Introduction. In 2025 the Russian scientific and practical journal «Emergency medical care» turns 25 years old. This journal is the press organ of the Russian society of emergency medical care and the Specialty profile commission for the direction of emergency medical care of the Ministry of Health of Russia. The journal discusses topical issues of emergency medical care, disaster medicine services, and draft clinical guidelines. The purpose of the study: to analyze the journal›s publication activity over 25 years. Materials and methods. According to the scientific electronic library Elibrary.ru the analysis of the journal›s publication activity is carried out. The results of the study. For the period 01.01.2000–31.03.2025 102 issues of the journal with a total number of articles — 2344 were published. The journal is included in the List of peer-reviewed scientific publications in which the results of dissertations for the degree of Candidate of Sciences and Doctors of sciences should be published —  in seven scientific specialties (category 2). Over the past 15 years, there has been a steady trend towards an increase in the number of citations of articles, the five-year and two–year impact factors, and the average Hirsch index of authors. The number of citations of articles in 2008 was 31, in 2023 —  158; the two-year impact factor of the RSCI in 2008 was 0.11, in 2023 —  0.40; the five-year impact factor of the RSCI in 2008 was 0.05, in 2023 — 0.40; the average Hirsch index of authors of publications in 2008 was 3.68, in 2023 —  7.36. Conclusion. The journal «Emergency medical care» is actively developing and has the potential to be included in the White List.

The past decade has been marked by the modernization of the ambulance system in the country, including specialized medical care. On the basis of multidisciplinary hospitals that receive and treat patients in need of emergency medical care, it is planned to create inpatient emergency departments. The lack of extensive experience in the implementation of these projects in the country required the development of new conceptual projects to implement the planned plans. The purpose of the study is to develop and implement organizational medical technologies aimed at improving and improving the quality of medical care to the city›s population. Materials and methods of research. To implement the new Moscow standard of emergency medical care — the introduction of new inpatient emergency care complexes, 6 multidisciplinary hospitals of the Moscow Department of Health have been selected, providing specialized, including hightech medical care. The research methods are analytical and statistical. The results of the study and their analysis. It is provided in the conditions of an inpatient emergency care complex around the clock to provide emergency and emergency medical care to patients in 12 profiles: surgery, traumatology and orthopedics, neurosurgery, cardiovascular surgery, gynecology, urology, ophthalmology, maxillofacial surgery, otorhinolaryngology, neurology, cardiology, therapy. Each complex has advanced intensive care facilities. The total area of all CSCs is more than 100 thousand square meters, the bed capacity is more than 600 beds (more than 50% are urgent), reaching the capacity of 1.5 thousand emergency patients per day. There are four SSCs: at the I. V. Sklifosovsky Research Institute of Joint Venture, S. P. Botkin State Medical University, V. V. Veresaev State Medical University, O. M. Filatov State Medical University No. 15. Conclusion. The inpatient emergency care complex based on a multidisciplinary hospital is a modern emergency care center equipped with modern medical equipment, a helicopter pad, staffed with medical personnel capable of providing emergency qualified medical care. The project makes it possible to increase the efficiency of providing medical care to the city's population.

The study of the causes and conditions of ectopic pregnancy remains one of the most important problems in modern healthcare due to the constant increase in the incidence of this pregnancy complication and the possible development of unfavorable long-term consequences. Intention of this study was to analyze statistical data obtained over three years on the prehospital stage diagnosis, hospitalization, and provision of medical care to patients in the conditions of a multidisciplinary emergency hospital in Krasnodar with the diagnosis of «Ectopic pregnancy», with the task of optimizing methods of diagnosis, prevention, and treatment of diseases of the female reproductive system. Materials and methods. Data from the information base of the comprehensive automated management system of the emergency medical service station and the hospital of the State Budgetary Healthcare Institution «Krasnodar Emergency Hospital» were used, as well as data from call cards of emergency medical service stations and medical histories. Research results. For the qualitative diagnosis, treatment, and prevention of diseases of the female reproductive system, it is necessary to pay great attention to timely identification of the main risk factors leading to the development of various pathological processes in pregnant women, especially in the early weeks of pregnancy.

