Medical Stations Research Articles

Становление и развитие системы здравоохранения в Горном Алтае в 1930-е гг.

The Altai Mountains were one of the national outskirts of Russia to which special attention was paid, as the indigenous population suffered particularly from epidemics due to their low standard of living and lack of immunity to many diseases. The meagre local budgets severely affected the population's material situation, social and medical services and led to an increased rate of disease. The Soviet authorities began to solve urgent problems in the sphere of public health protection. A consistent policy of the state in this sphere was expressed in the provision of sanitary and epidemiological well-being of the country, addressing the problems of the indigenous peoples of the national regions. The establishment and development of the health care system in the Altai Mountains took place in the context of measures taken by the state to solve these problems. With the help of state and local budgets, the organisation of the medical network emerged and developed, and certain socially dangerous diseases were successfully eliminated. The material and technical base of medical institutions was gradually formed. During this period the following important results in the field of health care have been achieved in the Altai Mountains: a wide network of stationary and mobile medical institutions: hospitals, medical and obstetric stations, antenatal clinics, specialized anti-epidemic institutions and sanatoriums; systematic training of medical personnel had started: medical staff was supplemented mainly through medical staff training, another way of training was the sending of fellows to higher and technical schools. These measures are an important step in the development of the health care system in the region. However, the regional characteristics of Oirotia, namely the patriarchal clan structure of much of the indigenous population, the nomadic way of life, the dispersion of the population and the small number of large settlements, have to a certain extent hindered the process of health care among the indigenous population.

SPHA-VC: Secure passengers health assessment via vehicular communications

Passenger health evaluation is a vital aspect of smart city applications. Remotely monitoring driver and passenger health save lives. Vehicular Ad Hoc Network (VANET)-assisted Internet of Things (IoT) will be an excellent option in that periodic vehicle health information will be sent to a nearby medical Base Station (BS). VANET communications are in an open wireless channel, making them subject to attacks against patient privacy. VANET-based healthcare monitoring systems must provide timely supervision with end-to-end security. Providing cost-effective healthcare utilizing dynamic and vulnerable VANET connections is a smart city research challenge. We propose novel Secure Passengers Health Assessment via Vehicular Communications (SPHA-VC) protocol to provide Quality of Service (QoS) efficient emergency medical information transmission with high security and privacy preservation. The SPHA-VC is consisting of security and privacy preservation-aware routing algorithms for IoT-based passenger health assessment connected with the VANETs. First, we design a reliable route formation algorithm using Artificial Intelligence (AI). Second, we propose a lightweight cryptography mechanism to achieve secure end-to-end medical data transmission. The reliable routing formation algorithm using Fuzzy Logic (FL) is integrated with Elliptic Curve Cryptography (ECC)-based secure data transmission mechanism. SPHA-VC's purpose is to accomplish secure communications in IoT-enabled VANETs and vehicle privacy reserving to guard against various cyber security threats using new FL-based reliable route formation and ECC-based secure data transfer. The simulation results revealed the efficiency of the SPHA-VC compared to state-of-the-art methods.

Incidence and risk factors of acute mountain sickness in grid construction personnel working at plateau

