Reformation of system of emergency medical help for injured persons on early hospital stage

Keywords: trauma; еmergency medical help; early hospital stage; the trauma centre; оrganization.

Abstract

Objective. To determine the key trend of reformation of the system of the emergent medical help to the injured persons on early hospital stage.

Маterials and methods. The systemic analysis, including a bibliographical one, semantic and economic methods of investigation, as well as organization of the medical help delivery to the injured persons in USA.

Results. The system of the emergency medical help delivery to the injured persons is based on the trauma centers net. Treatment of the injured persons, suffering severe trauma in the centers of trauma is by 40 - 60% more effective and by 50 - 60% more cost-effective, than in surgical/traumatological departments of the national Medical Health Service. The system of Emergency Medical Help for injured persons on early hospital stage in Ukraine demands organization of no less than 30 Centers of Trauma of the level І on the base of the University Regional Hospitals and in the cities with more than 1 million of inhabitants; approximately 200 the Level II Centers of Trauma on the base of multidisciplinary hospitals for intensive treatment of the second level and 300 the Level III trauma centers on the base of multidisciplinary hospitals for intensive treatment of the first level. Complete need for Ukraine constitutes 530 Centers of Trauma.

Conclusion. The system for the Emergency Medical Help Delivery to the injured persons must be based on the net of the Trauma Centers of a certain level. The trauma centers organization needs some preliminary work to do: to study the traumatism indices, analysis of the regional need in medical help delivery and depicting of the National Trauma Registry. Trauma Centers in Ukraine is expedient to create on the base of the university regional hospitals, multidisciplinary hospitals of intensive therapy and hospitals of urgent medical help. Possibility of inclusion to the medical help delivery of such specialists, as a surgeon, anesthesiologist, traumatologist and neurosurgeon, constitutes an obligatory element of the trauma center organization. Financial support for the medical help delivery to the injured persons, suffering severe combined trauma, demands additional input of the nonbudget resources.

Author Biographies

G. G. Roshchin, Shupyk National medical Academy of Postgraduate Education, Kyiv

Roshchin Georgiy G. - MD, DSci (Med), professor,
Head of the Disaster and military department, general surgeon
Shupik National medical academy of postgraduate education
9 Dorohozhytska Str. Kyiv 04112 Ukraine
3 Bratislavskaja Str., Kyiv 02000, Ukraine
+38 067 713 41 57
E-mail: roshchin@meta.ua
ID ORCID https://orcid.org/0000-0002-5800-2725

О. V. Mazurenko, Shupyk National medical Academy of Postgraduate Education, Kyiv

Mazurenko Oleg V. - MD, PhD. Associate professor
Disaster and military medicine department,
Shupik National medical academy of postgraduate education
9 Dorohozhytska Str. Kyiv 04112 Ukraine
3 Bratislavskaja Str., Kyiv 02000, Ukraine
+38 050 589 37 18
E-mail : oleg.v.mazurenko@gmail.com
ID ORCID https://orcid.org/0000-0003-2560-900X

V. M. Dorosh, Кyiv’s Municipal Clinical Hospital of Urgent Medical help

Dorosh Victor M. –
Head of Polytrauma department,
Kyiv Emergency Medical Aid Hospital.
3 Bratislavskaja Str., Kyiv 02000, Ukraine
+38 097 209 53 05
E-mail: politravma.dorosh@gmail.com
ID ORCID https://orcid.org/0000-0002-8394-9160

О. Z. Pagava, Кyiv’s Municipal Clinical Hospital of Urgent Medical help

Pagava Alexander Z. - surgeon
department of polytrauma,
Kyiv Emergency Medical Aid Hospital.
3 Bratislavskaja Str., Kyiv 02000, Ukraine
+38 096 408 59 01
E-mail: megrel1954@gmail.com
ID ORCID https://orcid.org/0000-0002-8404-6190

V. I. Ivanov, Ukrainian Scientific-Practical Center of Emergent Medical Help and the Disaster Medicine, Kyiv

Ivanov Volodimir I.- general surgeon,
Emergency medical team
Ukrainian Emergency and disaster medicine scientifical and practical centre by Health Ministry
3 Bratislavskaja Str., Kyiv 02000, Ukraine
+38 063 190 14 21
E-mail sstvova@ukr.net
ID ORCID https://orcid.org/0000-0002-2223-0363

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Published
2019-05-05
Section
Organization of Surgical Service