Introduction. Wide implementation of distance counseling of incident witnesses on first aid (DCFA) over the telephone by dispatchers of emergency medical services (EMS) can significantly increase the rate of provision of first aid (FA) by the bystanders and contribute to reduction of mortality from the life-threatening conditions. The purpose of this study was to investigate personal experience and opinions of the specialists of EMS of the Russian Federation regarding the practice of DCFA, that is important for planning and determining priority areas for the development of a unified domestic program on DCFA.

Methods. In September–October 2022, an anonymous interregional survey of the EMS specialists was conducted. EMS dispatchers constituted the target group of the survey. Participation of specialists without experience of dispatching was also allowed. The survey was carried out online using a pre-tested questionnaire that included 17 questions to assess, inter alia, personal experience of DCFA, self-confidence of the specialists when giving instructions on FA over the telephone, opinion on the importance of DCFA, level of the specialists’ knowledge on FA, experience of prior training on the methods of DCFA, as well as to identify factors that prevent or hinder real practice of DCFA. To analyze the results, nonparametric statistics was used.

Results. The final sample consisted of 965 EMS specialists from 58 constituent entities of the Russian Federation, of which 77.4% (n=747) were feldshers and nurses for receiving and transmitting EMS calls. 73.3% (n=707) of the respondents reported that they had experience of DCFA. The average number of cases of DCFA in the past year reported by one specialist was 97 (median=10). 87.6% (n=619) of respondents with experience of DCFA have highly rated the importance of this practice for saving human health and life. However, only 47.8% (n=338) of the specialists with experience of DCFA reported that they felt themselves completely confident when giving the instructions to bystanders. Despite the fact that the level of confidence was characterized by a positive correlation with the specialists’ assessment of their knowledge on FA (p<0.001) , only 46.4% (n=328) of the respondents with experience of DCFA have rated their knowledge as very good, and 15.7% (n=111) have ever learned the principles of DCFA. From the perspective of the respondents with experience of DCFA, main barriers to this practice include unreadiness of bystanders to follow instructions on FA, fears of dispatchers regarding possible egal liability, a lack of dispatchers and/or their overburden with receiving and transmitting calls, and a lack of clear algorithms/protocols for instructing witnesses.

Conclusion. EMS dispatchers generally highly rate the importance of DCFA, but feel themselves uncertain when counseling the bystanders, and have a lack of knowledge on FA. The vast majority of the specialists have never been trained in the methods of DCFA. Priority measures aimed at implementation a unified domestic practice of DCFA include the development of a universal program for training EMS specialists on the principles and skills of DCFA, creation and testing of standardized dispatch algorithms/protocols on DCFA for various health disorders, organization of effective legal regulation for the practice of DCFA, and solution of the problem of shortage of EMS specialists who operate as dispatchers.

Introduction. Pandemic of the new coronavirus infection 2019–2021. has become a serious test of the country’s health care system, mobilizing all possible resources of the health care system.

The purpose of the study: a medical and statistical analysis of the contingent of patients in emergency hospitals during the COVID-19 pandemic.

Materials and methods. Data from federal state statistics (sources — FSN No. 14 and 30, 2019–2021) of 2 multidisciplinary hospitals operating in emergency hospitals (24/7/365) with fundamental structural and functional features related to the availability of beds for patients with a new coronavirus infection. Regulatory, statistical and analytical methods were used.

Study results. The main factor contributing to the differences in the organization of the work of ambulance hospitals was the factor of their re-profiling to receive infectious patients — the deployment of beds for patients with COVID-19, the second — the assignment of additional volumes of specialized non-infectious medical care to non-infectious hospitals for emergency hospitalization, change routing schemes in the implementation of medical evacuation of patients to specialized hospitals. These factors determined the dynamics of the patient population in these beds. The reduction (termination) of planned hospitalization, sanitary and epidemiological restrictions and quarantine measures were also significant.

In recent decades, the Krasnodar Region has been leading among the regions of the Russian Federation in the number of technogenic and natural emergency situations.

The purpose of this study was to assess the effectiveness of the interaction of emergency services involved in the liquidation of emergencies including: EMERCOM, disaster medicine services, ambulance and other services of the RUERS.

