The round table under this name was prepared and conducted by the expert Council of the National Association Institute of Remote Healthcare (Inotzdrav), attended by representatives of the Russian Ministry of Health, health authorities of the Arctic regions of the Russian Federation, interested state corporations (Rosatom State Corporation), business entities (Rosneft, Gazprom, major shipowners) There are more than 200 people in total – a large enough audience for such a specific narrow topic, and this is evidence of a serious interest in the problems of emergency medicine in the Arctic.

    The invited speakers, leading experts in the field of industrial, marine, extreme and radiation medicine, highlighted the development of the medical care system for the population of the Arctic zone of the Russian Federation, the medical component of rescue operations and emergency response, first aid to sick and injured workers and residents of the Arctic territories, medical safety of navigation on the Northern Sea Route.

    The Arctic zone is a strategic and economic outpost of the country, which is important for the development of the economy due to its geopolitical position and resource potential. The full-fledged development of medical care in the northern regions depends on the livelihoods of the living and working population, as well as the fulfillment of tasks set by the country's leadership [6].  In recent years, much attention has been paid to Arctic medicine: within the framework of national projects, medical organizations are being modernized, the air ambulance service is developing, a network of specialized units of the FMBA of Russia is being deployed, and new forms of medical care for the population of remote territories are being introduced. In addition to the positive changes observed in recent years, the participants noted problems that still need to be worked on and issues that need to be resolved, and with joint efforts.

    To increase the effectiveness of emergency prevention and response in the Arctic, it is proposed to create a permanent working group to study, generalize and improve the system of primary health care and treatment of victims during emergency rescue operations and emergency response at remote industrial and civilian facilities, to study and evaluate the state and capabilities of the medical support system for the population. and the victims during the emergency. Understand the algorithms for predicting the medical and sanitary consequences of radiation accidents and determine the needs for medical forces and resources to eliminate these consequences. Develop regulations for interagency cooperation.

     Accessibility and quality of medical care. To ensure the availability of medical services, it is important to maintain an excess base of medical organizations and institutions in the Arctic, despite the low population density. In order to overcome the shortage of personnel, experts suggest developing a form of assistance specifically for remote settlements by mobile teams of doctors who are ready to conduct preventive examinations and provide on-site medical care.

    Effective medical care in case of any accidents or acute illnesses is unthinkable without competent first aid [7]. It is for this reason that it is necessary to adjust and put into effect the procedure for first aid for remote facilities as soon as possible. The experts recommended that the Russian First Aid Society develop a special educational and methodological complex for remote facilities, the materials used in the training of ship personnel can serve as a useful example [3].

    The system of remote consultation on first aid with the use of innovative technologies should be used more widely. It is advisable to develop and implement an algorithm for remote consultations in the "doctor—patient" format on ships traveling along the Northern Sea Route [2]. The current model of remote consulting for small mobile remote production facilities with evacuation support, the so-called assistance, can be used as a basis.

    It is advisable to introduce specialized training programs for advanced training and retraining in the field of remote healthcare. A similar experience was tested in Tomsk at the Siberian State Medical University, where the country's first professional retraining program for doctors working at remote facilities is being implemented.

    More recently, the Remote Healthcare handbook has been published, summarizing Russian and international experience in this field. There are no domestic analogues of the book, it examines the issues of assessing the state of health and reserve capabilities of the body of workers of industrial facilities, the basics of psychological stability in extreme conditions, assessment of occupational risks and health-threatening factors, the possibility of physical recovery during the shift period, the organization of emergency care and emergency medical evacuation, the effective use of digital technologies, etc. [8].

    It is absolutely necessary to continue working and expand the training of shipboard doctors, as well as to develop the so-called medical training of the command staff of civilian naval vessels [4].

    Development and strengthening of the air ambulance service. Recent observations show a steady increase in the number of medical evacuations [6]. It is important to increase spending on air ambulance from the federal budget in the near future. Provide the regions with small aircraft and airfields, which will significantly reduce the weather dependence of evacuation measures.

    Everyday practice determines the urgency of establishing the requirements for medical equipment used in the Arctic zone and along the Northern Sea Route as soon as possible [1].

    The participants of the discussion unanimously recommended that the health authorities, when making decisions on promising areas for the development of medicine in the Arctic zone, use the potential and human resources of the non-governmental sector of industrial medicine. Private medical companies have a lot of experience that they are ready to share, and they have a ready-to-use infrastructure. A network of industrial health centers and outpatient clinics on the coast of the northern seas can and should be used for high-level purposes of protecting and preserving the health of not only the employees of the production facilities where they are located, but also the population of nearby territories and the crews of passing ships [5].

    In general, in the resolution, experts emphasized the importance of the round table topics, outlined areas for further efforts to preserve the health of the population and workers, develop and strengthen the state emergency prevention and response system in the Russian Arctic, and noted the paramount need for coordination and interaction between federal, regional, and local government agencies, agencies, state corporations, and business entities. when providing medical care to the local population, workers at remote production facilities and on ships traveling the Northern Sea Route. The participants of the round table agreed to work together to find ways to overcome existing barriers and achieve solutions to the challenges facing the Arctic healthcare sector.