Medical Stations Research Articles

Using Deep Learning, Optuna, and Digital Images to Identify Necrotizing Fasciitis

Necrotizing fasciitis, which is categorized as a medical and surgical emergency, is a life-threatening soft tissue infection. Necrotizing fasciitis diagnosis primarily relies on computed tomography (CT), magnetic resonance imaging (MRI), ultrasound scans, surgical biopsy, blood tests, and expert knowledge from doctors or nurses. Necrotizing fasciitis develops rapidly, making early diagnosis crucial. With the rapid progress of information technology and systems, in terms of both hardware and software, deep learning techniques have been employed to address problems in various fields. This study develops an information system using convolutional neural networks (CNNs), Optuna, and digital images (CNNOPTDI) to detect necrotizing fasciitis. The determination of the hyperparameters in convolutional neural networks plays a critical role in influencing classification performance. Therefore, Optuna, an optimization framework for hyperparameter selection, is utilized to optimize the hyperparameters of the CNN models. We collect the images for this study from open data sources such as Open-i and Wikipedia. The numerical results reveal that the developed CNNOPTDI system is feasible and effective in identifying necrotizing fasciitis with very satisfactory classification accuracy. Therefore, a potential future application of the CNNOPTDI system could be in remote medical stations or telemedicine settings to assist with the early detection of necrotizing fasciitis.

Mobile stroke units based on rural emergency medical stations for pre-hospital intravenous thrombolysis of stroke in remote areas

ABSTRACT Objectives To explore a novel model of mobile stroke units (MSUs) integrated with rural emergency medical stations for pre-hospital care of stroke patients in remote areas. Methods We used MSUs + Ambulance mode, where both the MSUs and conventional ambulances are sent to the patient’s location. The conventional ambulance coordinates with the MSUs to choose the fastest route to meet and transfer the patient at the point along the way. We collected data from 149 patients from March 2022 to April 2023, including National Institutes of Health Stroke Scale (NIHSS) scores (on admission, 24 hours, day 7), 90-day modified Rankin Scale (mRS) scores, and other clinical variables. We performed propensity score matching (PSM) to balance the potential confounding variables between groups. Results We found that the MSUs + Ambulance mode (OR = 12.507, 95% confidence interval [CI] [3.633, 43.061], p < 0.001) and admission NIHSS score (OR = 0.583, 95% CI [0.493, 0.690], p < 0.001) were independent prognostic risk factors for stroke patients. The MSUs + Ambulance mode reduced NIHSS scores 7 days prior to admission (OR = 0.679, 95% CI [0.563, 0.819], p < 0.001). After PSM, patients who received MSUs + Ambulance mode had a better prognosis (χ2 = 9.573, p = 0.004), as well as a lower mRS score at 90 days (Z = -3.371, p = 0.001). Conclusions MSUs integrated with rural emergency medical stations show the feasibility and potential benefits of pre-hospital intravenous thrombolysis for stroke patients in geographically distant regions.

Cost management analysis of Objective Structured Clinical Examination (OSCE): guide to the universities of medical sciences

BackgroundThe Objective Structured Clinical Examination (OSCE) is a crucial assessment tool for evaluating learners’ ability to apply theoretical knowledge in practical clinical situations. It is widely accepted by both students and educators, and the costs associated with conducting OSCE assessments vary depending on the field of study, how it is implemented, staffing needs, standardized patients, and duration of the examination. This study examines the expenses related to administering OSCEs in medical universities.MethodConducted from June to September 2023; this mixed-method study elucidated the cost intricacies of executing a two-day OSCE with 14 eight-minute stations for 100 nursing students. This process unfolds in two phases: a qualitative segment comprising text reviews and 45-minute in-depth interviews with faculty members and OSCE experts, leading to the development of a validated checklist, followed by a quantitative phase in which the tool was distributed to 25 faculty members and 5 specialists for completion.ResultThe examination costs were delineated into three primary components: time, human resources, equipment, consumables, and necessary supplies. In 2023, the total implementation cost of the OSCE for 100 students across 14 clinical stations was $1028.07, with an estimated per-learner cost of $37.50. Human resources incurred the highest expenditure ($1649.37); while supply costs were relatively lower ($1072.17). Educational infrastructure expenses were excluded because the study focused on the Nursing and Midwifery Faculty’s Clinical Skills Center.ConclusionVarious factors influence OSCE costs, including national production capabilities of medical supplies, institutional credibility, governance status, examination frequency, student demographics, assessor composition, station count, course content, and examinee volume. The insights derived from this comprehensive examination are significant as entry benchmarks for healthcare systems and higher-level academic evaluations. Understanding OSCE cost dynamics facilitates resource optimization and assessment strategy refinement, thereby improving medical education efficacy.

