The results of the research conducted at the All-Russian Centre for Disaster Medicine “Zaschita” are presented. Goal of research: study of organizational issues of the system of emergency medical care for the persons injured in emergency situations, study of participation of territorial centers for disaster medicine in organization and rendering of emergency medical care to patients and persons injured during their work in the ordinary course of their day-to-day activities, study of models of functioning and interaction of emergency medical services in the course of their work in various modes of activity in the subjects of the Russian Federation. In conduct of the research the method of expert assessment by questioning of the experts participating in the organization and provision of emergency medical care in 58 subjects was applied. 242 experts participated in the survey. Analysis of the results of the research confirms the necessity of the further development and introduction into practice of the certain organizational activities aimed at perfection of the system of emergency medical care for the population both in the emergency situation and in the mode of daily activities. Thus, this refers to the construction of a functional vertical of the system of coordination and monitoring of the emergency medical care provision in various modes of activity with interrelated and well-functioning regional and federal segments.

A ball scale has been developed to assess the readiness of the stations and emergency health services (EHS) departments to eliminate the medical and sanitary effects of emergencies (ES). EHS standards were used as a basis, in accordance with regulatory documents. The application of this scale allows us to objectively assess the EHS readiness of to operate in case of emergencies, based on the EHS performance indicators in the daily work routine.

An analysis of typical injuries in 487 victims was conducted, depending on the conditions of injury in road traffic accidents — pedestrian, driver, passenger. Established major injuries in groups characterize the nature of high-energy trauma. Multislice Computed tomography is the method of choice in the diagnosis of associated trauma, it has a high diagnostic efficiency in comparison with other diagnostic methods.

Analysis of medical care that was administered to the injured with unstable pelvic ring fractures in the condition of theSaint Petersburgcity was done. The analysis of the effectiveness of anti-shock pelvic dressings in patients with unstable pelvic injuries and signs of unstable hemodynamic changes in the level of SBP over time. It has been found that the application of anti-shock pelvic bandage was no intermediate reduction in blood pressure, indicating a temporary halt intrapelvic bleeding and stabilize the hemodynamic parameters during time intervals sufficient to transport the victim to the nearest travmotsentr and implementation of appropriate diagnostic algorithm when pelvic injury. The necessity of using transport immobilization by fixing the unstable pelvic ring on the prehospital phase was based.

The analysis ofresults of 26 patients’ treatment with concomitant injury and pelvis injuries were conducted. Anti-shockaction of suggested by the authors immobilization belt were shown. Immobilizing beltat an early hospital stage contributes to the effect of intrapelvic biological tamponade, reducesthe rate ofinternal bleeding, stabilize the hemodynamics.

The initiation of the common register of all the patients who suffers from chronic diseases and is also observed by specialized clinics for all the city out-patient clinics and the emergency stations will significantly optimize the performance of both the emergency service and the network of out-patient clinics. The initiation of the common register will allow to hand the part of emergency calls from patients observed by a specialized clinic over to the emergency medical aid services of local policlinics. Owing to the information concerning patients presented in the register both the diagnostics quality during the pre-hospital period carried out by the emergency specialists and the performance of the adequate qualified medical care of the patients observed by a specialized clinic.

The article presents the results of the analysis of the composition of discharged adult patients taken to the hospital for emergency indications, including crews of emergency medical service, in theRussian Federationfor 2010–2016. Determined the increase in the proportion of adult patients taken to the hospital for emergency indications, from 41,5 to 48,2% of all discharged, of them by crews of emergency medical service — from 23,6 to 24,5%. The main causes hospitalization by emergency indications crews of emergency medical service were diseases of the circulatory system, pregnancy, childbirth and the postpartum period, injury, poisoning and certain other consequences of external causes, diseases of the digestive system.

This study demonstrates the effectiveness of procainamide, propafenone and amiodaronefor pharmacological cardioversion in patients with paroxysmal atrial fibrillation. The restoration of the sinus rhythm within 60 minutes was observed for propafenone 73,2%, for procainamide 55,00% and for amiodarone 16,13% of cases.

Patients with respiratory distress often seek emergency medical care and are frequently transported by emergency medical services (EMS). Some of them are in need of urgent respiratory support.EMSencounters with patients in respiratory distress and the role of mechanical ventilation (MV) in their treatment have not been well documented. The study objective was to characterize the epidemiology of prehospital respiratory distress and the impact of MV at subsequent patient outcomes. Some of the new trends in prehospital respiratory therapy have also been described.

The article highlights the burden of the venous thromboembolism (VTE) in clinical practice as one of the most frequent cause of cardiovascular death and disabling embolic stroke worldwide. The author compares the traditional use of VKA antagonists and new class of oral anticoagulants — direct thrombin and factor Xa inhibitors for VTE treatment and prevention. The results of most significant randomized clinical trials in VTE area and latest international guidelines are also discussed.