Purpose. To justify the need for centralization of the emergency medical service of the regions of the Russian Federation in order to ensure medical evacuation of patients with acute cardiovascular diseases from the place of emergency medical call directly to specialized medical organizations.

Tasks. To study the level of centralization of the emergency medical care service in the constituent entities of the Russian Federation; to analyze the implementation of medical evacuation of patients with acute cardiovascular diseases to primary vascular departments and regional vascular centers in groups of constituent entities of the Russian Federation with different levels of centralization of the emergency medical care service.

Materials and methods. The study was conducted using a statistical method for analyzing data from Form № 30 «Information on the Medical Organization» of the constituent entities of the Russian Federation for 2023.

Results. In 2023, in the constituent entities of the Russian Federation with a centralized emergency medical care service, the proportion of patients with acute cardiovascular diseases (acute cerebrovascular diseases and myocardial infarction) delivered by mobile emergency medical care teams from the place of emergency medical care call to primary vascular departments and regional vascular centers, from the total number of these patients who received emergency medical care outside a medical organization, turned out to be higher compared to the value of this indicator in the regions of the Russian Federation with a decentralized emergency medical care service.

Conclusion. Centralization of the emergency medical care service in the constituent entities of the Russian Federation, which provides for the unification of all emergency medical care stations (departments) into one independent medical organization in the constituent entity of the Russian Federation, ensures the implementation of medical evacuation of patients with acute cardiovascular diseases to specialized medical organizations (primary vascular departments and regional vascular centers).

The existing indicators of the industry incident «Improving the efficiency of managing the system of measures to reduce adult mortality», which are derived from the number of fatalities in road accidents, do not reflect the overall picture of mortality from injuries and external causes in the Russian Federation. In this regard, in order to reduce mortality from manageable causes, it seems appropriate to use indicators calculated in the group of victims with combined, multiple and isolated injuries accompanied by shock. The indicators should characterize compliance with routing for the specified group of victims and the timeliness of the start of anti-shock therapy. The purpose of the study is considering the feasibility of making changes to the structure of the industry incident in terms of indicators of mortality from injuries and external causes. Materials and methods. Mortality rates from injuries and external causes in the Russian Federation for the period 2020-2023 were studied, and proposals were developed to improve their monitoring within the framework of an industry incident. The results of the study. Mortality from injuries and external causes in the Russian Federation continues to be high: in 2023, this figure was 107.1 per 100,000 population, including mortality from road accidents — 9.2 per 100,000 population (8.6%). In order to improve the efficiency of managing the system of measures to reduce mortality in the adult population, it is advisable to include in the structure of the industry Incident indicators that allow assessing compliance with predetermined routing and the timeliness of providing specialized medical care to all victims with combined, multiple and isolated injuries accompanied by shock.

Introduction. A mobile ambulance team is a functional unit of a medical organization (department, station) of emergency medical care, a resource-intensive element of the healthcare system. Purpose of the study: to study the structure of mobile emergency medical teams in the Russian Federation in the dynamics of recent years.

Materials and methods. Data from federal statistical reporting (Ministry of Health of Russia, Rosstat) for 2010–2023 were used. in the Russian Federation, normative legal, statistical and analytical methods were applied.

Results of the study: the main resource of the EMS are general teams (92.0%), performing 95.0% of emergency medical care volumes; among them, 80.3% are paramedic teams; nursing staff (95.1 thousand people) is the main human resources of emergency medical services, 6.9 times larger than medical personnel (13.7 thousand people); In dynamics, there is an increase in the number of specialized emergency medical teams of anesthesiology and resuscitation (by 33.6%) and pediatric (by 26.3%), a significant decrease in teams of cardiology (by 55.8%) and neurological profiles (by 56.9%).

Conclusion. One of the important areas of healthcare development today is the improvement of the emergency medical care system. Optimizing its resource potential, including structural and personnel aspects, will help improve the availability and quality of emergency medical services and the economic efficiency of medical organizations.

One of the most pressing issues in modern healthcare is finding ways to optimize the work of the emergency medical service, its deep reform, and the introduction of information and digital technologies into its organization.

The aim of this study is to create an application for calling an emergency medical team through the user›s personal account.

Materials and methods. A central call reception service is being created through a mobile application operating on Android-based systems compatible with version 11 or higher. Android is capable of performing all the functions of the web service.

Results. To facilitate interaction between the caller and the EMS team, a corresponding web service is created, enabling calls to 03 or 103 numbers. The service provides information about the stages of call processing. Implementing the service will reduce the number of phone calls to the 03 line, including repeat calls, and reduce the waiting time for an operator. To create a patient profile in the call reception service, each registered user must enter their data or the data of relatives for the possibility of calling EMS for them and subsequently track information about the call. Creating an application for calling EMS teams through the subscriber›s personal account allows: 1) рromptly forwarding EMS calls (often there is a need for prolonged dialing due to line congestion), improving subscriber or their relatives› accessibility to the EMS service and to the call reception dispatcher; 2) the service contains information (archive) about previous calls, including information about chronic diseases; 3) receiving feedback on the quality of medical care provided; 4) tracking the movement of the EMS team and indicating the arrival time of the team.