Involvement of healthcare staff in hospital hygiene during emergency hemodialysis.

Healthcare-associated infections are still a worrying health problem that complicates patient care and increases morbidity and mortality. The incidence of infections in hemodialysis patients is still high and they constitute the second cause of hospitalization and death in this category. The study's objective was to evaluate nursing and medical staff's involvement in hospital hygiene. This is an observational study that took place within the hemodialysis unit of a Moroccan university hospital from March 2021 to June 2021. A surface swabbing technique for bacteriological examination was also carried out. The study revealed some shortcomings regarding hand hygiene which was respected by the nurses in only 17.5% of sessions and in 42.2% by the doctors. Other shortcomings in asepsis measures, were also noted such as the non-change of gloves after skin preparation (1.03%) and before manual compression. The serological status of patients concerning HBV, HVC, and HIV was also not always known (31.1%). The bacteriological samples from the surfaces also showed colonization of the medical devices and the ultrasound scanner used for the ultrasound-guided introduction of the central catheters. The results of the study showed some deviations concerning the recommendations; however, they are comparable to other studies conducted internationally, especially in terms of hand hygiene. Our study results highlight some shortcomings adherence to hygiene measures like inconsistent disinfection of medical devices and dialysis stations, as well as insufficient hand hygiene practices among some staff members. However, we observed an improvement in practices following the implementation of awareness-raising sessions. To maintain improved hygiene practices and prevent infections, it is crucial to provide ongoing training for staff, ensure adequate resources, and regularly monitor compliance with hygiene standards.

NEUROPROTECTIVE THERAPY OF CEREBROVASCULAR INSUFFICIENCY

One of the leading manifestations of chronic cerebrovascular diseases is impairment of cognitive and motor functions. Drugs recognized as neuroprotectors are used to correct such impairments. They intervene in and inhibit the pathogenetic cascade that results in the cell death in vascular pathology. The aim of the study is to evaluate the effectiveness of neuroprotective therapy for cerebrovascular insufficiency (CVI). Materials and Methods. The study was conducted at the neurological department of the Ulyanovsk Central Clinical Medical Sanitary Station. The study included data analysis on 60 patients divided into two groups of 30 people each. Patients of the main group received neuroprotective therapy with Cortexin and Neuromexol (Geropharm, Russia) for 10 days along with standard treatment. Patients of the comparison group received only standard treatment. Blood was sampled twice: before and after treatment. The total antioxidant status (TAS) was determined in the blood serum. Such markers as neuron -specific enolase (NSE), antibodies to NR2 peptide were also examined. Statistical processing of the results was performed using Microsoft Excel 2010 and Statistica 13.0. Differences were considered statistically significant at p&lt;0.05. Results. Against the background of neuroprotective therapy, patients of the main group with cerebrovascular insufficiency demonstrated a statistically significant improvement in TAS (by 87.7 %), a decrease in the NSE level (by 2 times) and concentration of antibodies to NR2 peptide (by 47.1 %) compared with the comparison group (p&lt;0.05), which pathogenetically justified use of neuroprotective drugs. Conclusions. According to our study, neuroprotective therapy is effective in the treatment of patients with cerebrovascular insufficiency.

