Training of Emergency Medical Specialists in Contemporary Realities

Relevance. In accordance with Federal Law No. 323-FZ [17], emergency medical assistance, including emergency specialized medical care, is provided in emergency form outside a medical organization, as well as on outpatient and inpatient basis. An ambulance is an emergency medical service that travels to those whose lives and health are in danger. Emergency medical assistance, including emergency specialized medical care, is provided in case of diseases, accidents, injuries, poisonings and other conditions requiring urgent medical intervention. The reasons for calling an ambulance in an emergency form are sudden acute diseases (conditions) and (or) sudden exacerbations of chronic diseases without obvious signs of a threat to life, requiring urgent medical intervention. In the training of doctors, including in postgraduate education, these factors are taken into account.

Aim of the study. Improvement of the quality of theoretical and practical training of emergency medical specialists, as well as clinical residents and practical doctors of various specialties, taking into account issues of emergency and military medicine.

Material and methods. A review of official documents of the Ministry of Healthcare of the Russian Federation and the literature on postgraduate education of doctors with subsequent primary specialized accreditation for 2018-2022 was carried out. The literature on modern approaches to the provision of emergency medical care to victims was studied, taking into account the specifics of military (tactical) medicine for 2020–2022.

Conclusion. The training of emergency medical professionals, taking into account the realities of the present, should include issues of tactical medicine and be practice-oriented using simulation equipment. It is necessary to know and be able to work with modern means of protection and medical care available in the troops; be prepared to work in medical institutions of various levels with the mass flow of injured and wounded.

1. Maksumova NV, Fattakhov VV, Yusupova NZ. Ekstrennaya meditsinskaya pomoshch’. Simulyatsionnyy kurs. Kazan; 2022. (In Russ.).

2. Kavalerskiy GM, Garkavi AV. Meditsina chrezvychaynykh situatsiy. Khirurgiya katastrof. Moscow: Meditsinskoe informatsionnoe agentstvo Publ.; 2015. (In Russ.).

3. Smirnov AA. Takticheskaya meditsina. Pskov: Sterkh Publ.; 2020. (In Russ.).

4. Metodicheskie rekomendatsii po lecheniyu boevoy khirurgicheskoy travmy. Moscow; 2022. Available at: https://vmeda.mil.ru/upload/site56/document_file/3w7uzoaLyP.pdf [Accessed Sep 29, 2023]

5. Penn-Barwell JG, Roberts SA, Midwinter MJ, Bishop JR. Improved survival in UK combat casualties from Iraq and Afghanistan: 2003- 2012. J Trauma Acute Care Surg. 2015;78(5):1014–1020. http://doi.org/10.1097/TA.0000000000000580 PMID: 25909424

6. Belmont PJ, Schoenfeld AJ, Goodman G. Epidemiology of combat wounds in Operation Iraqi Freedom and Operation Enduring Freedom: orthopaedic burden of disease. J Surg Orthop Adv. 2010;19(1):2–7. PMID: 20370999

7. Eastridge BJ, Hardin M, Cantrell J, Oetjen-Gerdes L, Zubko T, Mallak C, et al. Died of wounds on the battlefield: causation and implications for improving combat casualty care. J Trauma. 2011;71(1, Suppl):S4–S8. http://doi.org/10.1097/TA.0b013e318221147b PMID: 21795876

8. Mamczak CN, Elster EA. Complex dismounted IED blast injuries: the initial management of bilateral lower extremity amputations with and without pelvic and perineal involvement. J Surg Orthop Adv. 2012;21(1):8–14. PMID: 22381505

9. Eastridge BJ, Mabry RL, Seguin P, Cantrell J, Tops T, Uribe P, et al. Death on the battlefield (2001–2011): implications for the future of combat casualty car. J Trauma Acute Care Surg. 2012;73(6, Suppl 5):S431–S437. http://doi.org/10.1097/TA.0b013e3182755dcc PMID: 23192066

10. Kelly JF, Ritenour AE, McLaughlin DF, Bagg KA, Apodaca AN, Mallak CT, et al. Injury severity and causes of death from Operation Iraqi Freedom and Operation Enduring Freedom: 2003-2004 versus 2006. J Trauma. 2008;64(2, Suppl):S21–S26. http://doi.org/10.1097/TA.0b013e318160b9fb PMID: 18376168

11. Morrison JJ. Noncompressible Torso Hemorrhage. Crit Care Clin. 2017;33(1):37–54. http://doi.org/10.1016/j.ccc.2016.09.001 PMID: 27894498

12. Brown KV, Guthrie HC, Ramasamy A, Kendrew JM, Clasper J. Modern military surgery: lessons from Iraq and Afghanistan. J Bone Joint Surg Br. 2012;94(4):536–543. http://doi.org/10.1302/0301-620X.94B4.28602 PMID: 22434472

13. Evkurov Yu, Pavlov A. Takticheskaya meditsina v obshchevoyskovykh podrazdeleniyakh. Armeyskiy sbornik. 2022;(5):97–102. (In Russ.).

14. Kryukov EV, Zhdanov KV, Kozlov KV, Lavrenchuk DV, Maltsev OV, Gordienko VV, et al. Clinical Efficacy and Safety of Using Immune Plasma from Donors Vaccinated Against COVID-19 to Treat Patients With Infection Caused by SARS-CoV-2. Military Medical Journal. 2023;344(3):39–46. (In Russ.).

15. Zil’ber AP. Meditsina kriticheskikh sostoyaniy. Petrozavodsk: PGU Publ.; 1995. (In Russ.).

16. Reva VA. Travmy i raneniya krovenosnykh sosudov: otkrytye, endovaskulyarnye i gibridnye metody lecheniya: Dr. med sci. diss. synopsis. Saint Petersburg; 2020. Available at: https://emergency.spb.ru/wpcontent/uploads/2022/04/Автореферат-Рева-В.А..pdf?ysclid=lm7nqjkz5i624413812 [Accessed Sep 06, 2023]