Objective: To analyze the incidence and risk factors of acute mountain sickness (AMS) in grid construction personnel working at plateau. Methods: A total of 10 956 plateau construction personnel of Ali Network Project from January 1, 2019 to December 31, 2020 were included. Baseline information (including age, sex, body mass index, developmental and nutritional status, relevant clinical indicators, etc.) and follow-up data of AMS were obtained from the medical record of Ali Internet engineering staff medical station. The altitude of the residence place in early life and the working environment were obtained from the website (https://zh-cn.topographic-map.com/legal/). The incidences of overall AMS and its subgroups were calculated, and the Cox proportional hazards model was used to explore the risk factors for AMS. Results: The age of the participants was (36.1±10.5) years old at baseline, and 95.27% (10 438) of them were males. The follow-up time was (17.46±4.23) months. The altitude of the residence place in early-life and working environment were (1 959±937) m and (4 533±233) m, respectively. During the follow-up period, the incidence of AMS was 15.58% (1 707 cases), and the incidence for acute mountain sickness and high altitude pulmonary edema were 15.53% (1 702 cases) and 0.05% (5 cases), respectively. No high altitude cerebral edema patients were found. Cox proportional hazards model showed that the risk of AMS increased by 45% for every 100 m elevation in the altitude of working environment [HR (95%CI): 1.45 (1.41-1.51)]. The higher the altitude for the residence place in early-life, the lower the risk of AMS [HR (95%CI): 0.84 (0.80-0.88)]. Compared with the group with oxygen saturation during 90%-94%, the participants with oxygen saturation<75% [HR (95%CI): 1.67 (1.24-2.23)] at baseline was also associated with increased risk of AMS. Conclusions: The incidence of AMS is relatively low in grid construction workers working on plateau. The risk factors of AMS included higher working altitude, lower altitude of the residence place in early-life and oxygen saturation<75%.

Urban-sub-urban-rural variation in the supply and demand of emergency medical services.

Emergency medical services (EMSs) are a critical component of health systems, often serving as the first point of contact for patients. Understanding EMS supply and demand is necessary to meet growing demand and improve service quality. Nevertheless, it remains unclear whether the EMS supply matches the demand after the 2016 healthcare reform in China. Our objective was to comprehensively investigate EMS supply-demand matching, particularly among urban vs. sub-urban vs. rural areas. Data were extracted from the Tianjin Medical Priority Dispatch System (2017-2021). From supply and demand perspectives, EMS resources and patient characteristics were analyzed. First, we performed a descriptive analysis of characteristics, used Moran's I to explore the spatial layout, and used the Gini coefficient to evaluate the equity of EMS supply and demand. Second, we analyzed urban-sub-urban-rural variation in the characteristics of EMS supply and demand by using the chi-square test. Finally, we examined the association between the EMS health resource density index and the number of patients by using the Spearman correlation and divided supply-demand matching types into four types. In 2021, the numbers of medical emergency stations and ambulances were 1.602 and 3.270 per 100,000 population in Tianjin, respectively. There were gradients in the health resource density index of the number of emergency stations (0.260 vs. 0.059 vs. 0.036; P = 0.000) in urban, sub-urban, and rural areas. There was no spatial autocorrelation among medical emergency stations, of which the G values by population, geographical distribution, and the health resource density index were 0.132, 0.649, and 0.473, respectively. EMS demand was the highest in urban areas, followed by sub-urban and rural areas (24.671 vs. 15.081 vs. 3.210 per 1,000 population and per year; P = 0.000). The EMS supply met the demand in most districts (r = 0.701, P = 0.003). The high supply-high demand types with stationary demand trends were distributed in urban areas; the low supply-high demand types with significant demand growth trends were distributed in sub-urban areas; and the low supply-low demand types with the highest speed of demand growth were distributed in rural areas. EMS supply quantity and quality were promoted, and the supply met the demand after the 2016 healthcare reform in Tianjin. There was urban-sub-urban-rural variation in EMS supply and demand patterns.

Материалы Е. Д. Прокофьевой о системе здравоохранения на р. Таз в 1921-1963 гг.

