[Medical care rendered to the wounded with abdominal nonpenetrating injury during pre-hospital stage].
Of 4477 lethal outcomes the death caused by ACI constituted 6.2%. At pre-hospital, stage the lethality was 45.7%, including 67%--from massive hemorrhage, 19%--from shock, 14%--from reflex cardiac arrest caused by abdominal stroke. Of 157 ACI cases 70% were admitted at the peak of development of posttraumatic complications, 20%--in 24 hours after trauma. According to "VPH-SP" scale the severity of casualties' state was the following: 18% (up to 12 points), 43% (16-17 points), 31.2% (21-23 points), 12% (34-37 points), 5% (45-53 points). At admission 36% had a shock, 50.3%--continuous hemorrhage, 18%--peritonitis symptoms. According to the investigation results the main factors that have an influence on the outcome during ACI are the qualitative skilled medical care at the place of trauma with the use of analgetics and infusion therapy as well as qualitative surgical care. Type of transport and speed of the wounded delivery are of minor importance. According to the state severity during ACI 3 groups were selected: up to 10 points; 10-20 points; 21-45 points. For each group the necessary optimal volume of medical care at prehospital stage was recommended (the use of analgetics, infusion and hemostatic agents). To improve the quality of medical care rendered to ACI casualties the medical service adequate to the trauma is required. Besides the emergency care units should be provided with sanitary transport equipped with special apparatus and have the trained medical staff.
Efimenko
N A
NA
Revskoĭ
A K
AK
Lesik
P S
PS
Iutanin
S N
SN
Maĭorov
A A
AA
D000007:Abdominal Injuries / Q000401:mortality / Q000628:therapy*; D000328:Adult; D004632:Emergency Medical Services / Q000592:standards*; D006801:Humans; D008875:Middle Aged; D008887:Military Medicine / Q000592:standards*; D008889:Military Personnel; D011785:Quality Assurance, Health Care; D015996:Survival Rate; D013997:Time Factors; D015599:Trauma Severity Indices; D014949:Wounds, Nonpenetrating / Q000401:mortality / Q000628:therapy*