with the correct expiration date.
servit, there were slightly different rules before.
2010: They gave a vehicle inspection certificate for 3 years. Moreover, they gave it after purchasing MTPL, according to the rules in force at that time. Therefore, it could be used also in 2013 to purchase another MTPL. Therefore, the second technical inspection was obtained only in 2014.
2016: The technical inspection will be issued for 2 years, because the car is 7 years old (but not more than 7 years old).
2018: Technical inspections every year.
I brought standard option and expected a question, but there was none. Alternatively, you can buy a 2010 vehicle (damaged), lay it up until it is restored, and undergo a technical inspection in 2014.
But I don't agree with you. Maybe I'm wrong in theory, but in practice it's different.
2010: Inspection with diagnostic card for 3 years.
2014: Inspection with diagnostic card for 2 years.
2016: The technical inspection will be issued for 1 year, because The car will be 7 years old in 2017.
2017: Technical inspections every year.
servit, the specified car will be 6 years old in 2016, the seventh year will begin. He will only be 7 years old in 2017.
Hello. I have a passenger GAZelle 2002. Not used for commercial purposes. The numbers are white. I use it as a family car. How many times a year do I need to undergo maintenance? once or every six months?
Novel, Hello.
If the specified vehicle is a bus, then it must undergo a technical inspection once every 6 months.
Good luck on the roads!
Sergey-137
I'm a little dumb. If I bought a new car at a car dealership on April 26, 2013, do I not need to undergo a vehicle inspection in 2016? Or should I still pass? this year?
Sergey, this year you need to undergo a technical inspection before purchasing MTPL.
Good luck on the roads!
Sergey-137
Vasily-24
I bought a new car from an official dealer on 02/25/2014. When should I get a technical inspection? it's written in the data sheet. that the car was produced by the plant in 2013. ????
It is necessary to undergo technical inspection in 2016.
The starting date for the three-year period is the date of issuance of the PTS for the vehicle, i.e. the year of manufacture of the vehicle. The reference point is not the date of purchase by the first owner at the car dealership, but the date of issue of the title for this vehicle. Therefore, if you bought a car at a car dealership in 2014, and the year of manufacture according to the title is 2013, then you will have to undergo a technical inspection not three years after the purchase, but three years after the vehicle was released.
UAZ 220695-04, in the PTS and vehicle registration certificate category "B", however, some diagnostic points establish the frequency of technical inspection every six months, citing the fact that the vehicle type is indicated in the registration certificate as "other buses". Who is right in this case, because according to the UN EAC classification, this car is classified as “M1” - passenger cars, there was even an explanation from the head of the traffic police of Syktyvkar that cars of this type undergo technical inspection as cars?
If I and the traffic police are right, could you explain how you can influence the management of diagnostic control points.
Thank you in advance, best regards, Yuri.
Yuri, what difference does it make to the management of diagnostic control points regarding the frequency of maintenance? If the vehicle is faulty and you have been repairing it for two years, how can you get it checked? THAT is only necessary for OSAGO. And what does the leadership have to do with it? We arrived at Dyrnos 5, a checkpoint at the city traffic police, it’s completely boring, there’s only one person working there, you pass control without any problems.
If it's not a secret, at what diagnostic point did you try to get a diagnostic card?
Andrey-175
Good afternoon. Please tell me what to do. The car's technical inspection and compulsory motor vehicle insurance expire in April, but the driver is deprived of the right to drive the car until July, that is, in fact, the car is laid up and not in use. Is it possible to undergo a technical inspection and compulsory insurance after returning the license? Or does this need to be done before the end of their validity period?
Andrey, Hello.
The following options are possible:
1. Add an additional driver to your existing OSAGO policy who will undergo a technical inspection before the expiration of the OSAGO policy. After the return of rights in July, purchase a new OSAGO policy.
2. Complete all operations in July. But in this case the order will be as follows:
Purchasing a “temporary” compulsory motor liability insurance to pass a technical inspection.
Passing technical inspection.
