Medical evacuation of patients (injured) in the Arctic zone by non-staff units of the Disaster Medicine Service of the Northern Fleet of Russia

Relevance. The development of the Arctic territories of Russia determines the need to protect civilian and military facilities and improve the provision of emergency specialized medical care to servicemen in remote garrisons.

Intention. To study the organization of medical evacuation of military personnel with community-acquired pneumonia from remote garrisons in the Arctic zone of Russia for 2013–2017.

Methodology. We conducted a retrospective analysis of all cases of medical evacuations of military personnel from remote Arctic garrisons. In addition, we studied data from 87 case histories, medical evacuation cards for military personnel with moderate and severe community-acquired pneumonia transferred to the 1469th Naval Clinical Hospital of Severomorsk and the central military medical organizations from 2008 to 2010 and from 2013 to 2017.

Results and Discussion. In 20% and 20–30% of cases, medical evacuation was performed, respectively, due to injuries and community-acquired pneumonia. A structural-functional model of the provision of emergency specialized medical care to servicemen with community-acquired pneumonia in remote Arctic garrisons has been formed using the forces and means of emergency forces of the Disaster Medicine Service of the Northern Fleet of Russia. The results of optimization of the organization of medical evacuation of patients with severe community-acquired pneumonia are presented.

Conclusion. To improve the effectiveness of emergency medical care in patients with community-acquired pneumonia, it is advisable to include in the system of special training of medical staff and nursing staff a training course on the organization of medical evacuation in the Arctic zone of Russia.

1. Arkhangel’skii D.A., Panina T.V., Zakrevskii Yu.N. [et al.]. Diagnostika, lechenie i evakuatsiya voennosluzhashchikh s vnegospital’noi pnevmoniei tyazhelogo techeniya v usloviyakh Krainego Severa [Diagnosis, treatment, and evacuation of the military personnel with severe out-of-hospital pneumonia under condition of the Far North]. Voenno-meditsinskii zhurnal [Military medical journal]. 2016. Vol. 337, N 8. Pp. 34–39. (in Russ.)

2. Evdokimov V.I., Sivashchenko P.P. Osnovnye pokazateli sostoyaniya zdorov’ya matrosov i starshin po prizyvu Voenno-Morskogo flota Rossii v 2003–2016 gg. [The main indicators of the state of health of draft sailors and sergeants in the Russian navy in 2003–2016]. Morskaya meditsina [Marine Medicine]. 2017. N 4. Pp. 42–53.(in Russ.)

3. Evdokimov V.I., Sivashchenko P.P., Grigor’ev S.G. Pokazateli zabolevaemosti voennosluzhashchikh kontraktnoi sluzhby Vooruzhennykh sil Rossiiskoi Federatsii (2003–2016 gg.) [Morbidity indicators in contract servicemen of the Armed Forces of the Russian Federation (2003–2016)] : monografiya. Sankt-Peterburg. 2018. 80 p. (in Russ.)

4. Zaitsev A.A. Epidemiologiya zabolevanii organov dykhaniya u voennosluzhashchikh i napravleniya sovershenstvovaniya pul’monologicheskoi pomoshchi [Epidemiology of respiratory diseases among servicemen and directions of improving pulmonological care]. Voenno-meditsinskii zhurnal [Military medical journal]. 2018. Vol. 339, N 11. Pp. 4–9.(in Russ.)

5. Lemeshkin R.N. Normativnoe pravovoe soprovozhdenie deistvii Sluzhby meditsiny katastrof Minoborony Rossii: problemnye voprosy i puti ikh resheniya [Standard legal support of actions of Service of disaster medicine of the Ministry of Defense of the Russian Federation: problematic issues and their solutions]. Vestnik Rossiiskoi voenno-meditsinskoi akademii [Bulletin of Russian Military medical Academy]. 2016. № 1. Pp. 188–198.(in Russ.)

6. Ob utverzhdenii Polozheniya o Sluzhbe meditsiny katastrof Ministerstva oborony Rossiiskoi Federatsii : prikaz Ministra oborony Rossii ot 29.05.1997 г. № 217. [On the Disaster Medicine Service of the Ministry of Defense of the Russian Federation: Order of the Minister of Defense of Russia of 29.05.1997, N 217]. URL: http://lawru.info/dok/1997/05/29/n436429.htm (in Russ.)

7. Popov A.V., Garmash O.A., Gromut A.A. O sozdanii sistemy aviameditsinskoi evakuatsii i ekstrennoi meditsinskoi pomoshchi naseleniyu Rossiiskoi Federatsii [On Creation of Aeromedical Evacuation and Emergency Medical Care System for the Russian Federation Population]. Meditsina katastrof [Disaster medicine]. 2009. N 3. Pp. 45–49.(in Russ.)

8. Tyurin V.P., Sergoventcev A.A., Axenfeld D.I. Provedenie neinvazivnoi ventilyatsii legkikh patsientu s dvukhstoronnei pnevmoniei tyazhelogo techeniya [Non-invasive ventilation conducting to the patient with bilateral severe course pneumonia]. Vestnik natsional’nogo mediko-khirurgicheskogo tsentra im. N.I. Pirogova [Bulletin of Pirogov National Medical and Surgical Center]. 2016. N 1. Pp. 139–140.(in Russ.)

9. Fisun A.Ya., Yakovlev S.V. Sostoyanie i osnovnye napravleniya sovershenstvovaniya Sluzhby meditsiny katastrof Ministerstva oborony Rossiiskoi Federatsii [Present State and Main Directions to Improve the Disaster Medicine Service of the Ministry of Defense of Russian Federation]. Meditsina katastrof [Disaster medicine]. 2016. N 4. Pp. 9–15.(in Russ.)

10. Shelepov A.M., Vislov A.V., Kanibolotsky M.N., Oblizin R.E. Perspektivy ispol’zovaniya aviatsionnogo transporta dlya evakuatsii ranenykh i bol’nykh v Vooruzhennykh silakh Rossiiskoi Federatsii [Prospects for the use of air transport to evacuate the sick and wounded in the Armed forces of the Russian Federation]. Vestnik Rossiiskoi voenno-meditsinskoi akademii [Bulletin of Russian Military medical Academy]. 2013. N 2. Pp. 158–164.(in Russ.)

11. Nysto/ yl D.S., Hunskaar S., Breidablik H.J. [et al.]. Treatment, transport, and primary care involvement when helicopter emergency medical services are inaccessible: a retrospective study. Scand. J. Prim. Health Care. 2018. Vol. 36, N 4. Pp. 397–405. DOI: 10.1080/02813432.2018.1523992