The article studies healthcare system of the Northern Selkups in the period of active socialist transformations (1921–63). This topic has not been detailed in the scholarship, hence the scientific significance and novelty of the study. Its relevance is enhanced by its usefulness to the Selkups, who are in search of new forms of ethnic identity, and to officials responsible for the northerners’ health, to whom it transfers historical experience of creating a healthcare system in the Far North. Its objectives include consideration of the chapter “Healthcare” from an unpublished monograph by the Siberian ethnographer E. D. Prokofieva, provisionally titled “Selkups”; it is stored in the archive of the Museum of Anthropology and Ethnography (Kunstkamera) of the Russian Academy of Sciences. The chapter is based on materials collected by E. D. Prokofieva during her expeditions to the Northern Selkups in 1925–28 and in 1962. The study of E. D. Prokofieva’s manuscript has used comparative historical method. The following conclusions have been drawn: The healthcare system creation in the Northern Selkups area began with establishment of paramedic position for the Taz tundra population; The next step was opening of medical and obstetric stations (in settlements that emerged in the 1930s) and a hospital (in the district center, Krasnoselkupsk); The doctors used medical aviation: sanitary aircraft took emergency and difficult patients to the medical facilities in Salekhard; Medics were sent to the Krasnoselkupsk district after concluding education. Despite difficulties and failures, the health care system of the Krasnoselkupsk district, built in 1921–63, continues to function. It has reached a new qualitative level and significantly improved its indicators in fighting diseases. E. D. Prokofieva’s manuscript contains valuable data; its analysis introduces into scientific use a new source on the history and ethnography of the peoples of Siberia.

“The Life of the Russian Settlers Here Turned Out to Be, However, a Difficult Ordeal for Them”: the First Attempts to Provide Medical Care to Russian Settlers in the Astrabad Province

The article is devoted to the initial stages of the organization of medical care for Russian settlers and the local population in the Astrabad province of Iran on the eve and during the First World War. Archival and published materials show the interaction of various levels and government structures of the Russian Empire on the organization of medical care for settlers, the complexity of this interaction, the activities of Red Cross detachments in Persia, and then the beginning of the activities of permanent medical and paramedic stations. It is shown that the organization of medical care to the population was due not only to practical considerations, but also to the influence of the ideas of the civilizing mission of Russia.

Современные проблемы розничной торговли лекарственными средствами через обособленные подразделения медицинских организаций в Новосибирской области

Introduction. Low population density, complexity of drug delivery, a low level of solvency of rural population, the insufficiently developed infrastructure of pharmaceutical care, shortage of pharmaceutical specialists in municipal districts make remote territories unattractive for the development of retail trade of medicines, whereas the inconsistency of state programs for social and economic development of rural areas, the timing of their implementation, different departmental orientation, insufficient funding do not allow achieving the targets, which requires an in-depth study of the problems and determining the directions for optimizing retail trade of medicines. Aim. The study of modern problems of retail trade of medicines via separate divisions of medical facilities in the Novosibirsk region (NR). Materials and methods. The sources of information were the main health indicators of the NR for 2022, departmental materials of the Ministry of Health of the NR, questionnaires of primary care workers, the register of licenses for pharmaceutical activities in the NR, financial reports of the central district hospitals of the NR for 2022 for 30 municipal districts of the region. According to specially designed questionnaires, 95% of the total number of primary care workers involved in the retailing of medicines via separate divisions of the NR medical organizations (917) were interviewed. Results. In one third (9) of the municipal districts of the NR, the population served by one pharmacy organization is 3057 people, which is characterized as very high and corresponds to low geographic availability of pharmaceutical care. The average number of rural population served by one pharmacy organization in municipal districts in 2022 was 2138 people. According to the number of rural residents per one medical and obstetric station (MOS), the first, second and third groups of municipal districts are the most numerous and available (a total of 22) in which there are from 278 to 531 residents per one MOS, which is 73.33%, and in the rest 8 (26.66%) municipal districts, the average number of rural residents ranges from 718 to 1051, thus exceeding the indicator of the 1st group by 3.78 times. The most cost-effective are the drugs included in the first priority group (398 trade names (TN)) which has high indicators in terms of the amount of drugs sold and the number of packages dispensed, but the proportion of drugs of this group is small – 10.75%. The second priority group included 687 TN. The group has average indicators, it accounts for 18.55%. The third priority group consists of drugs with low indicators in terms of the amount of drugs sold and number of packages dispensed (2618 TN; the group’s proportion is 70.70%). The survey of primary care workers showed that only 20.7% of respondents are satisfied with the level of knowledge and skills they have. Primary care workers of MOS experience the greatest difficulties in the order of prescribing medication, accounting and storage of drugs, medical devices and other goods of pharmacy range (57.8%). Conclusion. As a result of the study, 6 groups of municipal districts were identified according to the geographic availability of retailing entities for the subsequent formation of individual development trajectories. The analysis of the realized range of drug allowed us to develop proposals for its optimization for retail trade via MOS. The results of the survey of primary care workers require the development of additional training programs for the retail trade of medicines, making reasonable management decisions to optimize retail trade.