Административно-правовое противодействие чрезмерному употреблению алкоголя как метод охраны здоровья населения

The article is devoted to the issues of administrative and legal regulation of the prevention of alcoholism, treatment of alcohol abusers, as well as measures to suppress illegal behavior associated with the use and circulation of alcohol. The issue of changing the legislation regulating the work of medical sobering-up stations is raised, and issues of the competence of government bodies in connection with countering excessive alcohol consumption are also examined.

Modernization of simulation classes and improvement of simulation training at the level of emergency medical care stations in the Republic of Kazakhstan

В настоящее время симуляционное обучение является одним из наиболее эффективных методов подготовки медицинских работников в экстренной медицине. Оно позволяет имитировать различные ситуации, которые могут возникнуть в клинической практике, и развивать навыки принятия решений в условиях стресса. Однако, для того чтобы симуляционное образование было более эффективным, необходимо учитывать некоторые аспекты. Например, важно создавать реалистичные сценарии, которые будут максимально приближены к реальным ситуациям.

Surveying knowledge about hypertension and related factors among hypertensive patients at some medical stations in Thua Thien Hue province

Introduction: Understanding hypertension is essential for its effective treatment and management. This study aims to assesse the knowledge level of hypertensive patients at commune health centers in Thua Thien Hue provinceand identify influencing their’ knowledge of hypertension. Methods: A cross-sectional approach was employed in this study. Hypertension knowledge was assessed using the Hypertension Knowledge - Level Scale (HK-LS) by SB Erkoc, while demographic details, lifestyle, clinical characteristics, medication adherence, and patient’s beliefs about mediicne were also collected. The analysis involved the use of the Chi-square test, t-test, and multiple logistic regression model in SPSS 27.0 software to examine relevant factors. Results: A total of 355 participants took part in the study, with women constituting 55.5%. Only 35.2% of patients demonstrated a high level of knowledge about hypertension. The mean knowledge score was 13.8 (standard deviation: SD = 4.9). This score was significantly higher in the high knowledge group (mean = 18.3, SD = 1.2) compared to the low knowledge group (mean = 11.3, SD = 4.3), with p &lt; 0.001. Education level, ethnicity, monitoring of blood pressure at home, and patient beliefs about medicine were identified as significant factors associated with knowledge about hypertension. Conclusions: The study reveals a low proportion of hypertensive patients with a high level of knowledge at commune health centers in Thua Thien Hue province. Factors such as education level, ethnicity, home blood pressure monitoring, and patients’ beliefs about medicine were significantly associated with knowledge about hypertension. Coordinated interventions, including patient education and addressing medication beliefs, are essential to enhance treatment outcomes. Key words: knowledge, hypertension, blood pressure, beliefs about medicine.

Establishment of a digital electrocardiogram telemonitoring system and remote consultation service.

The use of telemonitoring electrocardiogram (ECG) improves the detection rate of various arrhythmias as it offers an extended recording time and does not impose activity restrictions. However, many community hospitals lack the resources to conduct this test due to a lack of cardiac function specialists and antiquated screening equipment. To establish a digital ECG telemonitoring system and remote consultation service between tertiary hospitals and community medical service stations to improve diagnosis and treatment effectiveness. We used the PI ECG telemonitoring data acquisition system, with a personal digital assistant (PDA) or computer serving as the platform for ECG acquisition, storage, display, printing, and transmission. We introduced this system to standardize the storage and transmission of ECG telemonitoring data, and ensure accurate transmission, reproducibility, and preservation of data. The implementation of the PI ECG telemonitoring data acquisition system enabled the sharing of remote ambulatory electrocardiography data between Beijing Shijitan Hospital and its affiliated community hospitals. This has resulted in reduced waiting times for patients to receive reports (from 0.3 to 1 hour, to 0.1 or less), shortened consultation times (from 2 hours to 0.1 hour), and improved patient satisfaction with consultations (> 20% of the patients reported they were highly satisfied). The system successfully combined the goals of intelligence, real-time synchronization, and efficiency, revolutionizing ECG telemonitoring diagnosis in the network era. Sharing digital telematics information between tertiary and community hospitals enables a tiered approach to diagnosis and treatment and allows for more efficient, accurate, and convenient remote diagnostics.

