[Prehospital stage of care of patients and accident victims with acute neurosurgical diseases].

Prehospital care of victims with craniocerebral injuries and patients with cerebrovascular diseases is evaluated by means of retrospective analysis of emergency files and case histories of 258 patients with acute neurosurgical diseases treated in intensive neurosurgical care wards of N. V. Sklifosovsky Institute of Emergency Care. The results evidence that the majority of patients were hospitalized in a grave or extremely grave state. Prehospital care was inadequate: respiratory support was carried out in only 57% patients and oxygen therapy in but 23%, which resulted in pronounced disorders of blood gas composition and acid-base status. The highest mortality was observed among patients in whom intubation of the trachea was delayed. Prehospital infusion therapy was administered to 11% and inotropic support to only 1.1% patients. Oxygenation and active infusion therapy are recommended for all patients at the prehospital stage of care; indications for intubation of the trachea and sympathomimetic therapy should be extended.