Introduction

Big Medical Encyclopedia defines Urgent medical care as the first aid, at which in urgent state and traumas the victims are being rendered medical care at home, out-of-doors, at the enterprises and institutions, provided with the stations, substations and hospitals of the acute care and lately with the Centers of Urgent medical care, disposing of required staff, equipment, transport.

Pathological changes in the human organism bringing to abrupt aggravation of the health, able to threaten the life and therefore demanding urgent medical measures, are usually qualified as urgent conditions.

Urgent conditions include:

• pathological states posing immediate threat to the human life;
• pathological states not posing immediate threat to the human life, but at the presence of which such threat may become real at any time;
• the states, at which unavailability of the timely medical aid may entail persistent pathological changes in the organism;
• the states at which the sufferings of the patient should be relieved in the shortest possible time;
• the states demanding urgent medical interference in the interests of those around the patient because of inadequate and pathological behavior of the sick.

The main principles of the urgent medical aid have always been: belonging to the state, being free of charge, accessibility, close connection with the achievements of the science.

In the framework of implementation of the health protection system in the Republic of Uzbekistan, there has been created a real system of urgent medicine, the main task of which is rendering state-guaranteed and high-grade urgent medical care, capable to involve all regions and all levels of the population of Uzbekistan. The structure is headed by the Republic Scientific Centre for Urgent Medical Aid (RSCUMA). The branches of RSCUMA have been established in all regional centers and in the Republic of Karakalpakistan, and sub-brunches in the form of urgent medical care stations (UMCS) functioning under central district and urban hospitals of 171 districts. The system of urgent medical care involves ambulance service “03” and air medical service.

Pursuant to the Decree N.2107 “On the State Program for Reformation of Health Protection System of the Republic of Uzbekistan” of the President of the Republic of Uzbekistan I.A. Karimov dated November 10, 1998, by Resolution N.232-K of Samarkand Region Khokim (mayor) dd. December 10, 1998, Decree N. 82-K “On Repair-and-Renewal Operations at Samarkand branch of Republic Scientific Centre for Urgent Medical Aid” of Samarkand Region Khokim dd. March 09, 1999, Order N.37-У “On Arranging Urgent Medical Care for Population” of Samarkand Regional Health Protection Board and Samarkand Medical Institute of January 28, 1999, Order N.98-Д “On Provision of the Centre of Urgent Medical Aid with Highly Experienced Staff” of Samarkand Regional Health Protection Board dd. January 15, 1999, there has been started organization of Samarkand Branch of the Republic Scientific Centre for Urgent Medical on the basis of the Clinic N.2 of Samarkand Medical Institute with active assistance of the Minister of Health of the Republic of Uzbekistan Nazirov Feruz Gafurovich.

Samarkand Branch of the Republic Scientific Centre for Urgent Medical (SBRSCUMA), opened on November 26, 1999, became the first of the opened republican branches. Inauguration was attended by the minister and the vice-minister of the health protection of the Republic of Uzbekistan, khokims of Samarkand Region, city and districts, administration of Samarkand Region Health Protection Board, Samarkand Medical Institute and representatives of medical communal organizations of the city of Samarkand.

There were opened following departments at Samarkand Branch of RSCUMA: admission and diagnosis, somatic resuscitation, surgical resuscitation, pediatric resuscitation, multi-system and compound trauma, emergency surgery, thoracic-and-vascular surgery, urgent urology, urgent genecology, pediatric surgery, urgent cardiology, urgent therapy, urgent neuralgia, burns, early rehabilitation and physiotherapy, extracorporal detoxication.

Samarkand Branch of RSCUMA and its sub-branches have assumed the entire organization related to the rendering urgent medical aid to the urban and regional population, settling of the matters pertaining the rendering aid at the extraordinary situations and giving consultations to all serious and urgent patients in the region. Previously the system of rendering urgent medical aid in Uzbekistan and in particular in Samarkand Region was performed at all patient care institutions in accordance with the worked out schedules. Thus urgent medical aid was rendered by the regional hospital, urban hospital N.2, Clinics N.1 and 2 of Samarkand Medical Institute in the city of Samarkand and by the hospital of Samarkand District. Urgent medical aid was rendered to the population of the regional districts by the central district hospitals.

Samarkand Branch faced acute problem of reorganization of rendering urgent medical aid to urban population “03”, shortage of the specialists in the field of neurovascular surgery, vertebrology, resuscitation, around-the-clock service of clinical and especially para-clinical services. There existed necessity in the development of scientific investigations and methodological work on the manpower training.

With the object of increasing activity of Samarkand Branch RSCUMA in view, there have been arranged a number of measures directed to the improvement and repair of the building and communal system on the initiative of khokim of the region Mirziyaev Sh.M., minister of health of the Republic of Uzbekistan Nazirov F. G., in 2002. there have been allocated additional funds (increased by 4 times) for medicaments, consumption materials, and received humanitarian aid. 5 specialists (surgeons, anesthesiologists- reanimators) from the leading clinics of the republican level have been sent to an assignment, the residents were given opportunity to study and train on the basis of Samarkand Branch.

All the stated, as well as daily methodical work being carried out by the administration of the branch and its entire staff could not help telling on the efficiency of rendering urgent medical aid at all its levels.