On the issue of the development and revision of clinical guidelines and standards of emergency medical care

Abstract

The Ministry of Health of the Russian Federation has approved 74 standards of emergency medical care and approved 409 clinical guidelines. The purpose of the study is to analyze the compliance of the nosological structure of approved standards and clinical guidelines with the actual structure of calls. Materials and methods: the nosological structure of 66948 emergency medical calls of the St. Petersburg State Medical Institution ≪Ambulance Station № 4≫ of the Pushkin relief district for 2023 was analyzed. The diagnoses of the visiting ambulance teams were formalized in accordance with the International Classification of Diseases ICD‑10. The patients were divided into three age groups: group 1 — adults, group 2 — children from 1 to18 years old, group 3 — children under 1 year old. Results. Standards of emergency medical care have not been approved for diagnoses of diseases (conditions) established in 42.8% of cases (group 1 — 43.7%, group 2 — 73.2%, group 3 — 85.4%); clinical guidelines have not been approved for diagnoses of diseases(conditions) established in 29.4% of cases (group 1 — 25.6%, group 2 — 24.0%, group 3 — 21.8%). At the same time, it should be noted that most of the clinical guidelines are not applicable or are only limited in the provision of emergency medical care outside a medical organization, since they were developed without the involvement of appropriate specialists. Conclusion: it is advisable to develop (revise) clinical guidelines and standards of emergency medical care for the most relevant groups of diseases (conditions) and include abstracts-guidelines for emergency medical care in all developed (revised) clinical guidelines.