The objective of the study based on the analysis and evaluation of key performance indicators of the all-Russian center for disaster medicine "Zaschita" FMBA Rossii (WCMC "Protection" in the Center) and disaster medical Service (QMS), Russian Ministry of health to develop proposals and to identify priority areas for further development and improvement of the system of medical support of the population in emergency situations (es). Materials and methods of research. Materials research: normative and methodical documents governing the organization and operation of the all-Russian service for disaster medicine (VSMK), medical aid to victims in emergency and medical evacuation; records of the regional centers of emergency medical care and disaster medicine (SMP RC and IC), the territorial centers of emergency medicine (TSMC) and WCMC "Protection" on the activity of the elimination of the health consequences of emergencies in 2020 etc. Research methods: analytical, statistical, direct observation method, logical and information modeling. The results of the study and their analysis. In 2020, 2108 emergencies with health consequences occurred in the Russian Federation, excluding the COVID-19 pandemic, which is almost 25% less than in 2019. This situation can be explained by a decrease in the intensity of transport operations and the activity of the population during the pandemic. In order to further develop the system of medical support for the population in emergencies, the main tasks for 2021 are formulated.
The purpose of the study is to develop and to substantiate proposals for optimizing management activities for organizing the provision of medical care and medical evacuation of victims of terrorist attacks with the use of explosive devices and conventional weapons. Materials and research methods. Research materials: normative and methodological documents regulating the procedure for management activities in the medical provision of the population affected in emergency situations; data of expert assessment maps on the research topic; scientific works and publications devoted to topical issues of management activities in the framework of the issue under study. In the course of the study, the following scientific methods were used: methods of content analysis and expert assessment, statistical method, method of logical and information modeling, analytical method. Research results and their analysis. The results of the study showed that one of the organizational issues in the system of countering terrorism and of organizing the elimination of medical and sanitary consequences of terrorist attacks is the presence of a coordinating management body, on which it is advisable to assign the appropriate functions to coordinate the activities of medical forces and means. In the course of the study, the rank value of each medical brigade and medical unit participating in the elimination of medical and sanitary consequences of terrorist attacks was determined; quality of methodological support for predicting medical and sanitary consequences of terrorist attacks and for planning the organization of medical assistance to victims of terrorist attacks has been studied; main methodological approaches that should be taken into account when planning the organization of medical care and medical evacuation of victims of terrorist attacks in each constituent entity of the Russian Federation were formulated; a list of most effective measures has been identified, which make it possible to increase the readiness of health authorities, medical units and organizations to work to save lives and to preserve the health of victims of terrorist attacks, etc.
Relevance. In our country, as part of the digitalization of healthcare, a number of organizational decisions have been made and are being implemented to optimize the medical evacuation of the sick and injured in emergency situations. The digital transformation of healthcare in order to address the issues of treatment correction, patient transportability and the feasibility of medical evacuation to the greatest degree is realized so far only in the form of telemedicine consultations. At the same time, the latest developments can already be applied, allowing the use of advanced information technologies, including artificial intelligence technologies, for each sick or injured during medical evacuation in the prehospital and hospital periods in the event of emergency response and during everyday work. One of such developments could be the creation of a portable isolated robotic medical module.Intention: To justify the concept of a portable, isolated robotic medical module for the medical evacuation of the sick and injured using advanced medical digital technologies.Methodology. Based on an analysis of the advanced medical equipment, medical materials, digital medical technologies, many years of comprehensive in-house experience in medical evacuation, an information and patent search was conducted for conceptual solutions to create a portable isolated robotic medical module (Module) for medical evacuation of the sick and injured in the daily life and emergency situations.Results and Discussion. A key solution to the problem is to implement the following original ideas. Firstly, it is the “block” principle of layout of the Module structure. In the first (upper) block, robotic diagnostic and medical equipment, control systems and telemetry communications are installed. If you need to work offline, the unit is protected from external influences. The second (middle) block is designed to accommodate a patient who receives medical care. The unit can be completely isolated from the external environment, a comfortable internal environment is created and elements of a video communication system are placed. The third (lower) block contains systems for patient’s life support and autonomic operation, and can be delivered on board the vehicle separately from the first and second blocks. The mass of the third block is not critical for the mass of theModule as a whole. Secondly, there is an idea of using special removable and replaceable shells to isolate the Module from adverse weather conditions. It is possible to use a removable cover made of protective materials. For the conditions of the Far North, these are heat-conserving materials, for the conditions of armed conflict - para-aramid fiber (Kevlar). Thirdly, ergonomic location of medical equipment above the patient provides convenient maintenance of equipment for medical manipulations. In this case, observation and treatment are not interrupted when moving the patient from one vehicle to another.Conclusion. Advanced digital medical technologies in the medical evacuation of the sick and injured within the concept of a portable, isolated, robotic medical module can significantly reduce risks and apply a patient-oriented approach during the medical evacuation of each patient. This makes a significant contribution to the development of medical evacuation and practical medicine.
The objectives of the study are to analyze the experience of exercises conducted in the counter-terrorism system by specialists of the regional Disaster Medicine Service, to identify key organizational issues of preparation and implementation of exercises; to develop proposals for their improvement in the subject of elimination of medical and sanitary consequences of terrorist acts committed with the use of conventional means of destruction. Materials and research methods. Sources of information and materials studied: normative and methodological documents regulating the procedures of organizing and conducting military training in the field of healthcare; materials of trainings performed by specialists from regional EMC on the subject of organizing the liquidation of medical and sanitary consequences of terrorist acts; data from expert evaluation maps on the subject of the study; scientific papers and publications on technologies of training and exercises involving specialists from healthcare management bodies, medical units and organizations. The following scientific methods were used in the research: content analysis method, expert assessment method, statistical method, logical and informational modeling, and analytical method. Results of research and their analysis. The results of the study of basic organizational issues of preparing and conducting special exercises (command-staff exercise, staff training, tactical and special exercises) conducted in the regions with the participation of specialists of public health authorities, medical formations and organizations within the framework of counter-terrorism are presented. Sound proposals were made to improve the technology of preparing and conducting special exercises and communicating their results to medical specialists. The results of the study showed that almost all the experts (98.0%) were in full agreement with the need, in order to maintain and increase the preparedness of health care authorities, medical organizations, including emergency medical care and the Disaster Medicine Service, to conduct regional trainings on the subject of medical support of the population during terrorist acts. And only 2.0% of the experts had difficulty in formulating a specific conclusion on this issue.
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