The article presents an analysis of the medical evacuation of victims with shock-producing injuries sustained in road traffic accidents (RTA) on the federal highway (FH) M-8 «Kholmogory» to a trauma center created in one of the Arctic regions of Russia. The aim of the study was to identify the features of the medical evacuation of victims of RTA on FH M-8 with severe trauma accompanied by shock to a trauma center based on a level III medical organization —  Arkhangelsk Regional Clinical Hospital (ARCH) to develop recommendations for improving evacuation measures. Materials and methods of the study. According to the criteria for describing a series of cases, a retrospective analysis of medical documents of 49 victims of RTA on FH M-8 «Kholmogory» who received severe shock-producing trauma and were admitted for treatment to the trauma center of ARCH was carried out. Results. It was established that 17 (35%) of the victims of the accident on the M-8 Kholmogory Federal Highway with severe shock-producing injuries were delivered to the AOKB trauma center within the first «golden» hour, and 95.5% of the injured were admitted within the first 24 hours from other trauma centers based at medical organizations located far from the AOKB and having areas of responsibility on the M-8 Federal Highway. Automobile and air medical transport were used to evacuate the victims. In general, in the Arkhangelsk Region (AO) there is an extremely uneven distribution of forces and means for providing emergency care, including emergency specialized medical care, to victims with shock-producing injuries on the M-8 Federal Highway and their evacuation to the AOKB trauma center due to the significant length of the federal highway (about 600 km). Conclusion. The conducted analysis of medical evacuation of victims of the road accident on the M-8 Kholmogory federal highway with shockproducing injuries to the trauma center of the Arkhangelsk Regional Clinical Hospital showed that at present it is advisable to: organize mobile route points on the federal highway in the Kholmogory, Vinogradovsky and Shenkursky districts to provide emergency, including emergency specialized medical care, to those seriously injured in road accidents; strengthen the personnel and logistical support of these hospitals in terms of creating emergency medical care teams (EMC) based directly on the territory of the specified medical treatment organizations (MTO); ensure the fulfillment of the target indicators of the «Strategy for the Development of Medical Aviation in the Arkhangelsk Region until 2024»; improve the development of telemedicine for the implementation of consultations by leading specialists of the AOKB for victims of road accidents with severe shock-producing injuries who are being treated at the LMO AO, to resolve the issue of involving, if necessary, qualified specialists (anesthesiologists, traumatologists, and in some cases, others) to provide specialized medical care to victims and resolve the issue of evacuating the latter to the trauma center of the AOKB.

Goal. To study the dynamics of changes in the nerve growth factor in combatants and their relationship with changes in psychological indicators. Materials and methods. The study involved 30 male military personnel who voluntarily agreed to participate in the study. The average age of the surveyed was 34±3 years. All the surveyed were divided into two groups of 15 people. The first (main) group included military personnel who took part in hostilities for a period of at least 6 months. In the second (comparison) —  military personnel who did not take part in hostilities. In the course of the study, the concentration of nerve growth factor was studied. To diagnose the severity of psychophysiological symptoms in response to stress and determine these symptoms, the following methods were used: the scale for assessing the severity of the psychophysiological reaction to stress, the Beck hopelessness scale, the scale for assessing the intensity of T. Keen›s combat experience. Results. Thus, the conducted studies show that changes in NGF indices in blood inversion have clinical significance in the psychological state of combatants. The conducted study allowed us to establish that the NGF content in the blood inversion during the entire study period was significantly reduced compared to the comparison group. At the same time, the dynamics of NGF content over time is noted. If a month after the end of the stress associated with military operations, the amount of NGF in the blood serum was minimal, then after three months its amount increased, after six months the amount of NGF in the blood serum also continued to increase, however, further, after twelve months, there were no significant changes in the amount of NGF in the blood serum. In the course of the study, the links between the changes in this parameter and the scales characterizing the psychological state of the combatants were established. It should be noted that this study requires further, more in-depth study. Conclusion. During the study, it was found that the NGF content in the inversion of the combatants› blood is reduced, while the relationship of this parameter with their psychological state is noted, which must be taken into account when developing drug therapy aimed at treating stress injury.