Purchasing a regular MTPL.
Good luck on the roads!
Explain the meaning of “No technical inspection is required in the first three years, including the year of manufacture...., my car was released on December 28 and the insurance company requires a diagnostic card since it counted the first year in the amount of 3 days, so I can pass the actual technical inspection due in two years. I agree when a car is released in the first half of the year, but as for me, it’s three days before the end of the year and counting it as a year is insanity. Can you explain?
The act of flooding the apartment is necessary to claim compensation for damage, which is expressed in monetary terms, to confirm the very fact of causing harm by the culprit (individual and/or legal entity), and is also the basis for determining the cost of repairing the apartment from the flood. Thus, without establishing the fact of the flood, which must be confirmed exclusively in writing, the claim for compensation for damage resulting from the flood of the apartment is futile.
ACT ONE -
Call registration.
If you discover that your home is flooded, you need to call the emergency dispatch service of the organization that manages the residential building. The operator must immediately send workers (mechanics) who will take urgent measures to eliminate the accident.
At the same time, in accordance with clause 106 of the Rules for the provision of utility services to owners and users of premises in apartment buildings and residential buildings, approved by Decree of the Government of the Russian Federation of May 6, 2011 N 354 The employee who receives the call must You must provide your last name, first name and patronymic, as well as the number under which your message is registered, and the time of its registration.
clause 106 of the RF GOVERNMENT DECREE of 05/06/2011 No. 354 No. 354 - read
A report of a violation of the quality of a utility service can be made by the consumer in writing or orally (including by telephone) and is subject to mandatory registration by the emergency dispatch service. In this case, the consumer is obliged to provide his last name, first name and patronymic, the exact address of the premises where a violation of the quality of the utility service was discovered, and the type of such utility service. Emergency dispatch worker obliged to inform information to the consumer about the person who received the consumer’s message (last name, first name and patronymic), number under which the message is registered consumer, and the time of its registration.
ACT TWO -
Localization of the bay.
Further, according to clause 108 of the Decree of the Government of the Russian Federation dated 06.05.2011 N 354from the moment you contact the dispatch service, the fact of flooding must be checkedno later than 2 hours
. Arriving mechanics localize the source of the flood and, if necessary, block the risers, after which In the magazine dispatch service do relevant record of the cause of the flood and indicate which apartments were damaged.
- Important! The mechanics who arrived are not authorized and competent specialists to inspect the damage and draw up a report on the flooding of the apartment.
clause 108 of the RF GOVERNMENT DECREE of 05/06/2011 No. 354 No. 354 - read
If the employee of the emergency dispatch service of the contractor does not know the reasons for the violation of the quality of the utility service, he is obliged to agree with the consumer on the date and time of checking the fact of the violation of the quality of the utility service. Wherein emergency dispatch worker must immediately upon receipt of the consumer message notify the resource supplying organization, from which the contractor purchases a utility resource to provide utility services to consumers, the date and time of the inspection.
If the contractor is a resource supplying organization that is responsible for the quality of provision of utility services up to the interface between the elements of in-house engineering systems and centralized networks of engineering support, and the emergency dispatch service employee of such an organization does not know the reasons for the violation of the quality of the utility service, he is obliged to agree with the consumer the date and time of the inspection that must be carried out at the location of the specified border. In this case, an employee of the emergency dispatch service of such an organization, if he knows the person hired by the owners of the premises to service the in-house utility networks, is obliged to immediately, after agreeing with the consumer on the date and time of the inspection, bring this information to the attention of such person.
The time for conducting an inspection in the cases specified in this paragraph is assignedno later than 2 hours from the moment of receiving a message from the consumer about a violation of the quality of the utility service, unless a different time is agreed upon with the consumer.
ACT THREE -
Act on the bay of the apartment.
Next, we need to obtain written proof of the flooding of our living space.
