Pre-Hospital Intensive Therapy in Severe Trauma

Extract

The organization of medical facilities in the USSR is able to provide adequate and rapid care, including intensive therapy in prehospital conditions for the whole population of a very big country. The principles of organization are very simple: the country is divided into regions and these into districts. Each district has to have a fixed number of hospital beds, stations for first aid and urgent care, and a determined number of physicians, and medical assistants (feldshers, nurses and others). The only difference between the emergency care in Moscow and Northern Siberia or Pamir is the distance to be travelled and the means of transport, i.e., modern first-aid cars, helicopters, planes or boats; or reindeer or dog teams when the weather makes aviation impossible. As a rule, all medical teams working in emergency medicine include physicians and medical assistants. Only in places where the population is very sparse are some emergencies still managed by only medical assistants at the pre-hospital stage.

In cases of severe trauma we prefer, when possible, to have teams especially trained in shock treatment. These are already available in the emergency ambulance systems of the bigger towns. These so-called “shock-teams” are experienced and well equipped for intensive therapy at the accident site and with problems occurring during transport. When necessary, we are now able to transport critically ill or traumatized patients not only inside the hospital, but also from one hospital to another, when better intensive therapy can be obtained.