mchsrosМедико-биологические и социально-психологические проблемы безопасности в чрезвычайных ситуацияхMedicо-Biological and Socio-Psychological Problems of Safety in Emergency Situations1995-44412541-7487«The Nikiforov Russian Center of Emergency and Radiation Medicine»10.25016/2541-7487-2022-0-2-42-51mchsros-802Research ArticleМедицинские проблемыMedical IssuesДиагностические ультразвуковые исследования при эвакуации ургентных пациентов санитарным вертолетом: обзор литературыDiagnostic ultrasound examinations during evacuation of urgent patients by ambulance helicopters: literature reviewhttps://orcid.org/0000-0002-4172-8263ГуменюкС. А.GumenyukS. A.

Гуменюк Сергей Андреевич – канд. мед. наук, директор

129090, Москва, Б. Сухаревская пл., 5/1, стр.1

Sergey Andreevich Gumenyuk – PhD. Med. Sci., Director

5, pr. 1, B. Sukharevskaya sq., Moscow, 12909 

cemp75@yandex.ruhttps://orcid.org/0000-0001-6998-1669АлексанинС. С.AleksaninS. S.

Алексанин Сергей Сергеевич – д-р мед. наук проф., чл.-кор. РАН, директор 

 194044, Санкт-Петербург, ул. Акад. Лебедева, д. 4/2 

Sergei Sergeevich Aleksanin – Dr. Med. Sci. Prof., Corresponding Member of Russian Academy of Sciences, Director

4/2, Academica Lebedeva Str., St. Petersburg, 194044 

medicine@nrcerm.ruhttps://orcid.org/0000-0001-8643-1829ЩикотаА. М.SchikotaA. M.

Щикота Алексей Михайлович – канд. мед. наук доц., ст. науч. сотр. ;  учен. секретарь 

 129090, Москва, Б. Сухаревская пл., 5/1, стр.1 

Aleksey Mikhailovich Shikota – PhD. Med. Sci. Senior Research Associate;scientific secretary 

5, pr. 1, B. Sukharevskaya sq., Moscow, 12909 

53, Zemlyanoy Val Str., Moscow, 105120 

alexmschikota@mail.ruhttps://orcid.org/0000-0003-0032-5828ЯремаВ. И.YaremaV. I.

Ярема Владимир Иванович – д-р мед. наук проф., вед. науч. сотр. 

 129090, Москва, Б. Сухаревская пл., 5/1, стр.1 

Vladimir Ivanovich Yarema – Dr. Med. Sci. Prof., Leading Research Associate

5, pr. 1, B. Sukharevskaya sq., Moscow, 12909 

npcemp@zdrav.mos.ruПогонченковаИ. В.PogonchenkovaI. V.

Погонченкова Ирена Владимировна – др мед. наук, директо

105120, Москва, ул. Земляной вал, д. 53 

Irena Vladimirovna Pogonchenkova – Dr. Med. Sci., Director

53, Zemlyanoy Val Str., Moscow, 105120 

PogonchenkovaIV@zdrav.mos.ruМосковский территориальный научно-практический центр медицины катастроф Департамента здравоохранения города МосквыРоссияMoscow Territorial Scientific and Practical Center for Disaster Medicine of the Moscow City Health DepartmentRussian FederationВсероссийский центр экстренной и радиационной медицины им. А.М. Никифорова МЧС РоссииРоссияThe Nikiforov Russian Center of Emergency and Radiation Medicine. EMERCOM of RussiaRussian FederationМосковский территориальный научно-практический центр медицины катастроф Департамента здравоохранения города Москвы; Московский научно-практический центр медицинской реабилитации, восстановительной и спортивной медицины Департамента здравоохранения города МосквыРоссияMoscow Territorial Scientific and Practical Center for Disaster Medicine of the Moscow City Health Department; Moscow Centre for Research and Practice in Medical Rehabilitation, Restorative and Sports MedicineRussian FederationМосковский научно-практический центр медицинской реабилитации, восстановительной и спортивной медицины Департамента здравоохранения города МосквыРоссияMoscow Centre for Research and Practice in Medical Rehabilitation, Restorative and Sports MedicineRussian Federation202203082022024251Copyright © Гуменюк С.А., Алексанин С.С., Щикота А.М., Ярема В.И., Погонченкова И.В., 20222022Гуменюк С.А., Алексанин С.С., Щикота А.М., Ярема В.И., Погонченкова И.В.Gumenyuk S.A., Aleksanin S.S., Schikota A.M., Yarema V.I., Pogonchenkova I.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://mchsros.elpub.ru/jour/article/view/802

