Creation and Establishment of the State Emergency Medical Services and Disaster Medicine Services in Russia (to the 100th Anniversary of the N.V. Sklifosovsky Research Institute for Emergency Medicine)

Abstract

After the October Revolution of 1917, the creation of the state healthcare and medical education system in the country played a decisive role in the organization of emergency medical services (EMS) in Moscow on the basis of the former Sheremetev Hospital which later became a large multidisciplinary medical institution — N.V. Sklifosovsky Institute of Emergency Medicine (since 1943 — N.V. Sklifosovsky Research Institute for Emergency Medicine), — and the city EMS station as a part of it.In the pre-war period, the working out of the main principles for the EMS provision was critically important for the development of the services. It became possible to solve scientific and methodological problems related to the training of specialists. The Institute grew into a large institution, research in the field of emergency medicine was carried out at the world level. This contributed to the organization of a network of EMS institutions in the country during 1926–1935.The years of the Great Patriotic War of 1941–1945 enriched the practice of providing emergency medical care, including during mass patient admission.In the post-war years (1946–1970s), the Institute became the leading institution on the problems of EMS in the country. Corresponding divisions were created within the Institute, and on its basis — “Emergency Medicine” scientific and practical association, research and organizational structures of the USSR Ministry of Health, the RSFSR Ministry of Health and the USSR Academy of Medical Sciences. Thanks to this, outstanding results were achieved in the EMS organization: the specialty of “emergency medicine physician” was introduced; emergency hospitals were created in a number of the country’s regions; government programs for EMS provision were successfully implemented; а large number of regulatory documents were prepared to facilitate the further EMS development.N.V. Sklifosovsky Research Institute for Emergency Medicine was among the main initiators of the disaster medicine service, which made it possible to fundamentally solve its organizational and technical problems. Thus, a significant contribution was made to the foundation of this service in Moscow and around the country.At the current stage (from 1992 to the present), EMS improvement has been continued, many developments turned out to be relevant for this services in the Russian Federation. In particular, the created structure of the Institute’s admission and intensive care unit remained the flagship among emergency care institutions in the country for about 20 years. The state program “Improving medical care for road accident victims” was successfully implemented. The Institute’s departments are being actively specialized, making it possible to obtain fundamentally new scientific and practical results for widespread implementation.Since 2011, “Scientific achievements in the field of emergency medical care in the Russian Federation” - collections of research works - have been published annually. The information presented in them can be used throughout the country.The experience in treatment for the novel coronavirus infection COVID-19 allowed the Institute to begin a new page in the history of emergency medical services.The recent opening of an emergency inpatient complex at the Institute contributed to optimizing the work of the hospital’s resuscitation and intensive care units and expanding their treatment and diagnostic capabilities.For more than 10 years, the public and consolidating activities of the scientific and practical society of emergency medicine specialists have been effective. Its work primarily concerns the organization and conduct of scientific and practical events, especially congresses of emergency medicine physicians, as well as the publication of Sklifosovsky Journal Emergency Medical Care, which has unifying significance for a large number of Russian specialists in the field of EMS. The decisions made at the congresses and conferences became the basis for expanding the introduction of advanced medical technologies in the Russian regions, as well as for carrying out important structural reforms in EMS institutions.One of the main achievements of the N.V. Sklifosovsky Research Institute for Emergency Medicine is the creation of the state EMS as a separate branch of healthcare in the country. Over the 100 years of the Institute’s activity, the foundations of its theory and practice have been developed, moreover, a contribution of world significance was made to the EMS development, thereby strengthening the scientific foundation for the activities of the Institute for many years to come.