Recently, the problems of medical escort of passenger transport services are becoming particularly relevant. Accidents involving the passengers using transport services, such as airplanes, trains, motor transport, etc., are increasingly covered in the mass media. At the same time, the emergency medical care provided by specialists with remote access to healthcare facilities, including specialized ones, is the only condition for minimizing injuries, their consequences, and the survival of victims. Therefore, nowadays the scientific community is often discussing the need to single out a separate industry in health care, such as transport medicine that would represent medical escort of passenger transport services and the order of its organization, which includes legislative definition and regulatory, structural, professional, financial, and technical supports. In the article the authors present their views of organizing transport medicine and offer possible ways of its solution.
The most common cause of neurological disability in childhood is cerebral palsy. The objectives of the treatment of children with cerebral palsy are the acquisition and maintenance of new motor skills; prevention of the development of contractures and other secondary orthopedic complications; decrease in the level of pain; improving the level of childcare. At the same time, the provision of treatment and rehabilitation assistance to children with cerebral palsy requires an integrated, systematic approach. The article describes the route of rehabilitation of children with cerebral palsy in the Chuvash Republic from the moment of diagnosis until reaching the age of 18. The study was carried out on the basis of an analysis of data from the regional register of children with cerebral palsy at all stages of treatment and rehabilitation (habilitation). The first stage includes the identification of risk groups for cerebral palsy, conservative, surgical specialized medical care. The register of children with cerebral palsy made it possible to keep records of patients at the stages of treatment and rehabilitation with an assessment of the results. At the second stage, high-tech conservative and surgical treatment is carried out. After operations, patients are sent for rehabilitation to a 24-hour hospital or to a Rehabilitation Center for Children (over 3 years, 1.5 thousand children were treated, 25.7% after operations). The third stage is organized at the outpatient clinic level and in specialized sanatoriums. For 20142018 the coverage of children with cerebral palsy with conservative treatment increased 1.9 times, with botulinum therapy 2.6 times, the proportion of those who received surgery decreased to 22.4%. 92.7% of patients of the Register are covered by conservative treatment. 33.3% of operated children were referred for sanatorium-resort treatment. The control section of the rehabilitation results showed an increase in the proportion of children with improved gait quality, the ability to stand independently, walk (with support), and an increase in the average level of physical activity. A multi-level system of interagency interaction in the provision of treatment and rehabilitation assistance to children with cerebral palsy in Chuvash Republic made it possible to ensure a sufficient amount of basic and availability of highly qualified medical care, effective management and control of the stages of rehabilitation.
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