Epidemiological characteristics of the shockogenic trauma in the Arctic and Subarctic zone of the Arkhangelsk Region

Abstract

Relevance.The harsh climate and remoteness of settlements make it difficult to provide emergency medical care to victims with a shockogenic injury in the regions of the Arctic zone of Russia. Intention. To analyze the medical and social characteristics of victims with a shock injury admitted to all the medical organizations of the Arkhangelsk region in 2002 and in 2008–2013, after organization of a first level trauma center at the Arkhangelsk Regional Clinical Hospital. Methodology. Medical documents from 140 victims with shock injuries aged 18 years and older (2008–2013, Group 1) and 104 victims (2002, Group 2) were analyzed. Source documents: work sheets for examining victims with a shock injury, inpatient medical records (Form No. 007/y), accompanying coupons from the ambulance (Form No. 114 / y). Results and Discussion. Road traffic injuries dominated among the shockogenic injuries in both groups. More than 30 % of road traffic injuries occurred on the federal motorway M-8 within 250 km from the city of Arkhangelsk. The greatest share of injuries occurred after 4 p.m, on Saturdays and Sundays and in winter in both groups. Among all the shock injuries, combined injuries comprised 51.8 %, 67.9 %, isolated ones – 38.4 and 21.4 %, multiple ones – 9.8 and 10.7 % in groups 1 and 2, respectively. There is an increase in the number of victims aged 20–29 years (p = .012) compared to 2002. The share of victims with alcoholic intoxication has practically not changed. About 1/3 of the injured had alcoholic intoxication. Conclusion. Since e most shockogenic injuries occur in winter under the severe Arctic climate, additional means should be provided for supporting life of the victims (heating, small-volume infusions, etc.). The analysis revealed the need for a single algorithm for diagnosis and treatment of victims with a shockogenic injury in the Arkhangelsk region.