Natsevych R. Clinical and organizational principles of pre-hospital and initial hospital care of the road traffic incident victims through following a roadside hospital concept

Thesis for a Candidate Degree in Medicine Sciences specialized inTraumatology and Orthopedics (14.01.21). - State Institution "Institute of Traumatology and Orthopedics of National Academy of Medical Sciences of Ukraine", Kyiv, 2018. The scope of the study is 316 accidents with the injured with polysystemic injuries as a result of road traffic incidents during pre-hospital and early hospital stages. Clinical and epidemiological and clinical and nosological characteristics of injuries were studied and analyzed; clinical resulting risks of the fatal outcome in the course of traumatic process were determined. Clinical analysis of the efficiency of the medical treatment technologies application at the pre-hospital and early hospital stages was conducted and measures to increase the efficiency of medical care were determined. The priority of application of a standardized system for assessing the severity of injuries at the pre-hospital stage was proved. The necessity of the road hospitals operation with functional integration of pre-hospital and early hospital stages was proved by the way of simulation with application of a risk-oriented method. The "risk zone" concept was introduced and the criteria of risk zones were defined. It was found that application of the road hospital model allows changing the cumulative risks from the indices of catastrophic cumulative risk (more than 0.8) and critical cumulative risk (0.5-0.79) corresponding to the areas of very high and high risks at least to the moderate-risk zone, where the cumulative risk index is significant (0.25-0.49), and the low-risk zone, where the cumulative risk index is non-significant (less than 0.25).