The material of the study was the information and analytical certificate, namely the report of the Regional Center of Disaster Medicine in Krasnodar, the emergency call card and the accompanying sheets of the emergency situations, the passport of the medical service of the catastrophes of the Yeysk district of the Krasnodar Region.

Research results. The coordination and timely use of municipal, regional, interregional forces and means of the disaster medicine service, ambulance, the EMERCOM and other emergency services of the RUERS allowed quickly eliminating the consequences of the technogenic emergency.

The analysis of the results of medical care at various stages of treatment of 86 people who received stab wounds in the neck area was performed. The male wounded predominated, of which there were 65 (75.6%) people, there were 21 (24.4%) women. The study shows that errors in the provision of medical care in the case of a neck injury occur in 31.4% of cases, while such errors were noted in 8.1% of cases when medical care was provided by medical teams of emergency medical care, whereas in the provision of medical care by paramedic teams of emergency medical care in 22.1% of cases. Basically, the errors were associated with incorrect performance of temporary hemostasis and underestimation of the condition of the wounded, as a result, the wounded from this localization developed or had a high risk of developing various compli[1]cations, including shock. This could not but affect the course of the nearest postoperative period with such injuries. Based on the analysis, it was found that in the group of wounded who received medical care by medical teams of emergency medical care, there was a statistically significant decrease in complications and deaths compared to the group where such assistance was provided by paramedic teams of emergency med[1]ical care. From this it can be concluded that neck injuries are the most severe injuries, higher qualifications are required to provide assistance with such injuries, while preference should be given to medical teams of emergency medical care.

The literature review is devoted to the analysis of the experience of prehospital whole blood transfusions (PHWBT) in combat casualties of XXI century military conflicts (Iraq, Afghanistan) and the results of the introduction of this experience into the practice of civil emergency pre-hospital care. Data from PubMed, Cochrane Library and other free Internet resources since 2001 to 2021 were analyzed. It has been established that PHWBT in traumatic hemorrhagic shock (THS) is a safe and promising method of care of massive blood loss. For a more objective assessment of the effectiveness of PHWBT in THS prospective multicenter studies are necessary.

Despite the success of recent decades in reducing mortality from diseases of the circulatory system (CVD), cardiovascular disease (CVD) remains the most common non-communicable pathology in all countries of the world. CVDs have high rates of morbidity, disability, and mortality. The most common of these are arterial hypertension and coronary heart disease. CVD occurs against the background of the presence of risk factors (RF). The ability to timely detect risk factors and manage their level underlies the prevention of CVD. Monitoring the level of risk factors at the individual level and assessing their prevalence at the group level is not feasible without the use of specialized software. Registration and monitoring of patients in the program allows you to create a data archive for use by medical professionals and the patient himself. In the literature there is information about the prevention and medical examination of the population with cardiovascular diseases. However, to date, the medical and social problems of FR management in CVD have not been sufficiently described. In this regard, the effectiveness of measures carried out within the framework of prevention and medical examination decreases.

The fight against diseases of the CVD group has not only social, but also economic significance. High rates of temporary disability and disability of patients lead to serious losses at the state level. This determines the need for further improvement of mechanisms for the prevention and treatment of CVD.

The purpose of the study. Search for criteria for objectifying the safety of emergency treatment of hypertension syndrome at the outpatient stage of emergency medical care.

Tasks: 1) еvaluate the possibility of hardware monitoring of blood pressure at the pre-hospital stage of emergency care; 2) select indicators that allow you to objectively assess the safety of emergency antihypertensive therapy with various two-component drug combinations; 3) the use of urgent blood pressure monitoring to demonstrate the differences between the safety of combinations of captopril with furosemide, moxonidine with furosemide, moxonidine with nifedipine.

Materials and methods. At the prehospital stage, blood pressure monitoring was carried out during the day simultaneously with taking a number of combinations of antihypertensive drugs (captopril and furosemide, moxonidine and furosemide, moxonidine and nifedipine). In the absence of intolerance to any of the studied drugs, the choice of drugs was carried out by fixed randomization using a table of random numbers. A total of 91 patients were included in the study, in whom the results of an instrumental study were analyzed against the background of drug therapy.

