Sanitary aviation evacuation of victims with combined trauma and intracavitary bleeding in a metrocity

Abstract

In Moscow, there are possibilities for evacuating victims by ambulance and ambulance helicopter, while pre-hospital diagnosis of bleeding resulting from trauma is important for the victim. The purpose of the study was to analyze the results of sanitary aviation evacuation in a metropolis of victims with trauma (isolated, multiple, combined or combined), including internal bleeding, the causes of which were the influence of external factors. The objective of the study was to assess the speed of hospitalization of emergency victims with the help of ambulance helicopters, as well as the results of their treatment, with the identification of possible places where the time of the start of the operation was delayed from the moment of injury. Materials and methods. Our study included patients (52 people) hospitalized with the help of AMB in specialized medical institutions in Moscow from 2019 to 2023, with diagnoses of trauma to various organs, bleeding (ICD-10 classes of trauma, poisoning and some other consequences of external causes (S00-T98)). Results. The time for evacuation of emergency victims to a multidisciplinary hospital using ambulance helicopters in Moscow ranged from 56.3 to 155.4 minutes, depending on the distance to the multidisciplinary hospital. When compared, the time of hospitalization of patients in hospitals by ambulance, at similar distances, ranged from 82.3 to 137.5 minutes when the victims were located up to 90 km from a multidisciplinary hospital. At distances of more than 90 km, ambulances did not go for hospitalization to multidisciplinary hospitals in Moscow, and there is currently practically no alternative to an ambulance helicopter in emergencies. Conclusion. In the article, we analyzed the results of treatment of victims of external factors, evacuated by a medical helicopter, with isolated, multiple, associated and combined trauma, including signs of intra-abdominal or intrathoracic bleeding. The number of evacuations of victims by ambulance helicopter in case of such damage in a metropolis per year was determined. The reasons that prevent the victim from getting to the operating table were identified and the results of treatment of these patients in hospitals were assessed. Creating a clear evacuation algorithm if the victim has hemoperitoneum or hemothorax will allow timely initiation of measures to finally stop bleeding and improve treatment results.