DISASTER MEDICINE No. 1•2022
Evaluation of the Efficiency of Work and Prospects of Sanitary Aviation Development in Megapolic Environment on the Example of Moscow City
Gumenyuk S.A.1, Aleksanin S.S.2, Yarygin N.V.3
1 Moscow Territorial Scientific and Practical Center for Disaster Medicine (TSEMP) оf the Moscow City Health Department, Moscow, Russian Federation
2 The Nikiforov Russian Center of Emergency and Radiation Medicine, EMERCOM of Russia, St. Petersburg, Russian Federation
3 Moscow State University of Medicine and Dentistry A.I. Evdokimova, Moscow, Russian Federation
UDC 614.883 (470.25)
Abstract. The objectives of the study are to develop a structural and functional model, principles and algorithms of organizational and methodological support of helicopter evacuation of patients to specialized medical organizations of megapolis; to evaluate their effectiveness analysing the results of treatment of patients with significant urgent pathology.
Materials and research methods. The results of treatment of 241 patients with urgent pathology at the treatment facilities of the Moscow Health Department — City Clinical Hospital No.15 named after O.M. Filatov, S.S. Yudin State Clinical Hospital and N.S. Sklifosovskiy Research Institute of Emergency Medicine in 2016-2019 — were analyzed. Inclusion criteria: patients with bleeding (isolated or in combination with acute trauma) requiring surgical intervention; with acute coronary syndrome (unstable angina pectoris, myocardial infarction with and without ST-segment elevation); with vascular pathology of central nervous system or craniocerebral trauma, requiring emergency hospitalization of the patient in a specialized medical institution — provided that the time of delivery of all these patients to the hospital was at least 30 minutes from the time of call.
Exclusion criteria: patients with mental illness, infectious-inflammatory processes, severe comorbid somatic diseases in decompensation stage (established by anamnesis, examination or autopsy reports); incurable cancer patients and any urgent patients whose delivery time to the specialized hospital was less than 30 minutes from the time of call.
All patients included in the study were divided into 2 groups:
The main — 1st group — included 112 patients delivered to the profile medical institution of the megapolis on a medical helicopter.
The comparison group — 2nd group — consisted of 129 patients with similar urgent pathology, hospitalized to the specialized hospitals of the city by ground ambulance transport.
Research results and their analysis. The analysis of the study results showed:
– performance of air medical teams is comparable to or exceeds that of ground ambulance teams;
– number of total bed-days in the group hospitalized by air ambulance was higher than in the comparison group;
– inpatient outcomes and long-term outcomes were comparable in both groups;
– pilot study of the use of mobile diagnostic ultrasound in providing emergency and urgent medical care allows us to consider this method as a promising one, but it requires further evidence accumulation.
Thus, the performance of medical aviation is not inferior to the performance of ground ambulance teams, and in some aspects, even exceed them, which confirms the high potential of its use in megapolis conditions and in remote and hard-to-reach areas.
Keywords: air ambulance, air medical teams, algorithms, development prospects, efficiency, megapolis, Moscow, organization, patients, urgent pathology
For citation: Gumenyuk S.A., Aleksanin S.S., Yarygin N.V. Evaluation of the Efficiency of Work and Prospects of Sanitary Aviation Development in Megapolic Environment on the Example of Moscow City. Meditsina Katastrof = Disaster Medicine. 2022;1:71–77 (In Russ.). https://doi.org/10.33266/2070-1004-2022-1-71-77
- Fedotov S.A., Kostomarova L.G., Potapov V.I., Buk T.N. Readiness of the Territorial Moscow Disaster Medicine Service to Eliminate the Medical Consequences of Emergency Situations in 2016. Vrach Skoroy Pomoshchi = Emergency doctor. 2017;4:75-81 (In Russ.).
- Blackwell D.L., Lucas J.W., Clarke T.C. Summary Health Statistics for U.S. Adults: National Health Interview Survey. National Center for Health Statistics. Vital Health Stat. 2014;10(260).
- Klochikhina O.A., Shprakh V.V., Stakhovskaya L.V., Polunina Ye.A. An Analysis of the Long-Term Stroke Morbidity and Mortality in the Regions of the Russian Federation Included in the Federal Patient Assistance Reorganization Program. Zhurnal Nevrologii i Psikhiatrii im. S.S. Korsakova = Neuroscience and Behavioral Physiology. 2020;120;12-2:37-41 (In Russ.).
