HISTORY OF THE DEVELOPMENT OF AIR AMBULANCE IN RUSSIA
- Authors: Abramyan A.A.1, Silkin A.V.1, Klyukin A.A.1
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Affiliations:
- Voronezh State medical university named after N.N. Burdenko
- Issue: Vol 11 (2022): Materials of the XVIII International Burdenkov Scientific Conference on April 14-16, 2022
- Pages: 35-38
- Section: Влияние факторов внешней среды на здоровье человека
- URL: https://new.vestnik-surgery.com/index.php/2415-7805/article/view/7165
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Abstract
Relevance. The use of air ambulance is the most important component of medical support, which, first of all, determines the effectiveness of medical care provided to various groups of the population.
Goal. To analyze the history of the development and application of aviation in medicine, as well as to try to justify further opportunities and ways to improve the air ambulance service in the Russian Federation.
Methods. There was a review and study of the literature that was devoted to this topic, the study of materials from the university archive, as well as the integration of information from historical sources about the development of air ambulance in our state from the beginning of the XX century to the present.
Results. In our country, the development of the air ambulance service was mainly through the introduction of specialized sanitary transport used during military operations and in peacetime in various emergencies. During the Second World War and in the post-war period, air ambulance was successfully used both for evacuation and for the provision of qualified medical care. The main advantage of the technical means used in this case was the ability to take patients out of the emergency zone with simultaneous monitoring of their condition and the possibility of carrying out the necessary resuscitation measures, including during flight, that is, on board these vehicles. The analysis of samples of transport, which was used in the past and is currently being used, showed their high efficiency, as well as the need for their use during emergencies. The use of this service has its advantages and disadvantages, which determine the expediency of using it in emergency situations of various kinds.
Conclusion. The use of sanitation during medical evacuation made it possible to significantly increase the effectiveness of providing medical care to the wounded and injured in emergencies of peacetime and wartime, thereby saving a large number of lives.
Full Text
Relevance
Air ambulance is designed to provide medical care in conditions of poor transport accessibility or considerable distance from medical institutions. The advantages of using air ambulance are obvious, these are: faster speed of arrival at the emergency site and transportation of patients and injured to the hospital. Since, according to statistics, most of the patients who die on the way to the hospital die as a result of ongoing bleeding, in this case, the only effective way to save such a patient is to deliver him to a medical institution as soon as possible, where he will receive the necessary assistance, air ambulance copes with this problem perfectly. The use of medaviation also makes it possible to solve the problems of monitoring the vital functions of the patient, immobilization of the damaged area or part of the victim's body during his transportation and treatment. [1]
The purpose
Is to get acquainted with the history of the development of air ambulance in Russia, as well as to consider examples of created vehicles that are used to evacuate victims from the emergency zone and provide them with emergency medical care. To try to suggest further trends in the development of air ambulance, as well as to consider the advantages and disadvantages of the currently existing system.
Method
Design of the research This article is an analysis of the literature data on the history of the development and application of air ambulance in Russia. The results of this work were presented taking into account the review of material from open archives, as well as published in various publications. In this study, a search, descriptive and comparative method was used.Criteria of conformity The selection of such literature was carried out, which covered in detail and accurately the history of the development of air ambulance in our country.The authors' review of the information that was obtained during the study was carried out under the supervision of scientific supervisors. Literature on this topic was found not only in Internet sources, but also in the university library and the scientific electronic library e-library.Duration of the study The study was conducted from December 2021 to January 2022.Description of medical interventions In the course of the study, no medical interventions were carried out. The main outcome of the research The main outcome of this study is the analysis and evaluation of the development and application of air ambulance in our country.Additional research outcomes Additional goals and objectives were not set in this study. Analysis in subgroups Analysis in subgroups was not carried out. Methods of recording the outcomes of this study were recorded in the process of reviewing the literature data on this topic.Statistical analysis Statistical analysis was not carried out.
