Совершенствование оказания скорой медицинской помощи пострадавшим в дорожно-транспортных происшествиях на федеральной автодороге в регионе России с низкой плотностью населения

Abstract

The aim of the study is to substantiate the necessity of a set of measures to improve medical care to the victims of road traffic accidents on federal highways in Russian regions with low population density on the basis of the developed system of medical care provision. Materials and research methods. Using the method of organizational experiment, we carried out the scientific substantiation and development of measures the implementation of which will improve the efficiency of first aid and medical care to the victims of road accidents on the federal highways in the regions of the Russian Federation with low population density. Materials of the study — a sample of 206 medical records of patients admitted for urgent indications after an accident on the federal highway M-8 “Kholmogory” to medical organizations of the Arkhangelsk region and who received medical care in hospital conditions (form 003/u) in the periods from January 1 to December 31, 2016 and from January 1 to December 31, 2018. Record forms were selected according to the criteria of retrospective continuous documentary observation — all medical histories of accident victims who received inpatient care during the study periods were selected. Inclusion criteria for the study were: Gender — male and female. Victims of road accidents on the sections of the federal highway M-8 “Kholmogory” in the Arkhangelsk region who received in-patient treatment. Trauma was got in the specified periods. Exclusion criteria for the study: Age — less than 18 years. No previous traffic accidents trauma. Categorical variables were used for statistical analysis and presented as percentages. The Pearson Chi-square test was used to determine if there was a relationship between the categorical variables. Statistical processing of the data was performed using a package of applied statistical programs SPSS 22. Study results and their analysis. Implementation of new approaches to the organization of medical care for victims of traffic accidents on the federal highway M-8 “Kholmogory” led to an increase by 2018 compared with 2016: of share of timely (up to 1 hour) delivery of ambulance crews to the place of the accident; of share of victims to whom specialists of ambulance crews performed anesthesia, transport immobilization, intravenous infusion of antishock drugs, as well as the creation of a regional competence center in the Level I trauma center and, consequently, an increase in the number of consultations for victims with polytrauma and in the number of medical evacuations of victims with polytrauma, performed to the Level I trauma center.