EMERGENCY MECHANICAL VENTILATION IN RUSSIAN MEGAPOLIS AMBULANCE PRACTICE

Abstract

Mechanical ventilation (MV) is most important integral part of the prehospital treatment of severe acute respiratory failure (ARF). Intuitively, better patient outcomes may be achieved when MV is applied promptly in the prehospital setting, but there are few studies to validate its use in this setting. To evaluate the mod- ern situation with emergency respiratory support, providing by ambulance brigades at Russian major city. Materials and methods: 250 ambulance physicians self-esteemed their theoretical and practical knowledge with a help of questionnaire. Indications for MV in prehospital settings and its features were evaluated dur- ing retrospective analyses of 141 ambulance brigade missions. Results: According to the results of our sur- vey, most of ambulance physicians estimated their theoretical and practical knowledge in MV as insuffi- cient. Most common indications for emergency MV were cerebral stroke and brain trauma, complications of coronary heart disease, severe pneumonias and acute intoxications. All patients got invasive MV. Most often VC-CMV (81%) and VC-SIMV (16%) modes of MV were used. The average duration of MV in survi- vors (128 of 141) was 85±19,7 minutes. Conclusion: Improvement in ambulance staff theoretical knowl- edge and practical skills in MV are needed. Noninvasive MV could be recommended for more often use in Russian prehospital settings. Such modes of MV, as CPAP, PC-CMV and PSV should be recommended for implementation to transport ventilators