Актуальность. Использование ультразвуковой диагностики при оказании скорой медицинской помощи в экстренной форме пациентам на месте возникновения острого заболевания или пострадавшим в зоне чрезвычайной ситуации является одним из перспективных направлений развития экстренной медицины. Особый интерес вызывает возможность использования догоспитальных диагностических исследований при санитарно-медицинской эвакуации ургентных пациентов вертолетом, притом что отсутствуют четкие алгоритмы и стандарты его применения, а также содержится ограниченное количество научных публикаций по проблеме.Цель – анализ научных публикаций по использованию диагностического ультразвукового исследования при санитарно-медицинской эвакуации ургентных пациентов вертолетом. Методология. Выполнен поиск научных публикаций по теме в электронном ресурсе PubMed и поисковой системе Google Scholar за период с 2000 по 2021 г.Результаты и их анализ. Догоспитальные диагностические ультразвуковые исследования ургентным пациентам на месте оказания скорой медицинский помощи в экстренной форме проводятся по алгоритмам, описанным в зарубежной печати как Focused Assessment with Sonography for Trauma (FAST), Point-of-Care UltraSound (POCUS), Prehospital ultrasonography (PHUS), Rapid Ultrasound in SHock (RUSH), Bedside Lung Ultrasound in Emergency (BLUЕ) и др. Они позволяют исключить повреждения жизненно важных органов, представляющих угрозу для жизни пострадавших и пациентов с острыми заболеваниями и травмами (например, пневмо- и гемоторакс, гемоперитонеум, гемоперикард, крупные переломы и др.), влияющих на тактику оказания скорой медицинской помощи и маршрутизацию пациента, также применять ультразвук с целью точного ориентирования патологии при ряде лечебных и диагностических манипуляций. По результатам опубликованных исследований и клинических наблюдений догоспитальная ультразвуковая диагностика ургентных пациентов успешно используется при санитарно-авиационной эвакуации вертолетом в экстренных медицинских службах многих стран мира (как врачебным, так и иным медицинским персоналом), позволяя с достаточно высокой точностью диагностировать ряд угрожающих жизни состояний без потери времени и ущерба для здоровья пострадавшего (больного). Важный аспект успешного применения метода во время полета – подготовка квалифицированного персонала. Перспективами его развития являются разработка более совершенных ультразвуковых сканеров и датчиков, адаптированных к условиям полета, а также применение телемедицинских технологий для дистанционного анализа ультразвуковых изображений.Заключение. Опыт применения догоспитального диагностического ультразвукового исследования при санитарно-медицинской эвакуации вертолетом требует дальнейшего накопления и анализа данных, но уже сейчас выявлена несомненная польза метода при определении тактики оказания скорой медицинской помощи в экстренной форме и маршрутизации госпитализации ургентных пациентов с острой травмой и рядом других патологических состояний.

Relevance. The use of ultrasound diagnostics at the place of providing medical care to an urgent patient is one of the promising directions in the development of emergency medicine. At the same time, of particular interest is the possibility of using diagnostic ultrasound in an ambulance helicopter, given the lack of clear algorithms and standards for its application, as well as the limited number of publications on this problem.Intention. Analysis of publications on the use of urgent ultrasound examination in an ambulance helicopter.Methodology. A search was made for scientific publications on the topic on the electronic resource PubMed, in the Google Scholar search system for the period from 2000 to 2021.Results and discussion. The main algorithms used for ultrasound diagnostics of an urgent patient in an ambulance helicopter are Focused Assessment with Sonography for Trauma (FAST), point-of-care ultrasound (POCUS), Rapid Ultrasound in SHock (RUSH), Bedside Lung Ultrasound in Emergency (BLUЕ), prehospital ultrasonography (PHUS), etc. They help exclude damage to vital organs and emergency pathology – pneumo- and hemothorax, hemoperitoneum, hemopericardium, large fractures and others that affect the tactics of treatment and patient routing; there is also the possibility of ultrasound navigation for a number of medical and diagnostic procedures. According to the results of published studies and clinical observations, prehospital ultrasound examination of urgent patients is successfully used during medical evacuation by an ambulance helicopter in emergency medical services in many countries of the world (both by doctors and other medical personnel), making it possible to diagnose a number of lifethreatening conditions with a fairly high accuracy, without loss of time and without damage to patient’s health. An important aspect of the successful application of the method during flight is the training of qualified personnel. The prospects for the development of the method are the development of more advanced ultrasound scanners and sensors adapted to flight conditions, as well as the use of telemedicine technologies for remote analysis of ultrasound images.Conclusion. The experience of using prehospital diagnostic ultrasound in an ambulance helicopter requires further data accumulation and systematic analysis, but the method is already undoubtedly useful in determining the tactics of treatment and the route of hospitalization of urgent patients with acute trauma and a number of other pathological conditions.

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The authors declare that there are no conflicts of interest present.