Analysis of Health and Demographic Data of the Rural Population of the Aiyrtau District

The task of restructuring the network of medical organizations, taking into account regional characteristics, in order to ensure maximum accessibility of medical care, fell into the national project "Quality and affordable healthcare for every citizen "Healthy Nation". The purpose of the study: to assess the availability of medical care for the rural population based on the analysis of medical and demographic indicators of the Aiyrtau district. Methods. In this study, in order to analyze the medical and demographic situation of the rural population of the Aiyrtau district, as well as to determine the accessibility of the healthcare system for the rural population, statistical data, accounting and reporting documentation of medical organizations were studied. Demographic indicators, morbidity rates, the number of medical institutions in the region, the equipment ofmedical organizations, the provision of medical workers, etc. were analyzed. Results. Medical and demographic indicators do not reach republican values. The overall mortality rate (15.87 per 1000 people) is 1.6 times higher than in the republic (9.53 per 1000 population). The birth rate (12.27 per 1000 population) is 1.9 times lower than the republican level (23.41 per 1000 population). Over the past 5 years (from 2017 to 2021), the birth rate in the region has decreased by 6.4% from 13.11 to 12.27 per 1000 population (Kazakhstan - a decrease of 7.5%). When studying the mortality rates of the population, a similar situation is observed, when in 2021 there was an increase to 15.07, and in 2022 it decreased by 10.6% to 13.46 per 1000 population. The total number of diseases was 23710, the leading position, as well as throughout the country, is occupied by respiratory diseases - 9519 (40.1%), followed by diseases of the circulatory system - 5348 (22.5%), endocrine diseases - 1844 (8%), followed by diseases of the digestive system - 880 (5.1%), neoplasms - 522, infectious and parasitic diseases - 427, injuries, poisoning - 422 (2.7%) and congenital anomalies (malformations), deformities and chromosomal disorders - 188 (1.79%). The healthcare system of the region is represented by 19 hospitals, 63 outpatient organizations (58 outpatient clinics, 5 outpatient clinics, including AIDS center, regional dentistry, etc.), 41 feldsher-obstetric and 403 medical centers. The bed fund of state medical organizations is 3223 beds. The district hospital with a polyclinic and a hospital is equipped with 85 beds for a round-the clock stay and 31 beds for a day stay, it has 10 medical outpatient clinics, 3 feldsher-obstetric stations, 46 medical stations. Conclusions. The results of the study show that the incidence among the rural population remains high. The main problems of the rural healthcare system, which significantly affect the availability of medical care for the rural population, are undeveloped infrastructure, under equipped medical organizations, which in turn leads to low detection of pathology, late diagnosis and treatment. There is also a shortage of personnel, especially a shortage of narrow specialists, which leads to low availability of specialized medical care.

