RENDERING HEALTH CARE TO POLYTRAUMA PATIENTS AT TRAUMA CENTERS OF ST. PETERSBURG

Relevance. Mortality and unsatisfactory results of polytrauma treatment are still high since no effective system of organizing specialized medical care for this category exists.

Intention. To study effectiveness of organizing specialized medical care for polytrauma in trauma centers in St. Petersburg.

Methods. Тen trauma centers provide specialized medical care to polytrauma patients in St. Petersburg, including six Level I and four Level II centers. Level I trauma centers have central and Level II trauma centers – peripheral location (in satellite towns). Annually, they treat and examine about 3000 patients. Most polytraumas result from traffic accidents. Polytrauma treatment at trauma centers of St. Petersburg was analyzed. Annual reports of trauma centers were studied, and surveys of their medical personnel were conducted with a selective study of case records of polytrauma patients. The following parameters were considered: time to trauma center admission, ambulance profile, types and volumes of specialized medical care provided at a specific trauma center. Death and complication rates along with total duration of inpatient treatment were assessed vs health care at the prehospital stage.

Results and Discussion. Presently, an advanced effective system of specialized medical assistance to polytrauma patients has been created in St. Petersburg. The whole arsenal of diagnostic and treatment facilities along with healthcare professionals of multidisciplinary hospitals helps to decrease mortality and complications rates. Mortality rates in patients with polytrauma in St. Petersburg are about 12 % at Level I trauma centers and about 19 % at Level II trauma centers, which is significantly lower than in other cities of Russia and slightly higher than in Moscow. Ambulance resuscitation teams and their adequate interventions at the prehospital stage play an important role. This article discusses the problems of trauma center underfunding, wider use of modern high-tech minimally invasive medical and diagnostic technologies (traumatology, endoscopy, endovascular, endovideosurgical ones), polytrauma monitoring, improving medical care at the prehospital stage, creating a rehabilitation system etc.

Conclusion. Based on the analysis of literature and own research, the main principles of polytrauma treatment were established, the need for connecting all the municipal trauma centers to the cloud server for statistical purposes was determined thus enabling proper resource allocation and timely treatment of patients with polytrauma.

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