Analysis of medical evacuation of victims with shock-gene injuries received in road traffic accidents on the federal highway M-8 «Kholmogory» to the trauma center at the basis of the level III medical organization of the Arkhangelsk region

The article presents an analysis of the medical evacuation of victims with shock-producing injuries sustained in road traffic accidents (RTA) on the federal highway (FH) M-8 «Kholmogory» to a trauma center created in one of the Arctic regions of Russia. The aim of the study was to identify the features of the medical evacuation of victims of RTA on FH M-8 with severe trauma accompanied by shock to a trauma center based on a level III medical organization —  Arkhangelsk Regional Clinical Hospital (ARCH) to develop recommendations for improving evacuation measures. Materials and methods of the study. According to the criteria for describing a series of cases, a retrospective analysis of medical documents of 49 victims of RTA on FH M-8 «Kholmogory» who received severe shock-producing trauma and were admitted for treatment to the trauma center of ARCH was carried out. Results. It was established that 17 (35%) of the victims of the accident on the M-8 Kholmogory Federal Highway with severe shock-producing injuries were delivered to the AOKB trauma center within the first «golden» hour, and 95.5% of the injured were admitted within the first 24 hours from other trauma centers based at medical organizations located far from the AOKB and having areas of responsibility on the M-8 Federal Highway. Automobile and air medical transport were used to evacuate the victims. In general, in the Arkhangelsk Region (AO) there is an extremely uneven distribution of forces and means for providing emergency care, including emergency specialized medical care, to victims with shock-producing injuries on the M-8 Federal Highway and their evacuation to the AOKB trauma center due to the significant length of the federal highway (about 600 km). Conclusion. The conducted analysis of medical evacuation of victims of the road accident on the M-8 Kholmogory federal highway with shockproducing injuries to the trauma center of the Arkhangelsk Regional Clinical Hospital showed that at present it is advisable to: organize mobile route points on the federal highway in the Kholmogory, Vinogradovsky and Shenkursky districts to provide emergency, including emergency specialized medical care, to those seriously injured in road accidents; strengthen the personnel and logistical support of these hospitals in terms of creating emergency medical care teams (EMC) based directly on the territory of the specified medical treatment organizations (MTO); ensure the fulfillment of the target indicators of the «Strategy for the Development of Medical Aviation in the Arkhangelsk Region until 2024»; improve the development of telemedicine for the implementation of consultations by leading specialists of the AOKB for victims of road accidents with severe shock-producing injuries who are being treated at the LMO AO, to resolve the issue of involving, if necessary, qualified specialists (anesthesiologists, traumatologists, and in some cases, others) to provide specialized medical care to victims and resolve the issue of evacuating the latter to the trauma center of the AOKB.

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