Development and Evaluation of an Immersive Cinematic Escape Room for Disaster Preparedness and Self-Efficacy Among Nurses

BackgroundThe occurrence of natural disasters is unpredictable. Nurses need to have the core competency of disaster nursing to effectively respond to natural disasters. This study aimed to develop and evaluate the effectiveness of an immersive cinematic escape room (ICER) instructional approach in disaster preparedness and self-efficacy in nurses. MethodThis quasi-experimental research design used a convenience sample of 115 nurses. The course contents covered establishment of medical stations, incident command system (ICS), personal preparedness and protection in disasters, and mass casualty triage (START). Evaluation of disaster preparedness and self-efficacy occurred before, one week after and four weeks after the course. ResultsThe experimental group, lacking prior disaster preparedness education experiences, demonstrated a statistically significant improvement (p < .01) compared to the control group with more such experiences. At week four, both groups showed improvement in the self-efficacy scores, but the improvement did not achieve statistical significance (p > .05). ConclusionThe ICER approach significantly enhanced nurses’ disaster preparedness and self-efficacy. Educators are encouraged to adopt this approach for comprehensive disaster nursing education.

Optimizing locations of emergency medical stations for rural areas: A case study in Iran

Given the dearth of emergency medical services in rural areas, offering these services is among the most important things that should be done right to save the lives of people who have suffered severe injuries. Rapid access to EMSs, which includes a shorter response time and the availability of all intensive care services, including the ICU, CCU, NICU, and PICU, is crucial in this regard. In this regard, a GIS-based ACO-QAP model is proposed for rural areas to optimize locations for EMS stations. This model takes into account the standards of EMS in rural areas, and the standards of out-of-city roads, reducing the response times from EMS stations to the scene of damage and from the damage scene to the closest hospital that offers the required intensive care services. Additionally, to increase the availability of intensive care services and to optimal use of available resources, the model determines which types of intensive care services should be provided in the EMS stations. As a result of the integration for setting up the out-of-city EMS, 614 optimized locations were identified. The identified EMS stations should provide single or multiple intensive care services. There were identified as 544 (88.6%) multiservice stations and 70 (11.4%) single service stations. Among the multiservice stations, 113 (20.8%) stations were identified as two-service, 150 (27.5%) as three-service, and 281 (51.7%), as four-service stations. This model generates a chain of EMS stations that improves spatial accessibility and emergency medical availability while reducing resource usage.

Zemstvo medicine and healthcare seeking in the late 19th – early 20th centuries: evidence from Samara uezd

This article examines the state of zemstvo medicine in Samara uezd in 1886–1913. An important aspect of this analysis is the study of healthcare seeking, which serves both as a statistical parameter of the frequency of medical care seeking and an indicator of very complex sociocultural dynamics within certain society. One’s decision to visit a hospital, and in general one’s perception of his or her own physical body and its deviations and abnormalities in medical terms are influenced by multiple factors that are not limited to the characteristics of the healthcare systems. Similar issues are studied in detail within the framework of medicalization, as well as the methodology of health seeking behavior, which examines the factors behind people’s decisions to follow healthy lifestyles, including visiting hospitals. This research is based on medical and statistical reports of the Samara uezd physicians in the late 19th – early 20th centuries and examines the temporal and spatial dynamics of the healthcare seeking; the main purpose of this study is to measure disparity levels of healthcare seeking practices in different parts of Samara uezd. Firstly, the study reveals that in the infrastructural aspect, healthcare in the Samara uezd was in an active development stage, which reflected in an increase in both the number of medical stations and hospitals, and physicians and paramedics. Secondly, the healthcare seeking rates was also evolved in a positive direction, which is reflected in an increase in both the number of medical services delivered to population. Furthermore, it shows the decrease of heterogeneity level of healthcare seeking rates between medical stations in uezd from 1898 to 1913; however, this level between the volosts remains high even after 15 years.

