Interhospital transport of the critical patients with polytrauma

The aim of our study was the organization and tactics optimization of the interhospital transport of critical patients with polytrauma.

During the past 5 years the proper transport service of the Federal State Medical Prophylactic Institution Scientific Clinical Center of Miners' Health Protection (Leninsk-Kuznetsky) delivered 1023 patients from Kuzbass territory and other nearby regions, 390 of them were in a critical state. During the transportation 121 patients were conducted on MLV, 48 of them used PEEP. The antishock cloth 'Chestnut' was used in the transportation of 358 patients. Motor-car transportation was carried out for a 400 km distance; a helicopter was used for a long distance in individual cases. The maximum transportation time was 4 hours. During the transportation we determined the central hemodynamics and oxygen-transport function parameters.

The state of 110 of 390 transported critical patients with polytrauma was appreciated as decompensated. According to the ISS, the severity value = 24 ± 4 marks. The prognosis of the probable lethal outcome during the nearest day was 100%. Transportation realized by the specialized team did not deteriorate the patients' state thanks to the conducted complex intensive therapy and prophylactic measures, in 19% cases a tendency to improvement of the state was observed. Lethal outcome during transportation was not registered.

The solution of the problem of safe interhospital transport of critical patients with polytrauma depends on the exact coordination of all interested services. Apart from the main quality criteria the essential point is competent guidance of the whole system that is connected with the clinics and transport service in this case.

All these components secure the high quality of the transportation of critical patients.