Assessment of the Magnitude of Medical and Sanitary Losses among the Population in Emergency Situations in a Metropolis, Using the Example of Moscow

Summary. The purpose of the study is to use the example of Moscow to estimate the magnitude of health losses among the population in emergency situations (ES) that arise in a modern metropolis.

Materials and methods of research. Research materials – regulatory and methodological documents defining the procedure for organizing and functioning of the Moscow Territorial Scientific and Practical Center for Disaster Medicine of the Moscow Department of Health (CEMP), as well as the procedure for providing medical care to emergency victims and their medical evacuation; reports from the emergency medical service (EMS) and the Center for Emergency Medicine on their activities to eliminate the health consequences of emergencies in 2018–2022; scientific works and publications devoted to current issues of medical evacuation of Moscow residents affected by emergencies.

Research methods – statistical and analytical methods, direct observation method, logical and information modeling method.

Research results and their analysis. Analysis of the research results showed:

– in 2018–2022 in Moscow, for each emergency there were an average of 13.9 victims (in the Russian Federation as a whole – 22.9 victims); the risk of death among emergency victims in the metropolis averaged 20.9% (in the Russian Federation as a whole – 43.0%), which was due to competent routing, i.e. timely hospitalization of victims to medical organizations (HMOs), which provide comprehensive medical care;

– medical and sanitary losses in emergencies in the metropolis are generally relatively stable. More pronounced differences are observed only in man-made emergencies;

– the so-called “Covid” restrictions introduced in 2020 contributed to a decrease in the number of emergencies in general, but did not lead to a sharp decrease in the proportion of victims in emergencies and may have contributed to a two- to threefold increase in the number of victims in subsequent years – especially in social emergencies character;

– in Moscow, in 35% of emergency situations, medical assistance was provided to victims at the emergency site; in 65% of cases, emergency victims were hospitalized;

– approaches to medical evacuation and treatment outcomes for victims in emergency situations depend on the strength and duration of the impact of the damaging factors of the emergency, timely provision of first aid and medical aid, and the provision of the latter is inextricably linked with the speed and time of delivery of the patient to a specialized hospital, which has all the capabilities for provision of specialized, including high-tech, medical care.

According to the authors, further development of the system for monitoring the provision of emergency medical care to victims of emergencies and compliance with the principles of routing during their medical evacuation, as well as improving the work of the Center for Medical Care of the population of the metropolis in various emergencies will lead to a decrease in the overall mortality rate among victims of emergencies with internal bleeding and some other pathologies.