Purpose of the study. The purpose of the study is to study the level and dynamics of mortality of the able-bodied population of the Arctic zone of the Republic of Sakha (Yakutia) from external causes in 2020–2022.

Materials and methods. The object of the study is the mortality of the able–bodied population of the Republic of Sakha (Yakutia), the subject of the study is the mortality of the able–bodied population of the Arctic region of the Republic of Sakha (Yakutia). The analytical method, methods of expert assessment, methods of mathematical analysis were applied and the data of the Federal State Statistics Service for 2020–2022 were studied.

Results. It was established that despite a positively decreasing trend by 18.0% (from 327.2 to 268.4 per 100,000 able-bodied population), the mortality rate from external causes for the able-bodied population in the Arctic districts of Yakutia in 2021 was double the regional average (141.7); 2.5 times higher than the all-Russian number (116.4); and by 74.6% higher than that of the FEFD (166.4). The issue remains urgent due to the high mortality rate from cold injury (24.6 per 100,000 able-bodied population against the regional average at 13.5), accidental drowning (43.8 against 11.9), suicides (30.1 against 22.1), and murders (38.3 against 16.1).

The purpose of the study was to examine the main expected risks and real-life challenges in combining emergency medical services and disaster medicine into a single legal entity in the region.

Methods. Using a selective survey of the constituent entities of the Russian Federation, an analysis of potential risks was carried out when creating a new organizational system of emergency medical care among 3 different organizational forms of providing emergency medical services (Separate substations, a Unified dispatch center and a Unified legal entity) in the constituent entities of the Russian Federation. The obtained data were subjected to statistical processing using Microsoft Excel and descriptive statistics methods, and the Pearson Correlation Coefficient was calculated.

Results. Analyzing the indicators of the Pearson correlation coefficient, a moderate inverse relationship was identified between the organizational form of the emergency medical service in the constituent entity of the Russian Federation and the level of economic fears. In comparison, a high negative correlation coefficient was noted for administrative factors. On the side of social factors, the Pearson correlation coefficient was 0, which suggests that, regardless of the organizational form, social concerns were consistently lower than economic and administrative ones.

Conclusion. The study showed that the majority of managers assess all possible risks and problems commensurately. At the same time, a clear overestimation of economic and administrative factors was revealed.

The purpose of the study is to evaluate the results of improving the medical support system for the population of the Tula region in eliminating the consequences of emergencies caused by road accidents based on the development, implementation and evaluation of the effectiveness of new organizational medical support technologies.

Materials and methods of research. Reports on the work of the TCMC of the Tula region, accounting forms filled out by specialists of the territorial Center for Disaster Medicine (TCMC) in the information system «Monitoring of disaster Medicine centers» (smk.minzdrav.gov.ru); reporting forms of sectoral statistical observation No. 55 and 56 «Information on the activities of medical organizations providing emergency medical care and medical evacuation during field visits forms of work, including those with departments of emergency advisory medical care» for 2018–2022. The research methods are analytical and statistical.

The results of the study and their analysis. A comparative analysis of road traffic injury rates in 15 regions of the Central Federal District of Russia has been performed. The changes that occurred during the improvement of the complex of systemic approaches to the organization of emergency medical care to the population affected by road accidents in the Tula region are analyzed.

One of the reasons for the low survival rate of victims with out-of-hospital cardiac arrest (OHCA) is the low readiness of bystanders to provide first aid (cardiopulmonary resuscitation (CPR) and the use of an automatic external defibrillator (AED).

The purpose of the study: to study the degree of readiness of the population for CPR, its determining factors and determine ways to improve the provision of first aid to victims with OHCA.

Materials and methods. In January — June 2023, an anonymous survey of workers in the fuel and energy complex of the Republic of Belarus was conducted using the developed questionnaire «Readiness to provide first aid». The study involved 894 respondents without medical education. Nonparametric statistics methods were used to analyze the results.

Results. 10.7% of respondents defined their readiness to perform CPR as extremely low; 12.2% — as low; 38.6% — as average; 22.3% — above average; 16.2% — as high. Significant predictors of high readiness of respondents to perform CPR (p <0.001) were: male gender, previous training in CPR skills and participation in performing CPR on a victim in real conditions. The main barriers to performing CPR were fear of causing irreparable harm to the injured person and lack of knowledge and skills in CPR. Conclusion. Reducing mortality in OHCA requires maximum involvement of the population in the process of first aid by means of broad information, formation of proper motivation and emotional-volitional readiness, and increasing the coverage of practical training in first aid skills.

Purpose of the study: to evaluate the analgesic efficacy of ketoprofen, ketorolac, sodium metamizole (combination with pithophenone and fenpiverinium bromide) and percutaneous neurostimulation method for the choice of optimal analgesia of nonspecific cervicalgia in the conditions of daily ambulance work and possible emergency situations.

