rfhealthЗдравоохранение Российской ФедерацииHealth care of the Russian Federation0044-197X2412-0723Federal Scientific Center of Hygiene named after F.F. Erisman10.47470/0044-197X-2023-67-4-284-291edtyrfrfhealth-1314Research ArticleОРГАНИЗАЦИЯ ЗДРАВООХРАНЕНИЯHEALTH CARE ORGANIZATIONОрганизационные аспекты внедрения практики диспетчерского сопровождения первой помощи при остановке сердца в Российской Федерации (обзор литературы)Managing aspects of the implementation of the practice of dispatcher-assisted first aid for cardiac arrest in the Russian Federation (literature review)https://orcid.org/0000-0002-2789-9760БиркунАлексей АлексеевичBirkunAleksei A.

Канд. мед. наук, доцент; доцент каф. общей хирургии, анесте-зиологии-реаниматологии и скорой медицинской помощи Медицинской академии им. С.И. Георгиевского ФГАОУ ВО «Крымский федеральный университет им. В.И. Вернадского», 295051, Симферополь.

e-mail: birkunalexei@gmail.com

 

MD, PhD, Associate Professor of the Department of General Surgery, Anaesthesiology, Resuscitation and Emergency Medicine, Medical Academy named after S.I. Georgievsky of the V.I. Vernadsky Crimean Federal University, Simferopol, 295051, Russian Federation.

e-mail: birkunalexei@gmail.com

birkunalexei@gmail.comhttps://orcid.org/0000-0003-2932-1724ДежурныйЛеонид И.DezhurnyLeonid I.noemail@neicon.ruМедицинская академия им. С.И. Георгиевского ФГАОУ ВО «Крымский федеральный университет им. В.И. Вернадского»РоссияMedical Academy named after S.I. Georgievsky of the V.I. Vernadsky Crimean Federal UniversityRussian FederationФГБУ «Центральный научно-исследовательский институт организации и информатизации здравоохранения» Министерства здравоохранения Российской ФедерацииРоссияRussian Research Institute of HealthRussian Federation202302092023674284291Copyright © Биркун А.А., Дежурный Л.И., 20232023Биркун А.А., Дежурный Л.И.Birkun A.A., Dezhurny L.I.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rfhealth.ru/jour/article/view/1314

Высокая летальность при внегоспитальной остановке сердца, обусловленная, главным образом, неспособностью непосредственных свидетелей происшествия оказать первую помощь до прибытия медицинских работников, составляет серьёзную проблему в России, что определяет необходимость скорейшего принятия организационных мер, направленных на максимальное вовлечение населения в процесс оказания первой помощи. В статье на основании анализа современной научной литературы представлено обоснование целесообразности создания и внедрения в России единой, согласованной программы «телефонной сердечно-лёгочной реанимации» (Т-СЛР), предполагающей дистанционное инструктирование свидетелей остановки сердца по вопросам оказания первой помощи силами диспетчеров экстренных служб. В частности, рассмотрен зарубежный опыт реализации программ Т-СЛР, подтверждающий высокую эффективность диспетчерского сопровождения первой помощи применительно к влиянию на показатели исхода внегоспитальной остановки сердца; обсуждается место Т-СЛР в современных международных рекомендациях по оказанию помощи при остановке сердца; проанализированы организационные и нормативные правовые предпосылки для внедрения Т-СЛР в работу службы скорой медицинской помощи и системы «112» в России, включая существующую диспетчерскую инфраструктуру для реализации программы Т-СЛР и действующую нормативную правовую базу, которая регулирует организацию и функционирование экстренных служб, осуществляющих дистанционное консультирование населения по вопросам сохранения здоровья. На основании результатов проведённого анализа определены приоритетные организационные меры, направленные на эффективное и унифицированное внедрение практики Т-СЛР на территории России. Для поиска литературы по теме исследования использованы библиографические базы данных Medline, Scopus, Web of Science, Google Scholar и eLibrary.

Участие авторов

Участие авторов:Биркун А.А. — концепция и дизайн исследования, сбор и обработка материала, написание текста, составление списка литературы, редактирование, утверждение окончательного варианта статьи, ответственность за целостность всех частей статьи;Дежурный Л.И. — сбор и обработка материала, написание текста, редактирование, утверждение окончательного варианта статьи, ответственность за целостность всех частей статьи.

Финансирование

Финансирование. Исследование не имело спонсорской поддержки.

Конфликт интересов

Конфликт интересов. Авторы декларируют отсутствие явных и потенциальных конфликтов интересов в связи с публикацией данной статьи.

Поступила 08

Поступила 08.08.2021Принята в печать 20.01.2022Опубликована 30.08.2023

High death rates in out-of-hospital cardiac arrest are mainly associated with failure of bystanders to provide lifesaving help before arrival of medical professionals. This constitutes a major problem for present-day Russia and determines the urgent need to take managing measures aimed at maximizing involvement of the lay public into the process of resuscitation and first aid provision. Based on an analysis of contemporary scientific literature, this paper provides a justification for creation and implementation of a unified coordinated program of dispatcher-assisted cardiopulmonary resuscitation (DA-CPR), when dispatchers of emergency services provide witnesses of cardiac arrest with instructions on how to perform resuscitation over the telephone in Russia. In particular, the article describes the foreign experience of implementation of DA-CPR programs that confirms a high effectiveness of the dispatcher support as it applies to outcomes of out-of-hospital cardiac arrest; it discusses a place of DA-CPR in current international guidelines on management of cardiac arrest; and it gives an analysis of managing and legal prerequisites for implementation of DA-CPR into the daily work of emergency medical services and 112-emergency system in Russia, including the existing dispatching infrastructure for implementation of the DA-CPR program, and current legal framework that regulates management and operation of the emergency services that provide remote consultations on health protection for the public. Based on the analysis, priority managing measures were identified aimed at effective and unified implementation of the DA-CPR in Russia. For relevant literature, we searched Medline, Scopus, Web of Science, Google Scholar and Russian Science Citation Index.

Contribution

Contribution:Birkun A.A. — research concept and design, collection and processing of material, writing the text, compilation of the list of literature, editing;Dezhurny L.I. — collection and processing of material, writing the text, editing.All authors are responsible for the integrity of all parts of the manuscript and approval of the manuscript final version.

Acknowledgment

Acknowledgment. The study had no sponsorship.

Conflict of interest

Conflict of interest. The authors declare no conflict of interest.

Received

Received: August 08, 2021Accepted: January 20, 2022Published: August 30, 2023 

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The authors declare that there are no conflicts of interest present.