Results
Sanitary aviation began to emerge in our country in the mid-20s of the last century, the initiator of its creation was the Red Cross and Red Crescent Society of the USSR. So in the 30s of the XX century, special types of aircraft were already designed and created, the main requirements for equipping these aircraft and their flight characteristics were formulated. During these years, the K-3 aircraft was created by the designer Graziansky, who developed it with the direct participation of health workers. "Nurse" - that's what the pilots called this plane. In this plane, the medical worker was at the feet of the patient on a special folding chair. Behind him was a medicine cabinet and an air tank. In the corner there were special containers with cold and hot water and a drain sink. [2, 3] During the Great Patriotic War, air ambulance helped save a huge number of human lives. But the experience of the very first days of the war revealed a tangible shortage of equipment, which was sorely lacking, so thanks to Grigory Ivanovich Bakshaev, the so-called cassettes for transporting the wounded, which were attached to the lower wings of the U-2, were released and tested on June 28, 1941. These cassettes were a stretcher platform with a light removable roof at the top, which was made of a special cloth and placed on a thin frame of slats. [4] After the Second World War, sanitary aviation began to be supplemented with new aviation equipment. It reached its peak in the second half of the twentieth century. At the same time, helicopters began to be actively used, their use made it possible to land the aircraft in places that were difficult to reach for a conventional aircraft. At this time, there is also a significant increase in the carrying capacity of aircraft, the cabins become airtight and more spacious, all these innovations allow you to transport a larger number of victims on board the aircraft with less inconvenience. In the 70-80-ies of the twentieth century, the following were developed: the Mi-8MB Bisector ambulance helicopter, the An-26M Rescuer resuscitation and operational aircraft, the Il-76MD Scalpel laboratory operating and resuscitation aircraft. [5] The Mi-8MB Bisector helicopter was equipped with a stretcher, an operating table, an apparatus for anesthesia and artificial ventilation, an electrocardiograph, a pacemaker, as well as other medical equipment and equipment. The use of this helicopter made it possible to effectively provide both first aid and qualified medical care, carry out infusion and drug therapy, ventilator, as well as to investigate and register the electrical activity of the heart using the ECG method. By the early 70s, there were about 160 hospitals in the Soviet Union that had An AN-26M "Rescuer", which was intended for medical evacuation with CPR, intensive care and surgical manipulations. It had four specialized compartments: one for medical personnel, the second operating room, as well as an intensive care unit and a technical compartment. [6] In 1983, the Il-76MD "Scalpel" flying hospital was designed and put into production. Its body had three container modules, which were interconnected and had an autonomous power source. In the first of them there were two operating tables, ventilators, electric pump, lamps. The second, intensive care unit, was occupied by 2 beds, ventilators, as well as an X-ray machine. The third, transport compartment provided for the placement of 12 suspended stretcher beds. All these three container modules were equipped with special wheels, which made it possible, if necessary, to take them out of the aircraft using a winch and deploy them at the emergency site. Currently, the following vehicles are used in the Russian Federation: Mi-8 helicopters, ANSAT, Il-76, AN-148 aircraft. At the beginning of the XXI century, the medical helicopter module (MMV) and the medical airplane module (MMC) were created, which were equipped with state-of-the-art medical equipment, their use in emergencies, thanks to their design features, can significantly reduce the time of transporting patients to a medical institution, therefore, significantly reduce the amount of sanitary losses among the population. These modules make it possible to effectively perform the entire complex of resuscitation and intensive care measures on board the aircraft, to carry out urgent evacuation of patients of different ages with the possibility of connecting to a ventilator. Significant disadvantages of MMV and MMC are the inconvenience or even impossibility of using them in ground transport, large mass, difficulty of installation and disassembly, limited operating time of medical equipment from an autonomous power source. [7] Despite the widespread use of air ambulance at the present time, it has several notable disadvantages associated with the high cost of aircraft and helicopters used and the high costs of their operation and maintenance. It is also worth noting the shortage of highly qualified personnel and the difficulties of conducting specialized training for them. Further development and improvement of the air ambulance service is possible by solving a number of problems that currently exist, such as difficulties with organizing flights over large cities, reducing the cost of operation and maintenance of aircraft. It is also necessary to improve the infrastructure for the use of helicopters, solve the problem of flying in bad weather conditions and at night, and in addition, create a specialized service in the Russian Federation that effectively unites rescuers and medics.discussion Summary of the main research result As a result of the research, we found out that the use of air ambulance can significantly reduce losses among the personnel of formations in wartime or as a result of an emergency in peacetime.
Discussion
Of the main result of the study Air ambulance begins to emerge in our country a few years after the end of the First World War, and already during the Second World War it was successfully used on the battlefields. In the post-war period, new aviation equipment appeared, which made it possible to more effectively provide medical care in emergency situations and significantly reduce the amount of sanitary losses. [8] Limitations of the study There were no restrictions for conducting this study.
CONCLUSION
Thus, based on all of the above, it can be concluded that the use of air ambulance has both its advantages and disadvantages. But using it to provide emergency medical care reliably reduces the amount of sanitary losses and saves the lives of a large number of victims as a result of emergencies of peacetime and wartime.
About the authors
Angelina Araikovna Abramyan
Voronezh State medical university named after N.N. Burdenko
Author for correspondence.
Email: linamia2000@gmail.com
ORCID iD: 0000-0002-9616-4362
SPIN-code: 5881-2587
4th course student of faculty of General Medicine of VSMU
Russian Federation, 10 Studentskaya str., Voronezh, 394036, RussiaAnton Vadimovich Silkin
Voronezh State medical university named after N.N. Burdenko
Email: anton.silkin.99@mail.ru
ORCID iD: 0000-0002-2238-5808
SPIN-code: 4207-6665
4th course student of faculty of General Medicine of VSMU
Russian Federation, 10 Studentskaya str., Voronezh, 394036, RussiaAndrey Andreevich Klyukin
Voronezh State medical university named after N.N. Burdenko
Email: flowye@mail.ru
ORCID iD: 0000-0003-2257-3216
SPIN-code: 4657-7314
4th course student of faculty of General Medicine of VSMU
Russian Federation, 10 Studentskaya str., Voronezh, 394036, RussiaReferences
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