Цифрлық дәуірде артериялық гипертензиямен ауыратын науқастарды қашықтықтан бақылау және басқару

The use of active remote monitoring of patients with AH receiving antihypertensive therapy helps to achieve target BP values with subsequent monitoring of health indicators, as well as to provide timely medical care. Remote monitoring and treatment using information and communication technologies has been proposed to improve the quality of medical care. The introduction of remote BP monitoring will significantly improve the existing model of diagnostics and treatment of patients with chronic diseases, increase the number of observed patients at each therapeutic site without increasing the time for dispensary observation, as well as attract the working-age population to primary prevention of cardiovascular diseases. Taking into account modern trends in medical care for the working population and progress in information technologies, there is currently an opportunity to build a new model, which, while maintaining the main levels and stages of medical care, should ensure compliance with uniform standards of medical care, which can be ensured through the introduction of telemedicine and mobile components. The new elements of the system include: retrofitting medical stations of enterprises with medical and telecommunication equipment, connecting them to medical information systems; application of patient-oriented personal hardware and software systems for prevention, treatment monitoring and rehabilitation; use of mobile medical and telemedicine complexes; building up the material, technical and human resource capacity of emergency medical aid and medical evacuation services; development of digital communication systems between hospitals and medical centers in remote areas; and development of a new system of medical and telemedicine services. Organizational solutions in the field of digital and mobile medicine can serve as a basis for building a promising model of medical support for the working population in remote areas, ensuring proper quality and accessibility of medical care. The article considers the main aspects of using remote blood pressure monitoring as one of the methods of telemedicine health control. The regulatory and legal framework regulating the provision of medical care with the use of remote blood pressure monitoring is presented. The main technical aspects and technological models of telemedicine monitoring of BP in patients with arterial hypertension are analyzed. The review of publications devoted to clinical and economic efficiency of remote monitoring of blood pressure is given.

Spatial Accessibility Analysis of Medical Facilities Based on Public Transportation Networks.

Aiming to look at the problems of the unreasonable layout of medical facilities and low coverage of primary medical services. This paper selects tertiary grade A hospitals, general hospitals, specialized hospitals, community-level hospitals, clinics, and pharmacies in the main urban areas of Chongqing as research objects. The nearest analysis, kernel density, mean center, and standard deviational ellipse method were used to analyze the spatial differentiation characteristics of medical facilities and public transportation stations. Spatial accessibility was assessed from the perspective of service area ratios and service population ratios by constructing multiple modes of transportation (pedestrian systems, bus lines, rail lines). The results show that (1) the spatial layout of medical facilities in the main urban area of Chongqing is unbalanced; and the spatial distribution of medical facilities is characterized by "large agglomeration, small dispersion" and "multi-center group"; (2) the sub-core circle is centered on the Southwest University Area in Beibei District, the University Town Area in Shapingba, the Yudong Area and Lijiatuo Area in Banan District, the Pingan Light Rail Station Area in Dadukou District, the Chongqing No. 8 Middle School Area in Jiulongpo District, the Tea Garden Area in Nanan District, and the Jiangbei Airport Area in Yubei District; (3) the medical facilities with the weakest average accessibility are tertiary grade A hospitals, and the strongest are pharmacies; (4) the areas with vital average accessibility are Yuzhong District, Shapingba District, Dadukou District, and Nanan District.

Telemedicine in Remote Areas: Possibility of Establishing a Telemedicine System

The COVID-19 epidemic is a severe test for the whole medical industry. Under such a circumstance, healthcare is seeking creative business models. Contemporarily, many countries have developed telemedicine, which is an innovative way of consultation brought by digitalization to healthcare. It has developed more rapidly under the spread of COVID-19. Popularizing telemedicine is a perfect method to deal with the epidemic, which can be specified with telediagnosis, teletherapy, and telemonitoring. Since patients in remote districts also long for professional medical services, this paper intends to explore the possibility of building a medical institution to provide telemedicine for patients living in remote areas. Besides, this paper discusses the application of each function and its limitations. Though telemedicine brings more chances for the patients who have a distance to the medical institution, high quality equipment and funds are needed to support the run of telemedicine. However, the implementation of 5G can improve the performance of telemedicine, especially in the latency of telesurgery. Overall, though building a medical station that supports telemedicine is challenging, there are particular populations have demand on it. These results shed light on guiding further exploration of digital updating for medical industry.

