Problematic issues on interregional evacuation of casualties during emergencies: results of an expert survey

The purpose of the study. Based on the data of a multicenter expert survey, to develop and substantiate the organizational and methodological framework for conducting interregional medical evacuation of patients and casualties during emergencies within the general system of medical evacuation support. 
Objectives of the study. Using expert assessments, to identify the main deficiencies of the current system of interregional medical evacuation of patients and casualties in emergencies and to formulate priority directions for improving its organizational and methodological support. 
Materials and methods. А semi-structured expert survey was conducted among 1,034 medical specialists from 100 cities and towns of the Russian Federation (physicians — 59.86%; nursing and paramedical personnel — 40.14%). Roles in interregional medical evacuation were distributed as follows: executors — 77.10%; managers — 5.12%; combined managerial and executive roles — 17.78%. A professional experience of more than 10 years was reported by 69.08% of respondents. Clinical bases included the Federal and Territorial Centers for Disaster Medicine (FCEMC, TCEMC), Regional Centers for Disaster Medicine (RCEMC), ambulance stations and departments, and other medical organizations performing field-based medical work. 
Results. Experts identified the following key problem areas: insufficient coordination between referring and receiving hospitals; inadequate clinical readiness of patients for transportation; mismatch between the profile and equipment of medical evacuation teams and the tasks of prolonged evacuation; imperfect medical documentation; shortage of specialized training materials; and insufficient professional preparation of medical personnel. Proposed solutions include: development and implementation of unified medical documentation forms allowing dynamic recording of patient condition and interventions; establishment of a single algorithm for interregional dispatch coordination; modular optimization of the material and technical equipment of medical evacuation teams; and the introduction of targeted programs of continuing professional education and simulation-based training for field medical specialists.

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