Clause 152 of the Decree of the Government of the Russian Federation dated 05/06/2011 N 354 tells us that the necessary Apartment Filling Certificate must be drawn up and signed by the operating organization (engineering staff + approved by the chief engineer + stamped)no later than 12 o'clock from the moment the consumer contacts the emergency dispatch service.
clause 152, 31, 1 of the RF GOVERNMENT DECREE dated 05/06/2011 No. 354 No. 354 - read
clause 152 If the contractor causes damage to the life, health and (or) property of the consumer, the common property of the owners of premises in an apartment building, the contractor and the consumer (or his representative) draw up and sign an act of damage to the life, health and property of the consumer, the common property of the owners premises in an apartment building, containing a description of the damage caused and the circumstances under which such damage was caused.
The specified act must be drawn up by the performer and signed by himno later than 12 o'clock from the moment the consumer contacts the emergency dispatch service. If it is impossible for the consumer (or his representative) to sign the act, including due to his absence from the occupied premises, the act must be signed in addition to the executor by 2 disinterested persons. The act is drawn up in 2 copies, one of which is given to the consumer (or his representative), the second remains with the contractor.
paragraph 31The performer is obliged:
I) accept, in the manner and within the time limits established by these Rules, consumer messages about the provision of utility services of inadequate quality and (or) with interruptions exceeding the established duration, organize and conduct inspections such a fact with drawing up an appropriate inspection report, and if there is harm caused by a violation of the quality of public services, also an act fixing harm caused to life, health or consumer property;
clause 1 « Executor » - a legal entity, regardless of organizational and legal form, or an individual entrepreneur providing utility services to the consumer.
So, at this important stage, my dear Visitor, I propose to dwell in more detail, namely, the preparation of the Act on the flooding of the apartment by the operating organization within the specified period - no later than 12 hours will not raise further questions in the following cases:
- if the culprit for flooding the apartment is the operating organization itself;
- if the culprit of the flood, the owner of the apartment above, is present during the inspection of the flooded apartment below and the preparation of the Flood Act;
- if the flood occurred in work time and working days of the operating organization.
As for carrying out an inspection of the damaged apartment without the alleged culprit of the flood, such a requirement is not provided for by any act. In this case, at the trial he will say that no one warned him, the Act was drawn up in his absence and the Act was declared invalid!
In order to comply with legal formalities, the operating organization, in this case, must invite the culprit in writing in advance for inspection, conduct an examination and may meet the deadline -3 days.
Subsequently, the guilty party will have fewer grounds to challenge the flooding act of your apartment.
If the flood occurred on a Friday evening or on the weekend, the locksmith on duty will localize the source of the flood, but he is not authorized or competent to draw up and sign the Report.
In this case, you and I again have deadlines for drawing up and signing the Act - 3 days.
Apartment Filling Act - Rules for filling it out!
What should the culprit of the bay do? You can't pay to defend yourself!
The basis for completing the study is that issued by the employer.
Labor Code of the Russian Federation. Article 69. Medical examination upon concluding an employment contract Persons under the age of eighteen, as well as other persons in cases provided for by this Code and other federal laws, are subject to a mandatory preliminary medical examination when concluding an employment contract.
Labor Code of the Russian Federation. Article 213. Medical examinations of certain categories of workers Workers engaged in work with harmful and (or) dangerous working conditions (including underground work), as well as in work related to traffic, undergo mandatory preliminary (upon entry to work) and periodic (for persons under the age of 21 years old - annual) medical examinations to determine the suitability of these workers to perform the assigned work and prevent occupational diseases. In accordance with medical recommendations, these employees undergo extraordinary medical examinations.
Employees of food industry organizations, public catering and trade, water supply facilities, medical organizations and child care institutions, as well as some other employers undergo the specified medical examinations in order to protect public health and prevent the occurrence and spread of diseases.
This Code, other federal laws and other regulatory legal acts Russian Federation For certain categories of workers, mandatory medical examinations may be established at the beginning of the working day (shift), as well as during and (or) at the end of the working day (shift). The time spent undergoing these medical examinations is included in working hours.