Application of Nursing Emergency Plan in the Treatment of Batch Wounded in Plateau Medical Station

Application of Nursing Emergency Plan in the Treatment of Batch Wounded in Plateau Medical Station

Studies of first‐aid medical stations by flow simulation of damaged patients by the earthquake part 2: Investigation based on the area scale of disaster base hospitals by predicting the number of patients affected by a northern Tokyo Bay earthquake

AbstractBased on a simulation of casualties potentially affected by a Northern Tokyo Bay earthquake, we examined the limits and possibilities of medical relief activities and building space at disaster base hospitals. Considering casualty numbers over time, we determined details about the overall space required to deal with affected patients based on degree of urgency and ascertained the needs of each area. We found that the yellow area (for high‐risk patients) was relatively large; however, it was also found that affected patients remained and continued to accumulate in the red (critical) area for some time after the disaster.

Experience in providing first aid in Pavlodar 103 by call hold

Practice shows that about 30 % of victims with injuries compatible with life may die without receiving first aid as soon as possible. That is why the emergency medical station developed the «call hold» algorithm. The bottom line is that the dispatcher instructs the patient or the person who is next to him/her, what needs to be done before the arrival of the medical team.

Designing Mobile Epidemic Prevention Medical Stations for the COVID-19 Pandemic and International Medical Aid.

The demand for mobile epidemic prevention medical stations originated from the rapid spread of the COVID-19 pandemic. In order to reduce the infection risk of medical practitioners and provide flexible medical facilities in response to the variable needs of the pandemic, this research aimed to design mobile medical stations for COVID-19 epidemic prevention, the emergence of which began in February 2020. The mobile medical stations include a negative pressure isolation ward, a positive pressure swabbing station, a fever clinic and a laboratory. In Taiwan, many medical institutions used the mobile swabbing station design of this study to practice COVID-19 screening pre-tests. Internationally, this study assisted Palau in setting up medical stations to provide anti-epidemic goods and materials. The design of this study not only provides a highly flexible and safe medical environment but the benefits of screening can also be used as resources for medical research, forming an economic circulation for operation sustainability. In addition, the design of this study can also be used during the non-epidemic period as a healthcare station for rural areas or as a long-term community medical station.

Organization of the activities of the infectious diseases hospital for the treatment of a new coronavirus infection (COVID-19) at a large construction site

