Due to the anniversary – the 75 anniversary of the Victory in the Great Patriotic War of 1941–1945 it is represented unforgettable historical pages of heroism and courage of residents of Leningrad who lived and fought in a ring of the enemy (08.09.1941–27.01.1944) in the conditions of bombings, shellings, cold and hunger. Together with all emergency medical service of Leningrad worked and fought.

This article presents the experience of using computer modeling to organize a three-tier system of emergency medical care in the Chechen Republic. An analysis of patients admitted for emergency indications to various hospitals in the Chechen Republic was carried out. Based on the data obtained, an adequate simulation model is created. At the last, a series of experiments was conducted aimed at determining the optimal redistribution of the flow of patients in need of emergency care in level 3 hospitals.

The article discusses the problem of providing medical care at the prehospital stage for children who have become participants in a traffic accident. Neck injuries are one of the main causes of death. First aid should include mandatory immobilization of the cervical spine. It is recommended to include the collar-tires in the kit first aid kit (“car”).

This paper presents an analysis of the quality of treatment of patients with posttraumatic acute kidney injury, died in intensive care units and intensive care district hospitals. Defects treatment in most cases arise from non-compliance with the recommendations for treatment, using outdated methods of treatment and the lack of contraindications when prescribing drugs.

The relevance of a subject is conditioned by the extreme importance of the medical and social issues of providing medical care services to patients with acute alcohol intoxication. This research is conducted to find ways to optimize medical care services for patients with the diagnosis “toxic effect of ethanol” (ICD-10-CM code T51.0). For this study, was analysed: course of 13172 clinical cases and the possibility of treating this pathology in the hospital emergency departments. Statistical and analytical methods were used to study data from the medical information system of The Saint Petersburg Research Institute of Emergency Medicine n. a. I. I. Dzhanelidze. As a result of the study the place of treatment of patients with diagnose “toxic effect of ethanol” was determined: for mild and moderate patient — emergency departments of multi-specialty hospitals, and for severe patient — in specialized acute poisoning treatment Center.

Тhe article is dedicated to providing medical assistance and conducting exercises in road traffic accidents.

The review discusses the current problems of organizing prehospital care for victims of severe trauma in overseas developed regional trauma systems. The results of studies on the features of pre-hospital triage, the choice of the amount of emergency medical care, the route and type of transportation of victims in the functioning of trauma systems are systematized. Foreign experience in providing emergency medical care for severe injuries can be useful for the creation and implementation of domestic trauma systems.

Background. The incidence of non-ST-segment-elevation acute coronary syndrome (NSTEACS) is especially high in elderly. In such patients, concomitant diseases are more common and there is a higher risk of complications, which emphasizes the relevance of the study of frailty syndrome and outcomes in NSTEACS. Objective. The aim of the study was to analyze the effect of frailty on the course of nonST-segment elevation acute coronary syndrome and outcomes in elderly and senile patients. Design and methods. 126 patients with non-ST-segment elevation acute coronary syndrome at the age of 61 to 90 were involved into the study. Follow-up was carried out during 1 year; clinical endpoints were mortality and recurrent acute coronary syndrome. All patients were divided into 3 groups according to the frailty index by M. Hoover et al.: the first group — 49 patients with frailty syndrome (38,9%), the second — 47 (37,3%) with pre-frailty and 30 patients (23,8%) without frailty. Results. Geriatric syndromes, cognitive impairment, depression, decreased basic and instrumental activity were more often in patients with frailty. They also had more complications, such as bleeding, arrhythmias and early post-infarction angina. During 1-year followup 5 patients with frailty (10.2%), 5 patients (10.6%) with pre-frailty, and 2 patients (6.6%) without frailty had adverse outcomes. When analyzing the influence of age and frailty on the development of adverse outcomes (death, repeated ACS), a higher contribution of age was revealed. Conclusion. Patients with ACS and frailty have a higher risk of adverse outcomes. Some of the reasons are various geriatric syndromes, changes in emotional and cognitive status and more frequent complications. Age and frailty were crucial for the development of adverse outcomes. However, senile age was of higher importance for the outcomes.

The aim of this study is to estimate the possibility of using the differences of negative T waves in the right precordial leads for the differential diagnosis of the pulmonary thromboembolism (pulmonary embolism) and Wellens syndrome. We studied the first ECGs with T-wave inversion in leads V₁ –V₃ in 70 patients (38 patients with pulmonary embolism and 32 patients with Wellens syndrome). The ratio of the magnitude of negative T wave in the lead V₁ to the magnitude of negative T wave in the lead V₃ (T_V1/T_V3) was more than 0.5 in all patients with pulmonary embolism and in only one (4.5%) patient with Wellens syndrome. So, this criterion T_V1/T_V3 >0.5 may by useful for the differential diagnosis of these diseases.

The most common and formidable complications of portal hypertension are bleeding from varicose veins of the esophagus and stomach, a radical method of treatment and prevention of which at present can only be considered liver transplantation. All other technologies (conservative, endoscopic, endovascular, surgical) are palliative measures, the most important task of which is to ensure for the patient the highest possible quality of life in the inter-relapse period.

Ethanol intoxication is analyzed from the point of ethanol interaction with receptors and enzymes. Ethanol dependence is based on neurochemical misbalance, which is different in acute ethanol intoxication and withdrawal. It is shown that the clinical manifestation of ethanol intoxication and its complications depends on ligand-receptor and enzyme imbalances. Pharmacological approaches to the treatment of acute ethanol intoxication and its complications at the pre-hospital stage and in the emergency, unit are discussed.