Emergency Medical Care for Patients in Coma in Ryazan in 2016-2020

Abstract

The study objectives were to investigate the prevalence and to determine the most frequent causes of coma in patients in Ryazan; to determine the frequency of fatal outcomes at the stage of medical evacuation and the frequency of hospitalizations; to identify the features of emergency medical care in the prehospital period. Materials and methods. We analyzed statistical data on the number of witnesses who applied for emergency medical aid in cases of disturbance of consciousness in patients who were subsequently diagnosed as comatose patients; we revealed main causes and types of comatose states, number of fatal outcomes and frequency of hospitalizations in Ryazan. Materials of the study – cards of calls of ambulance crews in Ryazan in 2016-2020. Results of the study and their analysis. Analysis of statistical data for Ryazan in 2016-2020 showed a steady increase in the number of ambulance calls to patients in coma. In Ryazan, as in Russia as a whole, cerebral coma prevailed, with diabetic coma in second place and toxic coma – in third. In 2016-2020, the proportion of coma-related deaths was 2.7% in the prehospital period and had no upward trend. In 84% of cases patients were hospitalized in medical treatment organisations, patients with hypoglycemic coma sometimes refused hospitalization, there was no tendency in increase of the number of refusals. In the prehospital period, ambulance care for patients with coma was provided in accordance with the algorithms, average time to reach the call was 12.4 min, which corresponds to the respective norms for emergency calls for Ryazan.

Structure and Dynamic of Acute Poisonings in the City of Ryazan in 2016-2021

“…Врачи и фельдшеры общепрофильных и реанимационных бригад СМП оказывали медицинскую помощь согласно протоколу «отравление» -при коматозном состоянии предотвращали аспирационно-обтурационные осложнения, проводили промывание желудка, осуществляли внутривенные (в/в) инфузии, контролировали пульс и артериальное давление (АД), измеряли уровень сахара в крови [9]. Учитывая сложности с дифференцированием токсиканта в догоспитальном периоде, действия врачей СМП прежде всего были направлены не на применение антидотов, а на поддержание жизненно важных функций организма и скорейшую доставку пациентов в стационар.…”