Relevance. The emergence of a large number of cases of a new coronavirus infection (COVID-19) required the formation of a new system of medical care and, above all, the creation of infectious hospitals for the treatment of patients with COVID-19.Intention. Analysis of the organization of the work of a temporary infectious diseases hospital for the treatment of COVID-19 in workers involved in the construction of the Amur Gas Processing Plant (AGPP). Methodology. The object of the study was a temporary infectious diseases hospital organized for the diagnosis and treatment of COVID-19 in workers mobilized for the construction of AGPP. During the study period from March 2020 to April 2022, the total number of employees participating in construction work daily at AGPP ranged from 17,759 to 39,437 people. Construction personnel worked on a rotational basis, the duration of the shift was from 2 to 6 months. Along with citizens of the Russian Federation, citizens of foreign countries from near and far abroad worked on the site. All shift workers lived in hostels on the territory of temporary construction camps, ate in common canteens. Development of the organizational and staff structure, completeness of medical equipment, medicines and property, evaluation of the effectiveness of the temporary infectious hospital performed using the methods of historical analysis and comparison, system and logical analysis, and expert evaluations. Results and Discussion. The results of a retrospective analysis of the measures for the construction and organization of the work of the temporary infectious disease hospital at the AGPP site presented. The hospital built based on a quickly erected building of block-modular type, passed sanitary-epidemiological examination and licensing in 45 days. The hospital has two departments with 44 beds each for the treatment of patients with COVID-19 (88 beds in total), an intensive care unit with 6 beds, two isolation wards with 2 beds each, a clinical and diagnostic laboratory that allows conducting studies by polymerase chain reaction (PCR) methods and immunofluorescence assay (ELISA), as well as the full range of general clinical laboratory tests, computed tomography unit, vaccination unit, medical gas supply station. The organizational and staffing structure and the number of medical personnel changed dynamically, depending on the epidemiological situation and the arising tasks of medical support of AGPP workers; at maximum staffing the hospital had 22 doctors, 1 pharmacist, 45 nurses, 30 paramedics and support personnel. From July 12, 2020 to April 10, 2022, inpatient treatment received 2622 people in the hospital’s infectious disease departments, and 198 people in the intensive care unit. Outpatient treatment provided to 4127 workers, of which 462 hospitalized for inpatient treatment and 3665 discharged to work upon recovery. There are 17,893 lung examinations including 12,582 primary and 5311 repeated (control) examinations performed and 6547 viral pneumonias detected in the computed tomography unit. The clinical and diagnostic laboratory performed 302,695 tests by PCR, 14,037 tests to IgM and IgG levels by ELISA, 9065 general clinical hematological and biochemical tests, 7832 coagulograms, and 20,782 tests to evaluate specific markers of inflammatory response characteristic for COVID-19. Medical personnel of the hospital carried out a mass vaccination against influenza for 42620 workers of AGPP, vaccination against COVID-19 with the first component of the “Sputnik” vaccine was given to 13678 workers, the second component – to 12,598 workers, the “Sputnik Lite” vaccine – to 19,214 workers. Conclusion. The construction of a temporary infectious diseases hospital on the basis of quickly erected building, its equipping with modern medical equipment and medicines, staffing with highly qualified medical personnel made it possible to organize laboratory and instrumental diagnostics of COVID-19, inpatient and outpatient treatment of patients, as well as vaccination for shift workers of all contractors involved in the implementation of the AGPP project.

Актуальные вопросы оказания медицинской помощи пострадавшим в дорожно-транспортных чрезвычайных ситуациях в Алтайском крае

The aim of the research was: – to elaborate organizational and methodical bases of medical evacuation for the population of the Altai region in cases of traffic accidents including emergency situations, in conditions of healthcare optimization, namely, under the process of merging of the territorial center for disaster medicine with the emergency medical aid station; – to determine starting points for further development of the Emergency Medicine Service of the Altai Krai. Materials and research methods. The statistical data of registration and reporting form no.55 “Information on the Activity of Healthcare Institution (Medical Formation) which took part in liquidation of medical and sanitary consequences of emergencies” of Altai Krai Disaster Medicine Service approved by the Order of the Ministry of Healthcare and Social Development of Russia dated February 3, 2005, no.112, and official statistical data of Altai Krai State Road Safety Department were analyzed. The sample included statistical data for 2019-2021. The study used a set of analytical and statistical methods, which made it possible to process and to analyze the data obtained, to assess the system of medical care and to develop a set of measures to improve the medical evacuation system in Altai Krai using the data about victims of traffic accidents, to predict the duration of their treatment and rehabilitation. The statistical data were processed by means of Statistica 10.0 program complex with the calculation of intensive indices, mean representativeness error (±m) and significance of differences by Fisher’s method. Results of the study and their analysis. The results of the analysis of organizational and methodological bases of medical evacuation of the population of Altai Krai in road traffic accidents in the conditions of optimization of healthcare in 2019-2021 are presented. The prospects for further development of the regional Disaster Medicine Service, directions of interdepartmental planning and conducting of special tactical exercises, which are one of the basic tools ensuring readiness of managers and personnel of territorial medical institutions for actions on liquidation of consequences of traffic accidents and emergencies, were determined. The necessity of training the population and interested persons in rendering first aid, which is carried out within the framework of the work of the training center of disaster medicine, has been substantiated.

Mental Health Support of Frontline Medical Personnel in the Javits New York Medical Station Federal COVID-19 Treatment Center.