Materials and methods of the study: in 160 patients in conditions of real work of emergency medical aid in 7 cities of the Russian Federation were used: 1 gr. — Ketoprofen («Ketonal») (100 mg), intramuscularly (n=31); 2 gr. — ketorolac tromethamine («Ketorol») (30 mg), intramuscularly (n=25); 3 gr. — Metamizole sodium 500 mg, pitofenone 2 mg, fenpiverinium bromide 20 mcg («Baralgin») in 1 ml, 5 ml intramuscularly (n=22); 4 gr. — percutaneous neurostimulation (CHENS-SCENAR-02) (n=82).

Results of the study: cervicalgia was accompanied by complaints of headache (86%), «noise» in the head (33%), dizziness (25%), less frequently by complaints of paresthesias in the hands, cardialgia, nausea, agitation or lethargy in antalgic posture. Reliable analgesic efficacy with evaluation on visual analogue scale is realized by 10 minutes by 20–25% decrease of pain; by 40 minutes by 70%; reduction of cranialgia to 20–40% of the initial one is noted. A slight decrease in BP, HR and HR was registered; ketorolac and SCENAR-therapy were the most effective in these parameters. There were no significant side effects in any group.

Conclusion. Ketoprofen and ketorolac are the most effective in the conditions of daily activities of the emergency department and possible emergencies, and percutaneous neurostimulation is also possible in conditions of drug deprivation and/or contraindications to pharmacotherapy.

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

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

Results: based on the data obtained, four models of patients with severe chemical burns were formed: industrial acid burns, acid attacks, burns caused by household cleansers and cement burns. According to the results of the study, 87% of patients with chemical injury corresponded to these four 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.

Introduction. Minor obstetric and gynecological operations are among the most frequently performed surgical interventions, including for emergency indications. At the present stage of anesthesiology, various anesthesia techniques are used, and there is no consensus regarding the optimal method of anesthesia for these operations. Purpose of the work: to determine the optimal method of anesthesia for minor obstetric and gynecological operations.

Objectives: 1. to study and analyze literature data on methods of anesthesia for minor obstetric and gynecological operations in outpatient practice and for emergency interventions in a 24-hour hospital. 2. Determine the optimal methods of anesthesia for this category of patients. 3. Identify factors influencing the choice of anesthesia method.

Material and methods. More than 20 literary sources have been studied, the main ones of which are presented in the list of references. A retrospective analysis of 2700 patients who underwent minor obstetric and gynecological operations at the Saint Petersburg I.I. Dzhanelidze Research Institute of Emergency Medicine and 400 patients of the Medsi clinic St. Petersburg.

Results. In our opinion, the optimal methods of general anesthesia are: usually non-inhalation or combined. The guarantee of effective and safe anesthetic care is preoperative preparation and selection of the optimal method of anesthesia in order to reduce the risks of negative effects, that is, a personalized approach is required. Propofol in combination with narcotic analgesics and combined anesthesia propofol-sevorane have proven to be the best in terms of controllability.

Conclusions. 1. The issue of pain relief during minor obstetric and gynecological operations is relevant and unresolved. 2. In our opinion, the optimal methods of general anesthesia are: non-inhalation propofol and narcotic analgesic and combined propofol and sevoran. 3. The choice of anesthesia method depends on many factors and should have a personalized approach.

Ethylene glycol poisoning is recorded in many countries of the world, but it is especially relevant in the Russian Federation, being one of the main reasons for hospitalization of patients with acute poisoning of chemical etiology. Ethylene glycol poisoning has severe medical, social and economic consequences.

Purpose of the study: analytical toxicological analysis, features of diagnosis and intensive care of patients hospitalized with acute ethylene glycol poisoning in the toxicology center of a specialized hospital.

Materials and methods of research. Medical documents of patients admitted to the Center for the Treatment of Acute Poisoning of the State Budgetary Institution of St. Petersburg Research Institute for Emergency Medicine named after. I.I. Dzanelidze in 2019–2022 with a diagnosis of «ethylene glycol poisoning.» ICD-10 rubric: T52.3. A statistical and chemical-toxicological study was carried out when patients were admitted to the hospital and over time after intensive care.

Research results. According to the toxicological center of the State Budgetary Institution of St. Petersburg Research Institute of SP named after I.I. Dzanelidze, the number of patients with ethylene glycol poisoning was: 2019–1 admission; 2020–1 patient; 2021 — out of 2 patients admitted, 1 patient died; 2022 — out of 2 patients admitted with ethylene glycol poisoning, 1 patient died.

All patients admitted with ethylene glycol poisoning were in critical condition with severe impairment of vital organs.

Conclusion: ethylene glycol poisoning occupies one of the leading places among acute poisonings of chemical etiology in terms of the number of adverse outcomes. Characterized by severe medical, social and economic consequences.