Abstract
The purpose of the study is to analyze and evaluate the decisions of specialists of regional Services for disaster medicine (SMK) of the country on the application of routing principles during medical evacuation and to identify ways to improve the quality and effectiveness of medical evacuation measures (LEM) under various conditions of emergency situations with a large number of victims. Materials and methods of research. The research is based on 85 solutions to actual problems "100 victims" with different structure of the lesions according to their location and severity, with different proportion of adults and children and different locations of emergency with the use of technology case method (Case study) and SWOT analysis of medical evacuation events in liquidation health impacts of various emergency situations. The results of the study and their analysis. Medical specialists who took part in solving situational tasks-cases, and experts of the Staff of the All-Russian Service for Disaster Medicine (VSMK) identified a fairly large number of factors that affect the quality of medical evacuation measures in emergencies, which, in relation to SWOT analysis, can be structured into "internal"- strong and weak, and "external" – increasing the possibility of quality medical evacuation measures or increasing the risk of adverse outcomes. The analysis of the factors identified, in relation to the conduct of medical evacuations in the event of an emergency in the city, suburban area and in a remote area – more than 50 km from the city - revealed the strengths and weaknesses of each option: - when conducting medical evacuation in the city - the prevalence of strong "internal" sides and the presence of certain risks; - when conducting medical evacuation in the event of an emergency in a suburban area – similar positions, but with a number of differences that affect the routing; - when an emergency occurs in a remote area – a large number of weak "internal" factors and "external" risks are compensated by the available opportunities. In all cases of emergency, a weighted score of factors was carried out. As a result of the SWOT analysis, the goal was achieved – the directions of improving medical evacuation measures for the development of a strategy for "breakthrough", "development", "defense" and "containment" in each case of an emergency were identified.
Highlights
Disaster Medicine No 12021 effectiveness of medical evacuation measures (LEM) under various conditions of emergency situations with a large number of victims
The research is based on 85 solutions to actual problems "100 victims" with different structure of the lesions according to their location and severity, with different proportion of adults and children and different locations of emergency with the use of technology case method (Case study) and SWOT analysis of medical evacuation events in liquidation health impacts of various emergency situations
Medical specialists who took part in solving situational tasks-cases, and experts of the Staff of the All-Russian Service for Disaster Medicine (VSMK) identified a fairly large number of factors that affect the quality of medical evacuation measures in emergencies, which, in relation to SWOT analysis, can be structured into "internal"- strong and weak, and "external" – increasing the possibility of quality medical evacuation measures or increasing the risk of adverse outcomes
Summary
Отсутствие мобильных медицинских формирований – ММО, БЭР, ПМГ Lack of flexible medical units – MMO, REM, PMG. Примеры «внешних» факторов, дающих возможность (O) повысить уровень эффективности и качество проведения ЛЭМ в ЧС при организации лечебно-эвакуационного обеспечения (ЛЭО). 1. Развитие интернета, улучшение покрытия сотовой связью, 3G, 4G, в перспективе – 5G. 2. Обеспечение транспортных, в том числе немедицинских, средств системой Глонасс. 3. Наличие новых медицинских технологий (оборудования), позволяющих снизить численность медицинского персонала. 4. Проведение регулярных, в том числе межведомственных, учений, тренингов медицинского персонала и пр. 6. Развитие системы дистанционного обучения – доступность образования. 7. Развитие системы менеджмента качества и безопасности медицинской деятельности при выездных формах работы. 9. Объединение ТЦМК, станций СМП и создание РЦ СМПиМК, позволяющее объединить организационные, кадровые и материально-технические ресурсы для проведения более эффективных ЛЭМ. Продолжительность медицинской эвакуации c места ЧС до ЛМО 1-го, 2-го, 3-го уровня, среднее значение, ч. Duration of medical evacuation from the emergency site to the medical organization (LMO) of the 1st, 2nd, 3rd level, average values, hour
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