The federal government responded to the early epicenter of the COVID-19 pandemic in the United States by mobilizing uniformed services and other federal medical personnel to treat patients at the Javits New York Medical Station. Deployment of large numbers of personnel required flexible psychiatric and psychological support. This report details the establishment of mental health support services for frontline personnel in a large convention center and explores lessons learned to encourage future mental health professionals to apply creative and assertive mental health interventions in disaster settings. Timely and effective interventions included securing safe therapeutic space in high-traffic areas, developing relationships with leadership and frontline workers in their own work environments, and disseminating services throughout the civilian medical system. We suggest mental health supplementation during the medical response mission strengthened morale in frontline workers in a disaster scenario.

Athlete Medical Services at the Marathon and Race Walking Events During Tokyo 2020 Olympics.

Epidemiological data from race walk and marathon events suggest that a high incidence rate of exertional heat illness is associated with high ambient temperature and relative humidity. The 2020 Summer Olympics in Tokyo was no exception, which led the organizing committee to relocate the race walk and marathon competitions to Sapporo, which was predicted to experience much milder heat. Nonetheless, during the Games, Sapporo recorded the highest daytime ambient temperature in the past 97 years, with consecutive days over 30°C from July 22nd to August 7th, 2021. Five events (men's and women's 20 km race walk, men's 50 km race walk, women's and men's marathon) were held in Sapporo from August 5th to August 8th, 2021. The percentage of athletes who did not finish (DNF) in each event was 8.8% in men's 20 km race walk, 20.3% in men's 50 km race walk, 8.6% in women's 20 km race walk, 17.1% in women's marathon and 28.3% in men's marathon. A total of fifty athletes were transferred to the athlete medical station: 28 athletes completed the race (i.e., collapsed after finish line), while 24 were DNF athletes transported from the course. Forty-eight (96%) of athletes who were admitted to the athlete medical station exhibited signs and symptoms of exertional heat illness. Two athletes diagnosed with exertional heat stroke and three athletes diagnosed with severe heat exhaustion (rectal body temperature >39.5°C with or without central nervous system disturbance) were cooled using whole-body cold water immersion at the heat deck located within the athlete medical station. All athletes who were cooled successfully recovered without any complications. These athletes required an average of 14 ± 9.4 min (range, 6–30 min) to cool their rectal temperature below 39°C. These results show the importance for event organizers to prepare strategies to keep athletes cool, such as an ample amount of ice and water to supply whole-body cold water immersion.

Healthcare worker safety program in a coronavirus disease 2019 (COVID-19) alternate care site: The Javits New York Medical Station experience.

In March 2020, New York City became the epicenter of the coronavirus disease 2019 (COVID-19) pandemic in the United States. Because healthcare facilities were overwhelmed with patients, the Jacob K. Javits Convention Center was transformed into the nation's largest alternate care site: Javits New York Medical Station (hereafter termed Javits). Protecting healthcare workers (HCWs) during a global shortage of personal protective equipment (PPE) in a nontraditional healthcare setting posed unique challenges. We describe components of the HCW safety program implemented at Javits. Javits, a large convention center transformed into a field hospital, with clinical staff from the US Public Health Service Commissioned Corps and the US Department of Defense. Key strategies to ensure HCW safety included ensuring 1-way flow of traffic on and off the patient floor, developing a matrix detailing PPE required for each work activity and location, PPE extended use and reuse protocols, personnel training, and monitoring adherence to PPE donning/doffing protocols when entering or exiting the patient floor. Javits staff who reported COVID-19 symptoms were immediately isolated, monitored, and offered a severe acute respiratory coronavirus virus 2 (SARS-CoV-2) reverse-transcriptase polymerase chain reaction (RT-PCR) test. A well-designed and implemented HCW safety plan can minimize the risk of SARS-CoV-2 infection for HCWs. The lessons learned from operating the nation's largest COVID-19 alternate care site can be adapted to other environments during public health emergencies.