Testing a new classification of acubarotrauma: results before and after implementation at the advanced stages of medical evacuation

Surgeons are the first physicians to provide medical care to wounded patients with ear injuries at the frontline stages up to Level 3. These circumstances determine the importance of providing surgeons with a clear and easy-to-use classification of acubarotrauma to make appropriate and timely decisions regarding treatment and evacuation measures.

Objective. Optimization of medical evacuation measures carried out by surgeons in patients with acubarotrauma by introducing a new classification of the latter and information technologies to support medical decision-making.

Materials and methods. Based on the results of diagnostics and treatment of acubarotrauma in the first months of the SVO, a new classification was developed. Then, a statistical observational study of the "before-after" type was conducted. It consisted of the analysis of the preliminary diagnosis of "acubarotrauma" confirmed by otolaryngologists, made by surgeons at the forefront of evacuation. An application was developed to support the establishment of the diagnosis of acubarotrauma according to the proposed classification. A survey was conducted on the Likert scale to assess the ease of use by surgeons of the proposed classification of acubarotrauma.

Results. Statistically significant changes were noted in the dynamics of the indicator of confirmation by an otolaryngologist of a preliminary diagnosis established by surgeons after the latter had become familiar with the classification of acubarotrauma (p=0.001, the method used was paired Student's t-test). The results of a survey among surgeons regarding the convenience of using the new classification of acubarotrauma showed that the answer "completely agree" for 7 statements was given by 67.5% to 79.9% of respondents. The developed application for assistance in making a medical decision could be used by surgeons only starting from level 3, in medical units where there was no otolaryngologist.

Conclusion. The introduction of the developed classification of acubarotrauma at the forefront of combat zones has increased the number of acubarotrauma diagnoses confirmed by otolaryngologists, previously made by surgeons. 

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