Epidemiological Study of Track-and-Field Meets On-Field Medical Care.

Most epidemiological studies on track-and-field meets have been limited to the Olympics and world championships. These are meets inwhich only high-performance athletes participate at a certain time of the year. In contrast, epidemiological studies on athletes of various ages and across different seasons may provide health care providers with valuable insights into injury prevention and on-field medical care. The study aims to determine the trends and locations of injuries during track-and-field meets in athletes of various ages and seasons based on on-field medical care records. The number and incidence of injuries requiring on-field medical care during or after the event were obtained from 39 track-and-field meets. Injuries were defined as cases that required on-field medical care. The incidence was defined as the number of injuries per 1000 athlete exposures wherein 1 athlete exposure is the athlete's participation in one event. We also recorded the number of injuries at each location and whether transportation to a medical station was required. A total of 191 injuries were reported. This study identified a population with a high incidence of injury (middle- and long-distance events, combined events, and athletes over the age of 19), areas within the stadium where injuries were more likely to occur (finish line and first turn), and a high rate of transport to the medical station (approximately 70%); most of them were transported to wheelchairs. The results provide insights into the trends, locations, and transport of injured athletes during track-and-field meets. Professionals will better understand the injuries occurring during track-and-field meets and can improve the efficiency of on-field medical care activities. They will also assist organizers in track-and-field meets to improve the safety of their meet operations.

Research on the Influencing Factors of Farmers’ Choice of Medical Treatment in Health Stations under the Background of Rural Medical Insurance—Taking Guangdong Province as an Example

This paper examines the decision-making process of farmers when selecting medical treatments at health stations. The purpose is to establish a more rational and scientific rural medical insurance system and to adapt the system to the current external environment. This will enable the system to fully utilize its potential and benefit the rural medical insurance sector. Innovation. This paper adopts a combination of literature review, field investigation, descriptive research, and statistical analysis to examine the medical treatment choices made by farmers in Guangdong Province under the rural medical insurance system. The hardware and software facilities of village health stations have a significant impact on farmers’ choice of medical treatment. Among them, the number of doctors is significantly positively correlated, while the facility investment in health stations is significantly negatively correlated. From this, it can be seen that farmers are more concerned about whether they can access medical services in a timely manner, but they have a negative reaction to the high cost of medical expenses at health stations. This paper proposes a rational allocation of resources for medical and health stations through the reform of the rural medical insurance system. The aim is to improve the level of rural medical and social security.

The spatial layout of community-based elderly care facilities in Lanzhou Chengguan district based on smart city construction

With the accelerated process of an aging society, the number of elderly people has increased dramatically, and community-based elderly care service has become a hot topic in recent years. Lanzhou City is a typical city suffering severe aging problems in the northwest region of China. This article takes Chengguan district in Lanzhou City as an example, focuses on community-based elderly care facilities, uses the network analysis method of public facility service areas via GIS software to analyze and evaluate the accessibility of three types of facility sitting, and proposes rational suggestions for the spatial configuration. The results show that the "Integrated Service Center for the Elderly" facilities are mainly concentrated in the downtown and the densely populated residential areas with a north-sparse and south-dense distribution pattern. The "Happy Kitchen" facilities are located mainly on the west side of the downtown, filled with many unit communities and thorough public infrastructure providing corresponding hardware support. The "Health Medical and Care Station" facilities are located on Qingbaishi Street in the northeast of the city, mainly relying on the newly built community health center. The uncovered areas mainly exist in the north and south sides of Chengguan district, because these areas are mountainous regions with fewer residential areas. This article suggests constructing elderly care facilities considering different facility functions and the needs of the elderly, carrying out the hierarchical layout of elderly care facilities according to the coverage range of accessibility, and building new elderly care facilities based on old sites and facilities.

