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Discussions surrounding the work of emergency ambulance services in Kazakhstan frequently surface on social media, often leading to confusion about the scope of care provided. Many individuals question why medical professionals might not administer pain relief injections or appear to offer only a cursory examination, while others defend the medical staff, emphasizing their role in handling only critical situations.

To address these concerns, TengriHealth reporters have investigated the specific assistance patients can expect and the defined duties of emergency medical teams.

Navigating Online Debates: "No Injection," "My Stomach Hurts"

A common point of contention among Kazakhstanis revolves around whether ambulance services have ceased providing on-site treatments or if their functions are strictly limited to emergencies. Online discussions reveal instances where paramedics reportedly declined to assist someone experiencing hysterics due to alcohol intoxication, advising the caller to contact the police instead. Another complaint voiced online questioned, "Why didn't the paramedics give a pain-relieving injection? It seems they just came to assess the situation."

Conversely, many online comments highlight that ambulances should not be called for non-urgent matters, with some users likening the service to a taxi. It is also noted that pain relief medication should only be administered when medically indicated.

Four Categories of Calls: From Cardiac Arrest to High Fever

According to the Ministry of Health, the reasons for calls and the extent of medical assistance are governed by the rules for providing emergency medical care. Doctors adhere to clinical protocols, prioritizing the stabilization of the patient's condition.

All calls are categorized into four priority levels, which determine the response time and actions of the medical team.

Category 1 and 2: Life-Threatening Situations (10-15 minutes)

These critical situations include loss of consciousness, respiratory arrest, severe multiple injuries, significant bleeding, burns, complicated labor, cardiac arrhythmias, poisoning, and psychotic episodes. In such cases, doctors are obligated to examine the patient immediately, assess their condition, measure vital signs like blood pressure, pulse, and oxygen saturation, and perform an ECG if necessary. Resuscitation efforts, airway management, medication administration (injections, infusions), hemorrhage control, and immobilization may be initiated. The patient is then transported to a hospital if deemed necessary.

Category 3: Moderately Severe Conditions (30 minutes)

This category covers acute abdominal pain, physiological labor, high fever (above 38 degrees Celsius) in young children and pregnant women, vomiting and diarrhea, and limited burns in children. The medical team will examine the patient, conduct basic diagnostics, provide symptomatic treatment (such as antipyretics or pain relievers), and administer injections if required. Hospitalization may be recommended.

Category 4: Non-Urgent Calls (60 minutes)

This category includes minor injuries, acute inflammatory and allergic conditions, exacerbations of chronic diseases not posing an immediate threat to life, and high blood pressure that does not require immediate intervention, as well as high fever manageable at home. Doctors will assess the patient, offer recommendations, and advise seeking further care at a local clinic. Hospitalization is typically not required for these cases.

Furthermore, new regulations for handling Category 4 calls were implemented in Kazakhstan starting May 1, 2025. Mobile teams from local clinics are expected to respond to these calls between 8:00 AM and 8:00 PM. After 8:00 PM and on weekends, all calls, including Category 4, are handled by ambulance crews.

Medications Available on Ambulance Brigades

The Ministry of Health states that ambulance crews are equipped with a mandatory minimum set of medications and medical devices defined by regulations. This kit is designed to provide timely and quality emergency and urgent medical care to patients before they reach a hospital.

The standard kit includes various supplies. A comprehensive list of medications and medical devices for emergency medical stations can be found via the provided link.

When Can Refusal of Service Occur?

The Ministry of Health clarified that medical teams may decline to perform certain procedures if there is no medical indication. "Requests to perform planned medical procedures may be refused, as these procedures are typically carried out at primary healthcare organizations or by a district doctor at home," explained ministry representatives.

For non-urgent calls, medical personnel provide necessary assistance at the scene and offer recommendations for follow-up care at the patient's registered clinic. In all circumstances, ambulance doctors and paramedics strive to provide the best possible care and do not refuse patients without significant justification.

Previously, it was reported that Kazakhstan planned to change the rules for registering with local clinics.