Editorial

Medical Emergency System in Sancti Spíritus

Lizet Guerra González^{1  *} 
http://orcid.org/0000-0002-8335-9232

Artinay Rodríguez León¹ 

¹Hospital Provincial General Camilo Cienfuegos de Sancti Spíritus, Cuba.

The Integrated Medical Emergency System (SIUM) in Sancti Spíritus province is formed by dedicated and scientifically trained professionals in the health sector; these ones work in the mobile emergency or are at the head of each of the coordinating bureau at the municipality, province and country level, they are silent heroes that guarantee the survival of medical emergencies and urgencies; these first aid provided to the serious ill patient become the key to the success of subsequent hospital treatment.

It integrates the mobile emergency, guard body, intensive municipal areas, intensive and intermediate therapies; that is, the entire network of seriously ill patient care, also has the mission of improving the quality of care for the seriously ill patient depending on the emergency medical services; the medical and paramedical personnel of the Integrated System of Medical Emergencies work with the vision of being a Moral Collective that transits through excellence in the emergency services of health, with a high scientific-technical development, with professionals categorized teaching and mastery of the best emerging and urgent treatment techniques.

The ambulance bases were created in 1997, and the first provinces in Cuba that developed this method of medical assistance were Pinar del Río, Cienfuegos, Sancti Spíritus, Villa Clara and Holguín. The Medical Emergency System over the years has gone through the following stages:

• From 1980-1989: Stage of the Development of Intensive and Intermediate Therapy Units.

• From 1993-1994: It emerged the Departments of Hospital Emergencies.

• 1996: Starting of the Emergency Network in Primary Care.

• 1997: Starting of the Mobile Emergency Network and the SIUM integrally.

• 2003: Foundation of the Municipal Intensive Areas.

• 2004-2005: Ambulances municipality

• Until 2019 Improvement of the Integrated Medical Emergency System (regionalized ambulance bases and deployed ambulances in the Health Areas)

In Sancti Spíritus there are four regionalized ambulance bases located in Sancti Spíritus, Trinidad, Yaguajay and Jatibonico municipalities; the rest of the municipalities have deployed ambulances, that is, subordinated to the Health Areas to guarantee timely assistance to the seriously ill patient.

The definitions of the seriously ill patient must be respected by the medical community because the consequence will be the vital support in the rescue of this one, these concepts are:

• Emergency: Sick or injured patients with immediate real or potential life danger; their transfer requires advanced vital support, after the first stabilization measures

• First priority urgency: Sick or injured people who do not have immediate life risk, but they can be mediated if they do not receive the required care.

• Second priority urgency: Emergencies that have no immediate or immediate vital risk to the patient; they do not necessarily require ambulances, except when there is a lack of resolving capacity for any specialty.

• Felt or no urgent Emergencies: These are patients who are considered emergencies only because of the appreciation of their family member; and all can be assisted in the emergency network of Primary Health Care.

In 2017, in Sancti Spíritus province it was carried out a study on the most transferred diagnoses in ambulances from the municipalities to the Camilo Cienfuegos General Provincial Hospital, which led to the analysis of the medical resolution in each territory and also the need for the decentralization of some specialties through the Community Projection.

The most transferred diagnoses by municipalities were in Trinidad (pregnant women with arbovirosis and obstetric pathologies, pediatric cases, ophthalmological and orthopedic cases), in Cabaiguán (encephalic vascular accidents, polytrauma, decompensated chronic non-communicable diseases, pediatric cases and obstetric pathologies), Jatibonico (digestive bleeding, polytrauma, acute abdomen, hip fractures, severe respiratory sepsis, stab wounds, obstetric pathologies, decompensated chronic obstructive pulmonary diseases), in Yaguajay (orthopedics, pediatric, neurology, urology, and obstetrics cases), in Fomento (appendicitis, stroke, acute abdomen, digestive bleeding, polytrauma, pre-eclampsia, gestorrhagia; in La Sierpe (acute abdomen, stroke, obstetric, myocardial infarction, digestive bleeding, hips fractures, decompensated chronic non-communicable diseases) and in Taguasco (polytrauma, decompensated chronic obstructive pulmonary diseases, brain vascular accident, obstetrics, acute myocardial infarction, some cases of angiology).

Without doubting, this study allowed us to comprehensively review the Medical Emergency System and make decisions regarding the formation of anemic specialties in some municipalities, and also review the concepts of each ambulance patient; achieving this way, the efficient use of ambulances and greater gratification in the seriously ill treated patient. It had such an impact that at the beginning of 2017 the total number of remittances was 2154 per month, at the end of the year it was 1952 monthly; with a decrease of 202 transfers per month.

It is necessary to understand and also to investigate the importance of the Integrated Medical Emergency System for the medical community; with the SIUM in optimal conditions, the decreasing in morbidity and mortality in the province, as well as in the country, can be guaranteed.

Received: August 05, 2019; Accepted: August 09, 2019