This article presents the experience of using simulation modeling for planning the organization of a threelevel system of emergency medical care in various constituent entities of the Russian Federation. An analysis of the work of the emergency service was carried out and various approaches to optimizing the provision of emergency assistance in the regions were considered.

This article presents the experience of the practical application of simulation modeling on the example of a model of an inpatient emergency department in working with a new coronavirus infection.

Clause analyzes the reasons of professional risks for health of the personnel of exit brigades of the first help. Clinical and hygienic researches in regional substation of a megacity have shown that in labour activity of these workers it is necessary to consider as leading professional harm action of transport vibration. The given circumstance and other reasons provide professional risks of development of illnesses of cardiovascular, bone-muscular system, a gastroenteric path. The interdepartmental complex of actions on improvement of operating conditions of the exit personnel is offered.

The article analyzes the structure of surgical complications in patients with COVID-19 from the point of view of a vascular surgeon in a multi-specialty hospital that has been converted into an infectious hospital for patients with a new coronavirus infection and suspected of it.

The article analyzes the autopsy reports of cancer patients who died in the Clinical Emergency Medicine Clinical Hospital in Smolensk in order to study the complications? Related to oncologycal disease in these patients. The complications of oncological diseases that doctors have to deal with in emergency hospitals and their specific manifestations depending on the location of the tumor are also analyzed.

Goal and objectives. Through a comprehensive case study to identify motivating and demotivating factors of professional activity of an anesthesiologists-resuscitators, which will implement the personnel policy of the healthcare security industry with highly qualified specialists of this profile.

Materials and methods. In 2019, 412 anesthesiologists and resuscitators from 20 multi-specialty hospitals in St. Petersburg were interviewed, and in 2020, 173 specialists from 8 hospitals were re-trained to treat patients with a new coronavirus infection. In sample populations, the deviation of the average value is 0.7%, while the acceptable reliability assessment of the results is up to 3.0%. The calculation of intensive and extensive indicators and the assessment of the reliability of their difference is made. A correlation analysis was used to assess the impact of a number of aspects of the professional activity of anesthesiologists and resuscitators on their job satisfaction.

Results. Anesthesiologists and resuscitators are committed to their work, despite the presence of a negative background: increased emotional load (59.4%), chronic diseases received at work (43.6%). The main negative aspects of their work are «overstrain and fatigue at work» (47.8 per 100 respondents), «the salary does not correspond to the load» (43.6 per 100 respondents), «rudeness on the part of patients and their relatives» (40.1 per 100 respondents), «lack of organized legal protection in the event of conflict situations» (26.8 per 100 respondents). Proper monetary compensation is not always an unambiguous condition for doctors to be highly satisfied with their work — only 26.6% would be fully satisfied with the profession if the salary level met their expectations. The analysis of the positive aspects of professional activity of specialists showed a high significance of factors that have a bright emotional color: the most important are the ability to help people (52.3 per 100 respondents) and a good work team (60.8 per 100 respondents). Salary, the level of which is not marked by doctors among the main aspects of work, however, is stated as a motivating factor by 34.2 respondents out of 100 respondents. A study in 2020 revealed an even greater number of doctors experiencing overstrain and fatigue at work (95.3%, t=4.5, p<0.05, including 59.5% –at the limit of their capabilities), increased psycho-emotional load (86.3%, t=3.8, p<0.05).

Conclusion. Most on the professional satisfaction of doctors and anaesthesiologists in Saint-Petersburg have a positive effect: the possibility of self-realization and professional growth (ρ=+0,9, p<0.05) and the wage (ρ=+0,8, p<0.05), the ability to help people (ρ=+0,7, p<0,05) and the presence of career prospects (ρ=+0,7, p<0,05). The greatest negative impact is caused by legal insecurity of specialists (ρ= -0,8, p<0,05), negative consequences of interaction with patients and their relatives (ρ= -0,7, p<0,05), abnormal load on specialists (ρ= -0,7, p<0,05), the need to perform unspecified functions for them (ρ= -0,5, p<0,05).

Despite the low injury of endovascular interventions, there are a number of complications that significantly worsen the prognosis of patients. The most unfavorable complications in patients with ST-segment elevation myocardial infarction during primary percutaneous coronary intervention are stent thrombosis, coronary artery perforation, tamponade, complications at the arterial access site, distal embolism, development of the "no-reflow", stroke. The article is devoted to the study of the frequency of these complications in primary percutaneous coronary intervention in combination with manual thromboaspiration.

Transluminal endoscopic interventions in the treatment of patients with spontaneous rupture of the esophagus can significantly improve treatment results. Esophageal stenting and vacuum therapy for the treatment of esophageal rupture and suture incompetence are alternatives to surgery.

At the present stage treatment of gastrointestinal bleeding, x-ray surgical methods play an important role. This review examines the features of the use of transcatheter arterial embolization in the most relevant nosological forms: ulcer bleeding, bleeding in chronic and acute pancreatitis, and in decaying tumors of the gastrointestinal tract.

Fast and cost-effective treatment of patients with diabetic foot syndrome (DFS) is still a great challenge today. The use of biomedical cell products (BCP) in this category of patients has its own pathogenetic orientation, however, it remains not fully understood and accepted. This review presents the results of numerous studies confirming the effectiveness of the use of BCP for the treatment of mainly superficial trophic defects in patients with neuropathic form of DFS. However, these technologies are still behaved to adjuvant therapies. There are no clear algorithms and regulations for the use of BCP in patients with DFS. It was shown that use of BCP accelerates the reparative processes of superficial trophic defects in patients with neuropathic form of DFS in combination with standard therapy and reduces the time of wound epithelization. In view of the complexity and high cost of BCP, it should be considered the possibility of their use in patients with a neuroischemic form of DFS of different grades by WIfI classification.

The article highlights the modern approach to the thrombolytic therapy of acute myocardial infarction at the prehospital stage. The results of most significant clinical trials and registers in this area are discussed. Recent international and Russian clinical guidelines on thrombolytic therapy and pharmacoinvasive strategy in the treatment of acute myocardial infarction are also highlighted.