Results of research with the purpose to reveal the most significant indicators of an emergency medical service which characterize the main directions of its work are presented in article and can be used as indicators of work of service. For a scientific assessment of the importance of the offered indicators of availability and quality of an emergency medical service (n = 51) the method of expert evaluations was used, heads of an emergency medical service, chief specialists of an emergency medical service of subjects of the Russian Federation (n = 76) acted as experts. Processing of results is carried out with use of a method of determination of weight coefficients and the cluster analysis. Indicators of structural quality of service-security with all-profile crews of an emergency medical service and motor transport became actual indicators. They allowed to carry out the detailed analysis of a condition of service of an emergency medical service and to reveal the main problems-deficiency of all-profile crews of an emergency medical service and motor transport of an emergency medical service, their deviation from standard indicators that creates threat of availability and to quality of an emergency medical service.

We studied the types and severity of injuries in victims of road traffic accidents registered in 2012 2014 in Severodvinsk of the Arkhangelsk region referring to the Arctic zone of Russian Federation. It has been found that medical care at the pre-hospital phase was provided to all victims in different extents. Immobilization and anesthesia were carried out at a sufficient level. However, there were found defects of infusion therapy in patients with multiple and concomitant trauma due to underestimation of the injury severity. Average delivery time of victims to the hospital was 40 minutes.

The prospect of diminution fatal outcome in acute period of traumatic disease are determined mainly optimization of infusion and blood transfusion therapy, making use of «small resuscitation», balanced crystalloid and colloid solutions period. Refusal of use whole fresh stabilized blood in patients who have the greatest loss of blood is not very good decision.

The present review assesses the frequency and type of ventricular tachyarrhythmias in senility (n = 388) patients with acute coronary syndrome, predictors of them development and effect on course of disease. Clinical and instrumental data have confirmed that ventricular tachyarrhythmias - life threatening arrhythmias most frequently develop at first 12 hours after coronary revascularization, accompanied by high level of hospital mortality, especially in patients with electrical storm. Ventricular tachyarrhythmias are associated with myocardial morpho-functional condition, electrolyte imbalance, coronary arteries lesion and duration of ischemic heart disease at pre-hospital stage. Prognosis of these arrhythmias depend on subepicardial myocardial ischemia availability and early coronary revascularization (infarct-depended artery).

General description of air transport of Russia is considered. Statistical information over is brought on aviation catastrophes. Principal reasons of aviation catastrophes. The analysis of size and structure of sanitary losses is conducted at air crashes. The features of organization of curatively-evacuation events are marked.

Ongoing bleeding is one of the main life-threatening sequences of trauma. A method of endovascular balloon occlusion of the aorta is used during first minutes after patient's admission to a trauma center or at pre-hospital stage. This method is now widely accepted worldwide to control intraabdominal or pelvic bleeding. We describe the modern approach to control of ongoing internal bleeding by means of the endovascular balloon occlusion of the aorta, indications and an operative technique of aortic balloon occlusion, based on a review of literature.

The analysis of clinical observations 148 patients of the associated trauma, were hospitalized at the clinic of military surgery, Military Medical Academy. Of these, 83 patients were the group of clinical observations, in which treatment is the concept of damage control surgery, 65 - a group of retrospective analysis of conservative treatment. Evaluated the effectiveness of the method extraperitoneal and transperitoneal pelvic tamponade, and especially the incidence of deaths and complications in the application of different treatments, including endovascular methods of hemostasis at pelvis bleeding.

Results of treatment of 389 cases with combined chest and abdomen stab wounds are present. It was proved that a correct choice of surgical procedures sequence and their capacity ensures the successful treatment in cases with combined chest and abdomen stab wounds. Usage of suggested algorithm allow to reduce a quantity of postoperative complications from 45,2% to 21,3% and mortality - from 13,5% to 6,2%.

The article gives the characteristics of the admission department of a major children's hospital when providing emergency assistance to children who are admitted with injuries of the musculoskeletal system by ambulance. The number of indicators is compared with the indices of the affected children with the same pathology, admitted to the admission department independently. Proposed concrete measures to improve medical assistance to affected children in the receiving and discharge Department.

In experimental research evaluated the effectiveness and safety of the reinfusion integral autologous blood during the using the damage control tactics of surgical therapy at the model of penetrating abdominal wound with the damage of the parenchymal organs. There is the evidence that the rational use of the blood reinfusion technique on wounded with the damaged internal organs will give an opportunity to improve the results of their treatment.

Comparison of the effect of a three-phase combined oral contraceptive (COC) containing estradiol valerate and dienogest in dynamic mode and single agent containing dienogest, to reduce menstrual blood loss on the background of adenomyosis. Women aged 18-50 years, with a diagnosis of adenomyosis and pain hospitalized for abnormal uterine bleeding. Hysteroscopy and curettage of the uterus were performed on all the patientsw. After discharge, and the results of histological examination, patients of group 1 (no need of hormonal contraception), dienogest monotherapy was administered at a dose of 2 mg per day continuously for 6 months. Group 2 patients (who needed effective contraception) were administered three-phase COCs containing estradiol valerate and dienogest (2 days 3 mg estradiol valerate, 5 days estradiol valerate 2 mg/2 mg dienogest, 17 days estradiol valerate 2 mg/3 mg dienogest, 2 day 1 mg estradiol valerate and 2 days of placebo); 3 groip patients (not need for contraception) were treated with antifibrinolytic drug tranexamic acid at a dose of 1000 mg per day orally. 4 group patient to obtain a monophasic combined oral contraceptive containing 30 mcg ethinyl estradiol and drospirenone 3 mg. Evaluates the performance of blood coagulation. Against the background of dienogest a significant and reliable reduction of menstrual blood loss and the severity of pain was shown that demonstrates its effectiveness in the treatment of abnormal uterine bleeding associated with adenomyosis.

According to current guidelines laparoscopic closure of perforated pyloroduodenal ulcers is the primary and preferred method of treatment. The continued risk of insolvency of the seams and the danger of the eruption of tissues in the formation of intracorporeal site attested to the relevance of the problem of further improving this technology through the development of new options for closing the perforations.

Implementation of the pilot project «Inpatient unit of emergency medicine» in a multidisciplinary hospital resulted in enhancement of indicator values of multidisciplinary hospitals of emergency medicine. The rate of unjustified hospitalizations in the share of short-term patients hospitalized in specialized subdivisions was reduced from 22.32% to 19.07% (p<0,05). It has been revealed a reduction in the number of patients by 1,82 times with the diagnosis-marker «S06.0 Cerebral Contusion» which were treated in the neurosurgery department up to 3 days of stay in hospital. It was identified an increase of frequency of medical care at emergency department by 17,81% (from 833,53 in 2012 to 981,98 in 2015 for 100 cases of medical resource utilization). Achieved changes gave rise to increase of admission capacity by 11,0% within 2013-2015 due to increase in the number of out-patient cases (15,26% to 27,71%) and reduction in the number of hospitalized patients (84,74% to 72,29%).