The development and progress of the Russian Emergency medical care trauma system are inextricably linked with the history of the formation of the first Level 1 Trauma center in War surgery clinic, Kirov Military Medical Academy. The article describes how the first Russian Trauma system was created in 1950- 60-s in Leningrad under the direction of Professor A. N. Berkutov.

There are results of clinic-experimental research of 582 injured patients. Comparative analysis of basic sorting scales took place. Advanced scale “VPH-SORT” was verified. Increase of sensitivity for 21,1-22,0% (83,3-85,0%) and specificity for 7,8-8,3% (71,9-72,2%) was revealed. This fact increase effectiveness of scale “VPH-SORT” considerably during medical assortment injured patients for revelation people who need in urgent surgical assistance.

Presents the analysis of the treatment patients with the long bones fractures of the limbs with associated trauma coming from the place of injury to war surgery department and victims transferred from other hospitals with using temporary external fixation. It was found that the lack of adequate temporary external fixation and immobilization of long bones fractures increases the risk of complications.

Mechanical ventilation (MV) is most important integral part of the prehospital treatment of severe acute respiratory failure (ARF). Intuitively, better patient outcomes may be achieved when MV is applied promptly in the prehospital setting, but there are few studies to validate its use in this setting. To evaluate the mod- ern situation with emergency respiratory support, providing by ambulance brigades at Russian major city. Materials and methods: 250 ambulance physicians self-esteemed their theoretical and practical knowledge with a help of questionnaire. Indications for MV in prehospital settings and its features were evaluated dur- ing retrospective analyses of 141 ambulance brigade missions. Results: According to the results of our sur- vey, most of ambulance physicians estimated their theoretical and practical knowledge in MV as insuffi- cient. Most common indications for emergency MV were cerebral stroke and brain trauma, complications of coronary heart disease, severe pneumonias and acute intoxications. All patients got invasive MV. Most often VC-CMV (81%) and VC-SIMV (16%) modes of MV were used. The average duration of MV in survi- vors (128 of 141) was 85±19,7 minutes. Conclusion: Improvement in ambulance staff theoretical knowl- edge and practical skills in MV are needed. Noninvasive MV could be recommended for more often use in Russian prehospital settings. Such modes of MV, as CPAP, PC-CMV and PSV should be recommended for implementation to transport ventilators

In recent decades there has been obvious progress in the treatment of severe thoracoabdominal injuries and skeletal injuries, however, there is practically no publications studying ways to improve treatment out- comes in patients with severe concomitant injuries of the head. The article presents the materials of research aimed at developing a multi-stage surgical treatment in casualties with combined cranial and maxillofacial trauma, as a result a significant reduction in mortality and number of complications was achieved.

Speciality of modern trauma is a high amount of multiple and combined trauma, that characterized by se- verity, high mortality and frequence invalidization of wounded. Venous thromboembolic complications are still remaining an unsolved problem and are one of the main reason for lethal outcomes, especially in cas- es with severe skeletal injury. One of the possibilities to reduce complications and mortality is a method of multi-stage surgical treatment in cases with skeletal trauma (“orthopedic damage control”). High risk of ve- nous thromboembolism complications requires a separate algorithm to score the risk assessment of venous thrombosis and pulmonary embolism, and appropriate treatment.

Injuries caused by non-lethal weapons predominate in the structure of peacetime gunshot wounds in a large city, and their frequency is 84.0% of all gunshot wounds. The maximum lethality injuring non-le- thal weapons observed when shot at close range (up to 1.5 m). Gunshot wounds caused non-lethal weap- ons have all the features peculiar to injury from conventional low-speed shooting of firearms or high-speed«a spent bullet» and must be treated according to the general principles of treatment of gunshot wounds. Surgical treatment for superficial non-invasive soft tissue injuries, to make up 80.0% of all injuries, is limited to the implementation of the wound toilet. Penetrating wounds of the character, as well as organ damage, the presence of life-threatening consequences of injury, require the operation - debridement, which shall correspond to the location and nature of the injury.

In the course of performed work the cases of infected spontaneous abortion with ascending infection by 338 women were considered. 190 of them was accompanying with systemic inflammatory reaction. For the diagnostics clinical, laboratory, instrumental and special methods of examination were used. The analysis of clinical-morphological peculiarities infected spontaneous abortion showed, that spread and difficulty of the infectious process depend of chronic gynecological pathology and pathological inflammatory processes in the cervix of the uterus.

The article presents an authors’ experience in management of different forms of complicated abdominal aortic aneurysms in for Russia novel medical division like emergency department of multi-filed hospital. The differences in logistic, diagnostic and care between new and past organization approaches were discussed based on two-year experience (2010 and 2012) in 208 patients in the single center. The comparative analy- sis showed a decrease of time between patient admission and disease definition, an enlargement of diagnos- tic resources, reduction of senseless patients stay in hospital and improvement of care results on the whole.

To study the dynamics of the recovery of microcirculation in burn shock period using laser Doppler imag- ing at the victims of the explosion of methane-coal mixture. Investigation of the basic indicators of microcir- culation in burn shock period was performed in 54 of fired miners, who were treated at the burns unit of the Institute Urgent and Recovery Surgery after Gusak. All the victims was carried out surgery in the period of burn shock lies in the primary surgical treatment of wounds with the simultaneous closure of the temporary biolog- ical covering. A statistically significant increase in the average value of blood flow in the skin is not affected at 4 hours after the surgery in the period of burn shock. According to the study, the most informative and sensi- tive diagnostic indicator of microcirculation, blood supply recovery characterizing the dynamics of the micro- vasculature in the period of burn shock, recognized parameter M - the average value of the blood flow.