One of the stages of emergency medical care in case of Acute Coronary Syndrome (ACS) (if there are medical conditions for surgical intervention) is directly linked to the time between the first contact with the patient and the and inflating the balloon in the coronary artery (in a medical institution). Time of the operation start a medical facility depends on the time of patient delivery to hospital, as well as on the waiting time in the queue in the institution. This paper describes a development of ambulance model for obtaining aggregate estimation of these two periods of time. The estimation time is obtained by means of described in the article the decision support system (DSS) in the ambulance service. Unlike modern navigation systems DSS takes into account ambulance vehicle behavior (the ability to exit into oncoming traffic) and availability of free operation rooms. With the help of the described simulation model of the ambulance service we carried out the time distribution analysis (between the first contact with the patient and surgical intervention in case of ACS) in St. Petersburg, Russia. Simulation scenario uses real data on the work of ambulance service in the city.

Simulation of emergency care for patients with ACS in Saint Petersburg for ambulance decision making

Use of video data for analysis of special transport movement

Details of pre-hospital medical care organization in patients with acute coronary syndrome (ACS) with ST segment elevation are discussed. The algorithm of pre-hospital diagnostics and emergency cardiac care to these patients is presented. The necessary methods of examination, drugs and their dosages are specified. The importance of reperfusion as a key approach to ACS patients treatment is emphasized. Advantages and disadvantages of reperfusion therapeutic methods and algorithm of their choice are presented.

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I. V. Zhirov

Papers

Treatment of the acute coronary syndrome with st segment elevation at the pre-hospital care