Evaluating the use of role-play simulations in teaching management of medical emergencies in the dental clinic

BackgroundPractical hands-on training is necessary for clinical competence in managing medical emergencies in the dental setting. Therefore, the King Abdulaziz University Faculty of Dentistry developed a role-play simulation-based clinical module for training clinical years (Years 4, 5, and 6) dental students in medical emergency management between 2016 and 2020. This study aimed to assess the knowledge and skills of years 4, 5, and 6 dental students before and after the completion of the role-play simulation-based medical emergency training module.MethodsA mandatory four-hour annual training module was designed consisting of a 45-minute lecture on the medical emergency basic action plan and overview, four hands-on stations, and six role-play simulation-based medical emergency stations. A 16-item multiple choice test was used to assess the knowledge of the students before and after the training module every academic year. An objective structured clinical exam (OSCE) on a medical emergency scenario was administered to the students graduating each year. The difference between the pre- and post-module test scores and the one-time OSCE pass/fail rate were analyzed statistically using appropriate tests.ResultsA total of 846 students participated in the study between 2017 and 2020: 275 once, 483 twice, 87 thrice, and one participated four times; in total, 1,506 assessments were conducted. Overall, the pre-test and post-test mean scores were 9.4 ± 3.0 and 13.5 ± 1.6, respectively. All students showed significant improvements in the post-test scores compared to the pre-test scores. Year 4 students showed the highest improvement, followed by Year 5 and Year 6. There was a statistically significant association between the pass/fail rate of the OSCE station and the number of times the module was taken.ConclusionsThe significant improvement in the scores of clinical year students in this study supports an annual mandate for all dental students to undergo simulation-based competency training in their clinical years. Teaching institutions are recommended to utilize simulation and hands-on instruction to teach medical emergency management.

The application of telemedicine technologies under medical care provision to crew members on shipboard

The impact of development of technique and technology as result of scientific and technological progress in modern society tremendously affected population life of people in its various areas. One of these technologies is telemedicine. The telemedicine technologies permit to ensure accessibility of highly qualified medical care to travelers, ship crew members and persons located at remote objects. The actuality of application of telemedicine technologies is excessively high in conditions of providing medical care to ship crew members working hundreds miles away from nearest medical care station. The article considers application of telemedicine technologies in world-wide practice. The legal norms of applying telemedicine in the Russian Federation were analyzed. The results of scientific research of telemedicine application on shipboard are analyzed and both advantages and disadvantages of technology under study are determined. The ways of resolving existing problems are proposed to minimize risks associated with application of telemedicine technologies on shipboard.

Clinical pharmacy services at the Tokyo Olympic and Paralympic Games and the sports pharmacist training program

AbstractIntroductionPrevious studies published on past Olympic and Paralympic Games have reported the role of pharmacists within different disciplines of healthcare services; however, emphasis on their clinical pharmacy services was limited. Furthermore, only a few studies have addressed pharmacists' involvement in sports, with the majority focusing on the organizational and managerial aspects of pharmacies. Sports and other pharmacists are well‐positioned to advise athletes and other healthcare professionals on how to promote and maintain health. Pharmacists should be properly trained in sports medicine.MethodsTo illustrate this point, this review analyzes pharmacy services at polyclinics and medical stations in the athletes' villages at the Tokyo 2020 Olympic and Paralympic Games, and shares examples of clinical interventions performed by pharmacists. This review also examines the level of satisfaction with their work and educational programs prior to the games.ResultsThese results show that despite coronavirus disease 2019 (COVID‐19)‐related complications in the Tokyo 2020 Games, pharmacists appropriately managed infection control, provided anti‐doping‐based pharmacy services, and implemented clinical interventions. As one of intervention results, 268 inquiries from pharmacists to physicians regarding prescriptions were recorded. Among the most common inquiries regarding prescriptions 89 resulted in changes in quantity and 76 resulted in changes in usage. Simultaneously, the questionnaire administered to the volunteer pharmacists showed a high level of satisfaction with their participation as healthcare professionals and with the pre‐Game training, as well as with their gained knowledge. Furthermore, the need for further extensive training related to rules specific to the Olympic and Paralympic Games was identified.ConclusionWe hope that this review will be useful to future pharmacists pursuing expertise in sports.

