An experience of organizing activities of Emergency and Elective Advisory Service and Medical Evacuation Department under ongoing armed conflict (an example of Luhansk People’s Republic of Ukraine)

Abstract

Relevance. Timely tertiary assistance is the most important predictor of victim survival; for this, fairly fast patient transfer directly to a specialized institution or rapid arrival of highly qualified doctors are required. Here, rescuers and medical personnel should cooperate. However, so-called sanitary aviation defined as a single service of the Ministry of Emergency Situations and the Ministry of Health actually cannot operate in the Luhansk People’s Republic (LPR), Republic of Ukraine, during the armed conflict. Functions of sanitary aviation in the LPR are assigned to the Emergency and Elective Advisory Service and Medical Evacuation Department of the Lugansk Republican Center for Emergency Medical Care and Disaster Medicine (Center). Intention. Summarize the experience of organizing the work of the Emergency and Elective Advisory Medical Aid and Medical Evacuation Department of the Lugansk Republican Center for Emergency Medical Care and Disaster Medicine over the first year of operation. Methodology. The sources of information for this purpose were official statistical data (plans and reports of the Center, reports of public health institutions of the LPR). Results and Discussion. The analysis showed that emergency and planned consultative specialized medical assistance to individuals in the territory of the LPR in the context of unfinished armed conflict is rendered both outside the health care institution, and in the settings of any LPR hospital free of charge round-the-clock and without delay in the mode of daily activities and high availability. More than 75 highly qualified medical professionals work in the department of the Center, of which 9 have doctorate degrees. For their transportation, specialized sanitary vehicles with up-to-date equipment are used (based on the Peugeot Boxer and Ford Transit). However, their deficiency amounts to 90%. On-site and further assistance in the evacuation process includes various interventions, anesthesia and intensive care, and television and medical technology. In general, over 2016 the Department received 1230 calls, of which 640 – from medical institutions in Lugansk, the rest – from the regions of the Republic. At the same time, 1336 patients (956 adults and 380 children) were examined and 249 surgical procedures were performed on site (195 adults and 54 children). The staff of Center also deliver medical equipment, blood, medicines etc. to the health care institutions of the LPR. The Center significantly improved the quality of tertiary medical care for the population in case of sudden diseases and life-threatening conditions in remote areas of the LPR. Conclusion. It is necessary to resolve issues with modern equipment of sanitary transport, training in emergency medical care using algorithms with proven effectiveness, as well as establishing interactions between the specialists of the Center and the health care institutions of the LNR to improve the outcomes of medical and sanitary care for the population of the LPR in the context of the unfinished armed conflict.