Results. To assess the effectiveness and safety of antihypertensive treatment, the protocol for analyzing primary data was modified, new highly informative quantitative criteria for assessing the effect of various drug combinations on the temporal dynamics of blood pressure were developed.

Conclusion. The proposed research methodology allows documenting the course of emergency therapy and can be offered for use during outpatient treatment

A clinical case of hybrid revascularization of the brain and myocardium was demonstrated in the volume: percutaneous coronary intervention of the left coronary artery by the method of Culote and carotid reendarterectomy using a temporary shunt. This surgical intervention was accompanied by a high level of complexity. The implementation of this method of treatment allowed to prevent the development of severe complications of the brain and myocardium.

Introduction. There is no separate register of patients with dysphagia who need an artificial nutritional fistula and enteral nutrition. The situation can be indirectly judged by the data of the information system of the city multidisciplinary hospital in which these operations are performed.

The purpose and objectives of the study. To study the structure of nosology, the order of hospitalization of patients with dysphagia and the ways of applying nutritional fistulas in the city multidisciplinary hospital of St. Petersburg.

Material and methods. The data of the St. Petersburg municipal hospital № 26 information system of cases of gastrostomy and eunostomy in 2021 are analyzed.

Results and discussion. In 2021, artificial nutritional fistulas were applied to 62 patients aged from 20 to 83 years, 63.1±12.64 years in average. In 49 (79.0%) hospitalized patients, the cause of dysphagia was malignant tumors that had already been diagnosed earlier. In 10 (16.1%) cases, patients underwent percutaneous endoscopic gastrostomy using the pull method, while dysphagia was of a functional nature and was a complication of non-tumor diseases. The patients operated by this method were aged from 20 to 80 years, 53.4±20.08 years in average. The imposition of an artificial nutrient fistula through laparotomy was performed in 52 (83.9%) patients aged 43 to 83 years, 64.94±9.90 years in average. All the patients of this group were older than patients, received puncture gastrostomy under the control of an endoscope (p<0.05).

Conclusion. It is necessary to determine the tactics of monitoring of patient with dysphagia and resolving the issue of timely hospitalization for gastrostomy. Planned hospitalization for palliative intervention before the appearance of signs of decompensation of the general condition and obstruction of the upper digestive tract, will allow performing minimally invasive and, as a consequence, low-traumatic puncture methods of gastrostomy.

Purpose: to develop models of patients with severe flame burns.

Material and methods: the analysis of scientific publications and own observations of the causes of flame burns was carried out.

Results: based on the data obtained, six models of patients with severe flame burns were formed: residential fires, liquefied petroleum gas-related burns, cookstove-related burns, flammable liquids-related burns, self-immolation and smoking-related burns. According to the results of the study, 94% of patients with flame burns corresponded to these six models. These models turned out to be homogeneous by gender, age, area, depth and localization of skin lesions, severity of the condition and other characteristics.

Conclusion: the using models of patients make it possible to form homogeneous groups of victims. Due to the homogeneity of these groups, it is possible to develop surgical treatment tactics for each of the formed models, which should improve the results of treatment of burned patients.

The article presents a comparative assessment of the effect of sevoflurane and desflurane on intraoperative hemodynamic parameters and sedation level during laparoscopic cholecystectomy was carried out. A modern scheme for assessing perioperative cognitive status is presented.

The aim of the work is to conduct a comparative assessment of the effect of sevoflurane and desflurane on hemodynamic parameters during laparoscopic cholecystectomy. To study the frequency of postoperative cognitive dysfunction in the immediate postoperative period when using sevoflurane and desflurane.

Materials and methods: The study included 60 patients of both sexes operated on for cholelithiasis by laparoscopic cholecystectomy. The patients were divided into two groups of 30 people depending on the anesthetic used. In group 1, sevoflurane was used. In group 2, desflurane was used. The degree of anesthetic risk of patients was according to ASA I–II degree.

The results and their discussion. The effect of sevoflurane and desflurane in the dosages used on hemodynamic and gas exchange parameters did not differ significantly, with the exception of a significantly lower value in group 1 of ADd, ADsr, heart rate at the 2nd stage of the study and ADs after applying carboxyperitoneum at the 3rd stage. With laparoscopic interventions of medium duration, sevoflurane and desflurane do not have a negative effect on postoperative cognitive status