Archive for the ‘Specialties’ Category

Emergency Medicine

Monday, April 19th, 2010

Field of medicine involved in the provision of qualified medical assistance to victims in emergency situations when there is a massive flow of injured or taken ill with a life-threatening condition and a situation of “one doctor – a lot of patients, in contrast to other areas of medicine, where the common is a situation of” one doctor – one patient.

An emergency is a sudden event has arisen, in which two or more people were killed or three or more people were injured / sick and are in serious condition. All such events information from the Emergency Situations Ministry, the bodies of internal affairs, military, health institutions and other organizations come to the Center of Disaster Medicine. There are emergencies, local (1-10 victims), spatial (10-50 cases), regional (50-500 cases), federal (more than 500 victims) and international level.

Service of Emergency and Disaster Medicine subordinated to the Ministry of Health and Social Development of the Russian Federation. By the nature of work has little in common with other health agencies, usually working in close collaboration with rescue groups ministry.

The objectives of disaster medicine service: Medical intelligence in the area of disaster, the affected sorting, organizing and casualty evacuations from disaster areas, an organization providing assistance and direct assistance to victims, involving additional medical forces to help the victims, if necessary, the organization of hospitalization of the victims, guide the actions of medical, rescue and all other groups and agencies, administration of human settlements in the area of disaster, on all matters related to the victims.

The structure of disaster medicine service (SMC) in Russia:

1. Central Airmobile Rescue Team “Tsentrospas” Emergency Ministry – a unique formation MOE, which formally includes physicians, are medical equipment and medicines. In other parts of Emergency medics there. At gladly accepted the position of rescuer people with medical education, but they do not have the medical equipment, medicines and licensed to provide medical care. “Tsentrospas” not directly related to disaster medicine service, but is actively involved in providing medical assistance to victims in emergency situations.

2. The lead agency of QMS – All-Russian Center for Emergency and Disaster Medicine (VTSMK) “Protect” Public Health Ministry. Engaged in scientific, educational and organizational work in the field of Emergency and Disaster Medicine, participates and leads in providing assistance to victims in emergency federal and international level. Has airmobile hospital. In everyday activities involved in issues related to air ambulance – aid and transportation of sick and injured in the air on the territory of Russia and abroad.

3. Regional Emergency Medical Center (TTSMK) – The establishment of regional subordination. The elimination of health consequences of emergencies local, territorial and regional level in the relevant field. Regional Emergency Medical Center (RTSMK) – an institution similar TTSMK, but in the subject of the Russian Federation, where there is no division in the area. In Moscow – a separate Emergency Medical Center – Scientific and Practical Centre of Emergency Medicine (TSEMP).

Ambulance stations and emergency care – in disaster medicine service are not included. Treated as a reserve formation of the QMS.

Federal Medical-Biological Agency (FMBA) – successor to the 3rd Main Directorate of Ministry of Health of the USSR. Engaged in patient care in nuclear industry, the military-industrial complex, etc., as well as “closed” settlements in such enterprises. Also, the elimination of the health effects of disaster in these companies and locations.

Structure of the Territorial Emergency Medical Center as an example GOOSE TTSMK Moscow region:

The structure TTSMK include:

1.Operativno-control department: gathering information, communication, leadership groups.

2. Clinical Department: Emergency medical assistance team (BEMP) – permanent formation TTSMK. In part – anesthesiologist-resuscitator, with the general experience of field work on ambulances and at least 10 years of experience in a hospital, two medical assistants with a similar experience on an ambulance driver. BEMP located in various locations throughout the controlled TTSMK. Typically, close to major federal highways. The area of responsibility includes BEMP sector along the federal highway from Moscow to the border area, including all roads, cities, towns, businesses, airports, railways, etc. Back-formation – an emergency response team (BARE) – employees of health facilities in settlements attracting in the case of emergency.

3. Inflatable mobile hospital – inflatable modules with the equipment.

4. Department of sanitary aviation – helicopters (because of financial problems until the stage of the organization).

5. Research Division.

6. Psychological Laboratory – psychologists and psychiatrists – assistance to victims in emergencies, and periodic testing and monitoring of staff TTSMK.

7. Support Services – Human Resources, Accounting, pharmacy warehouse, motor transport and etc.

The center can operate in three modes:

1. The regime of daily activity – causes the call BEMP – any disaster (more than 3 victims or 2 deaths) – an accident, fire, manmade or natural disaster, the collapse of buildings, bomb threat, terrorist attacks, hostage taking, riots and fights, knife and gunshot wounds, mine-blast injury The train accident, plane crash, fall from height, mass poisoning, cases of identification of particularly dangerous infections, any other emergencies. BEMP can leave the situation with one or two very hard-hit on the order of a senior doctor dispatching department. 90% of calls – major accident on the federal highways, outside the settlements. Objective BEMP – arrive, a medical intelligence and sorting, to seek additional forces (Ambulance and rescue from the nearest human settlements), direct assistance to victims on the spot emergency. Store medicines and consumables BEMP designed for 25 victims. There is a possibility of self-hospitalization of victims. Room BEMP corresponds to the department of anesthesiology and intensive care in hospital. Information about the disaster comes from local stations to ambulances, firefighters, rescue workers, police and traffic police in the dispatching department and directly doctor BEMP. Also BEMP drawn to the medical evacuation – transportation extremely difficult resuscitation of patients from hospital to hospital. Attention to health care events (alert).

2. Mode is the threat of a disaster – the deployment of mobile hospital, BARE mobilization, mobilization of bed resources in hospitals, and interoperability with other services.

3. Emergency Mode – Work under emergency regional or federal level.

Additional Information:

Disaster medicine service has its own dedicated circuit tsvetograficheskoy painting vehicles. Sanitary aviation uses tsvetograficheskuyu scheme aviation ministry. Typically, flight-technical personnel – officers and emergency medical personnel – members of the Center of Disaster Medicine. Ambulance use tsvetograficheskuyu scheme established by the State Standards for ambulances: a white or yellow body color, red stripe with a red cross on the board, the inscription “03″ front and rear of the car. Without fulfilling these conditions the car can not pass inspection, get permission to install spetssignalov and means of operational radio. In addition, may bear the inscription “Emergency Medicine”, “TSEMP, QMS logo – a golden bell on a red cross and the flag of the Russian Federation, the emblem of” Star of Life “(” Star of Life “) – Six-blue” snowflake “on a white background and other markings. Dress code – blue or dark blue with yellow accents and light reflective strips. Location of labels and decals may be different in different Emergency Medical Center.

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