Medical triage in mass injuries in road accidents in Bulgaria. Exploring the experience of the emergency medical care center in Bulgaria - a basis for compiling a medical standard
Background
The major causes of mass traumatism among the population in Bulgaria are transport catastrophs. Among them, mainly road transport accidents (RTC) affect the country. One of the serious RTC was in 2001 on the E79 main road to Blagoevgrad. The last major registered RTC in the country is that of 13 April, 2018 on the Trakia highway to Vakarel. In the case of mass traumatism, medical triage (MT) is an essential element and a practical tool of the diagnostic and healing process in the range of ""Emergency medicine"" specialty in the country and a significant factor for the rescue of the injured population. The main field of application and implementation of MT refers to the teams of the emergency medical care center (EMCC). Experiance in this direction is considerable for terrestrial medical transport teams and is the basis for compiling a medical standard for MT.
Methods. A questionnaire survey was conducted with the teams of EMCC-Blagoevgrad area about their preparedness and the real possibilities for conducting medical triage in the case of mass traumatizm. Available (EMCC, GDFSCP) databases are researched and analyzed as well.
Results. For the past 10 years, the number of people killed in RTC is nearly 5,000, and the number of victims is about 9,000 on the territory of the country. For the first quarter of 2018, more than 100 people died and injured more than 1,500. Research shows that 60% of the victims suffered severe injured. According to the nature of traumatism: with vital disorders - from a group T1 (20-40%); aid can be deffered for 6-8 hours - they forming a group T2 (20%); injured with cranial-brain and spinal cord trauma, and slightly impaired - represent a group T3 (40%); irreversible consequences refer to a group T4 (20%). The relative share of emergency medicine specialists in EMCC is only about 1% of staff. About 60% of staff think that MT needed to be held, but only about 5% said that they know how. More than 80% said that there should be a medical standard for MT.
Conclusions. Significant is the number of victims of RTC in the country. The need to apply MT based on a medical standard is available. The distribution of MT in several subtypes makes it clearer and more specific. EMCC teams are the main contractors of MT and need specialized training for MT application.