- Sander A., Spence R.T., McPherson D., et al. Prospective Audit of 805 Consecutive Patients with Penetrating Abdominal Trauma: Evolving Beyond Injury Mechanism Dictating Management. Ann Surg. 2020. doi: 10.1097/ SLA.0000000000004045. Epub ahead of print. PMID: 32568748.
- Wejnarski A., Leszczyński P, Świeżewski S., et al. Characteristics of Aeromedical Transport, Both Interhospital and Directly from the Scene of the Incident, in Patients with Acute Myocardial Infarction or Acute Trauma Between 2011-2016 in Poland: A Case-Control Study. Adv. Clin. Exp. Med. 2019;28;11:1495-1505.
- Vechorko V.I., Shapsigova O.A., Averkov O.V., et al. Search for Diagnostic Correlations in Females with Cerebral Infarction. Consilium Medicum. 2019;21;2:37-42 (In Russ.).
- Petrikov S.S., Parfenov V.Ye., Mitish V.A. Scientific Achievements in the Field of Emergency Medical Care in the Russian Federation in 2017. Issue 7. Moscow, NII Skoroy Pomoshchi Im. N.V. Sklifosovskogo Publ., 2018. 126 p. (In Russ.).
- Aleksanin S.S., Gudz’ Yu.V., Rybnikov V.Yu. Kontseptsiya i Tekhnologii Organizatsii Okazaniya Meditsinskoy Pomoshchi Postradavshim v Chrezvychaynykh Situatsiyakh s Travmami Silami i Sredstvami MCHS Rossii = The Concept and Technologies of Organizing the Provision of Medical Care to Victims in Emergency Situations with Injuries by the Forces and Means of the Ministry of Emergency Situations of Russia. Monograph. St. Petersburg Publ., 2019, 303 p. (In Russ.).
- Baranova N.N. Medical Evacuation of Victims: Their State, Problems. Report 1. Meditsina Katastrof = Disaster Medicine. 2018;4:37-40 (In Russ.).
- Garmash O.A. Sanitary Aviation of the Russian Federation: History, State, Prospects. Informatsionnyy Sbornik Meditsina Katastrof, Sluzhba Meditsiny Katastrof = Information Collection Disaster Medicine. Service for Disaster Medicine. 2013;3:1-19 (In Russ.).
- Kozyrev D.V., Khupov M.T. Sanitary Aviation Evacuation with Use of Light Helicopters in Megapolis Environment. Meditsina katastrof = Disaster Medicine. 2017;1:31-33 (In Russ.).
- Johnsen A.S., Sollid S.J.M., Vigerust T., et al. Helicopter Emergency Medical Services in Major Incident Management: A National Norwegian Cross-Sectional Survey. Ed. Abe T. PLoS ONE. 2017;12;2:e0171436.
- Stewart C.L., Metzger R.R., Pyle L., et al. Helicopter Versus Ground Emergency Medical Services for the Transportation of Traumatically Injured Children. J. Pediatr. Surg. 2015;50:347-352.
- Vankov D.V., Ivanova S.A. Department of Air Ambulance as Part of Multidisciplinary Hospital: Advantages and Disadvantages. Sovremennyye Problemy Zdravookhraneniya i Meditsinskoy Statistiki = Current Problems of Health Care and Medical Statistics. 2019;4:170-178 (In Russ.).
- Hoyer H.X., Vogl S., Schiemann U., et al. Prehospital Ultrasound In Emergency Medicine: Incidence, Feasibility, Indications And Diagnoses. Eur. J. Emerg. Med. 2010;17(5): 254–259.
- Jorgensen H., Jensen C.H., Dirks J. Does Prehospital Ultrasound Improve Treatment of the Trauma Patient? A systematic review. Eur. J. Emerg. Med. 2010;17(5):249–253.
- Vasilyeva E.Yu., Plavunov N.F., Kalinskaya A.I., et al. Organization of “Infarct Network” in Moscow and the Results of its Work over the Five-Year Period. Russian Journal of Endovascular Surgery. 2018;5(2):288-94 (In Russ.).
The material was received 26.04.21; the article after peer review procedure 04.03.22; the Editorial Board accepted the article for publication 21.03.22