Research on the Rescue Time of the Taiwan Marathon Emergency Medical Service System Between 2013 and 2021.

While there are several studies on marathon injuries worldwide, there are no related studies on the Taipei Marathon regarding the rescue time of onsite injury cases, the incidence of out-of-hospital cardiac arrest (OHCA) cases, and the success rate of recovery of spontaneous circulation (ROSC). This study aims to fill that gap. The rescue time onsite of contact injury cases was in the prime time for lifesaving. Descriptive epidemiological study. Level 2c. This is a retrospective study of numerical and timeflow data using descriptive statistics. Our data were obtained from records of the Taipei Marathon from 2013 to 2021. These included (1) notification data, (2) the time record of the emergency care personnel in contact with patients, (3) incidence of OHCA, (4) the success rate of ROSC, (5) the location of occurrence of OHCA, and (6) emergency medical service capacity and configuration. The average time taken for first contact was 1.56 minutes in OHCA cases, and the total incidence rate of OHCA in 9 years was 4 people per 100,000 people, with a 100% ROSC success rate. Further, the location of OHCA cases was mostly in Q4 of the race (66.67%), followed by Q3 (22.22%) and Q2 (1.11%). The average number of emergency care personnel per marathon was 78, spread across 6 rescue and 6 medical stations and equipped with 8 ambulances and 35 automated external defibrillators. Shortening the arrival time of medical personnel to the scene and implementing a complete chain of survival can improve survival rates. Other ways to provide faster and more timely emergency rescue services require further study. Contact with patients as soon as possible, timely implementation of cardiopulmonary resuscitation, and use of an automated external defibrillator are the basic requirements of the chain of survival theory.

The main problems and defects of the medical care on prehospital stage for patients with acute cerebrovascular accident in Stavropol

The purpose of the study was to identify the care provision defects on prehospital stage in patients with stroke in order to improve the quality of care for this category of patients. Objectives of the research: to study the frequency of hospitalization the patients with suspected stroke, depending on gender and age; to evaluate the efficiency of the ambulance team’s departure to the patient and the timing of the patient’s delivery to the hospital; to assess the quality of diagnosis and drug therapy at the prehospital stage. Materials and methods. The analysis of statistical observation forms No. 30, form № 109/y, accounting form № 110/y Stavropol Regional Clinical Emergency Medical Station, as well as case histories of patients with stroke in City Clinical Hospital No. 3, Stavropol, from 2016 to 2020. Results. A retrospective analysis of accounting and statistical documents of the Ambulance in a five-year period showed a fairly high efficiency in the work of dispatchers – 74.3 % of correct interviewing of patients to identify risk categories; ambulance crew within the framework of efficiency indicators – the time to reach the specialized department in Stavropol was 44 ± 4.1 minutes. However, the analysis of case histories of the ICU revealed violations in the observance of the algorithm for providing medical care to patients with stroke, in the form of: lack of protection of the upper respiratory tract and maintenance of adequate oxygenation — 43 cases (93.4 %); poorly correctable OSHF at the prehospital stage — 12 cases (14.5 %); non-compliance with the algorithm for examining a patient with stroke at the prehospital stage – 11 (13.2 %); lack of provision of adequate venous access – 9 (10.8 %) cases. Conclusion. The revealed defects of the prehospital stage contributed to the worsening of acute cerebral insufficiency, changes in the volume of the lesion, increased dislocation of brain structures, and in some cases led to daily mortality.