Harmful and (or) dangerous production factors and work, during the performance of which mandatory preliminary and periodic medical examinations are carried out, the procedure for conducting such examinations is determined by the federal executive body authorized by the Government of the Russian Federation.
If necessary, by decision of local authorities, individual employers may introduce additional conditions and indications for mandatory medical examinations.
Federal laws and other regulatory legal acts of the Russian Federation for certain categories of workers may require medical examinations to conduct chemical and toxicological studies of the presence of narcotic drugs, psychotropic substances and their metabolites in the human body.
Employees carrying out certain types of activities, including those associated with sources of increased danger (with the influence of harmful substances and adverse production factors), as well as those working in conditions of increased danger, undergo a mandatory psychiatric examination at least once every five years in the manner established by the authorized The Government of the Russian Federation is a federal executive body.
The medical examinations and psychiatric examinations provided for in this article are carried out at the expense of the employer.
The document indicates details of the organization and the applicant, the department and position of the employee, the nature of the upcoming activity and the associated risks, the name and address of the medical institution, the type of examination required (when hiring, it will be preliminary). We tell you in more detail about what the referral form for a medical examination looks like.
The employee must report to a medical facility and present your passport and directions.
The patient is issued outpatient card and health passport, certain specialists (endocrinologist, neurologist, psychiatrist, etc.) and examinations (tests, fluorogram, etc.) are prescribed. Where you can get a medical examination, which doctors you need to visit and what tests you need to take, we told you in.
The result of the examination is obtaining conclusions in 2 copies, one of which is attached to the outpatient card, and the second remains with the patient and is given to them at the place of presentation.
The conclusion required for employment is certificate of a unified form - 086/у.
Time to complete
From the point of view of labor legislation, there is no clear deadline for hiring. Typically, all examinations require no more than 3-5 working days.
When registering with an organization, a citizen writes an application, but he is considered officially employed only after signing a bilateral employment contract.
Preliminary inspection must be completed before signing the contract.
For this reason, the absence of a conclusion on the medical examination completed within the time period specified by the employer is grounds to refuse appointment to a position. As a rule, the established period is no more than one week.
How long does a medical examination last for work?
Separately, it should be noted that the question often arises: “How long is a medical examination valid for work?”
Upon employment must be presented medical certificate in form 086/у. Since 2009, a special program has appeared for civil servants form – 001-ГС/у.
A regular certificate is valid for 6 months. According to the form help 001-GS/u for A medical examination for work is valid for 12 months.
Schedule a repeat medical examination
A repeated medical examination upon hiring is appointed by the enterprise’s human resources department for the following reasons:
- During the period of validity of the medical examination upon hiring a person suffered a serious illness or surgery. In this case, it becomes necessary to undergo a new examination and obtaining a new report. Changes in a person's health status that have occurred after receiving the certificate, may lead to his professional unsuitability in the chosen field. For this reason, past results become irrelevant.
- During the validity period of the certificate, a person changed place of employment. For example, an employee underwent examination in the direction of the organization, but after receiving the certificate he changed his mind about working in the chosen place. The remaining medical report with valid period A person can bring his suitability to a new place, but, as a rule, human resources departments refuse to accept such a certificate. It's connected with different conditions labor, with different requirements for the list of examinations and examinations of specialists.
For objective reasons, the employer doubts in data reliability about the health status of the future employee.
A repeat examination is scheduled for the purpose of checking the results obtained. Often it includes examination by additional specialists, new tests, etc.
A person is being examined in a medical facility other than the one to which he was referred.
In most cases, HR departments do not accept certificates received from third parties medical institutions.
Time for re-examination
Deadlines repeat inspections are established by the employer and usually do not exceed one week.
Reluctance of the applicant for the position to be re-received current medical board to work in deadlines leads to refusal of his employment.
Thus, a valid pre-employment medical examination is a prerequisite in cases established by law.
The result of passing a medical examination when applying for a job is obtaining a certificate in a unified form, having an expiration date.
