Resuscitation and consultation centers in pediatric hospitals: history, current status, and prospects

BACKGROUND: In Russian pediatrics, a critical role is played by medical care for children in life-threatening conditions, ensuring consultations (including remote consultations), patient monitoring, and medical evacuation to specialized hospitals. The concept of the resuscitation and consultation center (RCC) was first developed by the Leningrad school of scientists in 1980. Over the following years, the system expanded and evolved, albeit without adequate regulatory and legal support. AIM: To determine the current organizational and clinical models for providing consultation assistance, including remote consultations, to children in critical conditions, as well as for their medical evacuation. The study also aims to identify trends in the development of this field across Russian regions and to justify prospective measures for improving specialized emergency and urgent medical care. MATERIALS AND METHODS: The study design is an observational retrospective study. Information was gathered from analytical reports prepared by the Association of Children’s Hospitals from 2011 to 2023. An expert evaluation method was applied based on a report analysis of pediatric hospital directors from 74 regions of Russia regarding the activities of the medical institutions they lead from 2021 to 2023. A total of 59 responses were collected. Additionally, state and departmental regulations were reviewed in terms of their compliance with hospitals’ responsibilities in providing consultation assistance and medical evacuation for children. The dataset was analyzed using descriptive statistics. RESULTS: Between 2021 and 2023, consultation assistance and medical evacuations were provided to 120,477 children. The distribution of organizational forms was as follows: resuscitation and consultation centers 60.9%; emergency medical consultation departments of adult hospitals 6.7%; regional disaster medicine and emergency medical services centers 5.0%; mobile medical teams of pediatric hospitals 3.7%; and other medical service divisions 23.7%. More than 10 different names were used for divisions performing similar functions, indicating a lack of unified terminology and a standardized approach to organizing and providing consultation assistance (including remote consultations) and medical evacuation for children. The frequency of using the abbreviation RCC for pediatric hospital divisions declined from 44 hospitals in 2006 to 18 in 2023 due to the absence of a regulatory framework. CONCLUSIONS: The study substantiates the need to establish a dedicated medical service division within multidisciplinary pediatric hospitals named the Department of emergency consultation and medical evacuation.