The relevance of forecasting, prevention and liquidation of consequences of emergency situations (es) for the entire global community is constantly increasing. Annually in the world, natural disasters, accidents, catastrophes, fires, accidents at home and at work, about two million killed and injured tens of millions of people, and material damages up to 3% of the gross industrial product of the world economy.
Emergency medicine is an integral part of emergency response in extreme situations. As an independent scientifically-practical direction, emergency medicine was organized in 1976, R. Frey and P. Safar as the “club of Mainz”, which developed the technology aid in accidents and disasters in the area of the incident, during transport and at subsequent stages. With 80 years of rapid emergency response create in many developed countries, based on different conceptual approaches to the system of Euma. The need for effective organizational and medical technologies in emergency situations led to the creation in 1976 of the world Association of disaster medicine and emergency (VLCCS.
Analysis of the aftermath of accidents, catastrophes and natural disasters in our country 70-80-ies have shown a lack of willingness of involved services to emergency mode; not an exception and the health care system. In the study of the organization of emergency medical care in emergency situations have identified the following weaknesses: lack in health institutions, specific action plans in case of mass flood victims, the violation of the principles of medical sorting and evacuation and transport provision, undue delay in initial response of health haphazard provision of first, qualified and specialized medical care, the lack of reliable records of victims.
To adapt the medical service of civil defense (GO) to eliminate the consequences of emergencies in peacetime failed because the service is initially focused on wartime conditions and was not sufficiently mobile for a fast extension of its forces and resources in emerging centers of disasters. Territorial medical officers of health did not have the skills for rapid translation of the existing system with mode medical worker – patient mode medical worker – a contingent of victims.
The need for targeted training of health care to work in emergencies is reflected in the Council of Ministers of the USSR from 07.04.90. No. 339, which declared “ the establishment Of the country of emergency medical aid in an emergency.
Emergency medical assistance (SEMP) or used in recent years, by analogy with foreign countries, the name “service of medicine of accidents” (QMS) in Russia is a centralized service priority subsystem “Unified state system of prevention and liquidation of emergencies.
To date the broad medical community is not enough aware of the content of the key concepts and terms, which leads to misinterpretation and distorts the representation of objectives, functions and activities of disaster medical service. In this connection it is necessary to introduce definitions used in legal documents and practical activities: (“the Basic concepts and definitions of disaster medicine”, vtsmk “Protection”, M. 1997.
Medicine – the branch of medicine which is a system of scientific knowledge and practical activities aimed at saving lives and maintaining the health of the population in case of accidents, catastrophes, natural disasters and epidemics; prevention and treatment of injuries (diseases) arising in emergencies; the preservation and recovery of health of participants of liquidation of emergencies.
Emergency medical care – a complex of therapeutic and preventive interventions in emergencies to save the lives of the affected (patients), prevention of complications and faster recovery of their health.
Use a two-stage system of rendering medical aid: 1st stage – pre-admission – at the border of the lesion and in the process of evacuation and transport support; 2nd step – hospital.
The provision of emergency medical care to victims of emergencies used by all types of medical care: first aid, first aid, first medical aid, qualified and specialized.
Type of medical care – the officially established range of health events, solving specific tasks in the overall system of medical care and treatment, and require to carry out the training of personnel providing equipment, and certain conditions. Within each type of care (except emergency medical and pre-medical) provides the standard list of preventive measures that are performed at this stage of medical evacuation with respect to certain categories of the affected for medical reasons, in accordance with the specific medical and tactical situation and the capabilities of the stage of medical evacuation. This list of preventive measures in aggregate is the extent of medical assistance . The volume of medical aid at the stages of medical evacuation is not permanent and may change depending on the situation.
The full scope of medical care includes the full range of activities inherent in this type of medical care, reduced provides for a temporary waiver of certain events.
First aid – medical care, including the complex of the simplest medical interventions that are performed directly on the site of the lesion or close to it in order self – help and participants of rescue works (or medical personnel) using organic and improvised.
Standard medical measures of first aid are: to stop the influence of weight status or the affected causing death; the elimination of the phenomena that directly threaten their life (bleeding, asphyxia, etc.); prevention of complications and ensuring the evacuation affected no significant deterioration of their condition.
The contents of first aid depends on the damaging factors in emergencies, and of the character of the people defeats.
Pre-medical care – medical care, activities of which complement the first aid. Aid prevents and corrects disorders (bleeding, asphyxia, convulsions, etc.), threatening the lives of the affected and prepare them for further evacuation. Turns out to be a paramedic or nurse in the hearth (area) of the lesion using standard-issue medical property.
First medical aid – medical care, including the complex of therapeutic and preventive measures carried out by doctors and to eliminate the effects of lesions (diseases) directly threatening the lives of the affected and prevention of complications, and preparation of the affected, if necessary, for further evacuation.
The main activities of first aid for urgency are divided into immediate and activities whose implementation in the current situation may have delayed or postponed to the next stage of medical evacuation.
Qualified medical care – medical care, including the complex of therapeutic and preventive measures performed by medical generalists (the surgeons.
Specialized medical care – medical care that includes comprehensive complex of therapeutic measures that are performed by medical specialists in specialized medical institutions with the use of special equipment.
The health effects of CHS – comprehensive description of emergency, including the content, volume and organisation of medical care, as well as data on the size and structure of sanitary and irretrievable losses, and needs in various types of medical care, sanitary and epidemiological conditions, violations of medical institutions, and livelihoods of the population in the emergency area and adjacent areas, economic damage.
Deadweight loss – the people who were killed or missing in the event of emergencies.
Sanitary loss – affected and affected by a disaster.
Situational – caused losses – “indirect victims of the disaster”- people who have suffered a disaster of severe trauma, exacerbation of chronic diseases, premature birth etc.
The QMS should provide sustainable operational response of the health system to crisis and emergencies of various types and scale to respond promptly to sudden and exceeding the daily need for emergency health care with efficient use of medical manpower and resources.
Health system QMS should consistently to respond to crisis and emergencies of various types and scale, when the need for emergency health care exceeds the everyday, rational using of medical forces and means.
Main tasks of the QMS.
1. The organization and implementation of rapid and efficient delivery of all kinds of medical assistance to victims in emergency situations.
2. Organization of maintenance of sanitary-and-epidemiologic wellbeing of the population in the emergency area.
3. The organization of interaction of authorities, groups and health care institutions involved in liquidation of medical-sanitary consequences of emergencies, regardless of their affiliation, coordination of their activities.
4. The organization of interaction of QMS staff with non-medical operational services involved in liquidation of consequences of emergency situations.