The aim of the study is a comparative experimental evaluation of the biodegradation of the hemostatic surgical polysaccharide resorbable hemostatic agent «Hemospas® Med». Materials and methods. The study was performed on the biomodel of hemorrhage from the rabbit liver wound, using the foreign analog — absorbable hemostatic powder «PerClot®» as the object of comparison. The observation period was 30 days. Results. The findings indicated complete biodegradation and the absence of the irritating, adhesion-inducing agent «Hemospas® Med. Conclusion. The local hemostatic agent «Hemospas® Med» has demonstrated its efficacy in replacing expensive and hard to get foreign analogues in the practice of emergency surgery of abdominal cavity and retroperitoneal organs.

Introduction. Nowadays the question of expediency of transporting patients with an out-of-hospital refractory circulatory arrest to a medical institution arises hugely due to the emergence of technical capabilities providing long-term automatic indirect cardiac massage. This is a worldwide problem. Although there are protocols in many countries which determine the need for further patient evacuation to a hospital or the validity of termination of resuscitation measures on the spot due to their ineffectiveness. Aim of the study. The main goal is to evaluate the treatment results of working-age patients admitted to St. Petersburg hospitals with an out-of-hospital cardiac arrest, and to investigate spectrum of factors influencing the outcomes of resuscitation measures. Materials and methods. This is a retrospective multicenter study. All in all, 349 inpatient treatment results were analyzed in adult working-age patients admitted to four multidisciplinary hospitals in St. Petersburg during 2022–2024 period. Patients were divided into 2 groups. Group 1 —  patients who suffered circulatory arrest, with heart rhythm restored during pre-hospital stage (97 people, 80.4% men, average age 45±1.3 years). Group 2 —  patients admitted in a state of clinical death with an ongoing resuscitation using a mechanical CPR device (252 people, 77.9% men, average age 49.7±0.7 years). Obtained data were statistically processed with the use of four-field tables method and the χ2 criterion. Results. There was a significant difference in hospital mortality between the groups: 78.4% in group 1 versus 98.8% in group 2 (χ2 45.78, p<0.001). A detailed study of surviving patients records in group 2 showed, that in all cases witnesses promptly initiated first aid in the CPR form; Two out of three survivors were rescued with the use of ECMO-CPR complex on a hospital bed. Conclusion. There is a growing need for a domestic protocol regarding the termination of resuscitation on the spot. Its› creation is dictated by the extreme mortality rate of patients hospitalized with refractory cardiac arrest. Survival chain implementation with the use of the entire range of modern technologies is absolutely necessary in order to achieve better treatment results.><0.001). A detailed study of surviving patients records in group 2 showed, that in all cases witnesses promptly initiated first aid in the CPR form; Two out of three survivors were rescued with the use of ECMO-CPR complex on a hospital bed. Conclusion. There is a growing need for a domestic protocol regarding the termination of resuscitation on the spot. Its› creation is dictated by the extreme mortality rate of patients hospitalized with refractory cardiac arrest. Survival chain implementation with the use of the entire range of modern technologies is absolutely necessary in order to achieve better treatment results.

Barbiturates are a group of drugs that have a depressant effect on the central nervous system. The toxic effect is determined by the dose taken and is manifested by disturbances of consciousness in the form of depression of the central nervous system from a mild degree of stunning to atonic coma. The purpose of the study: statistical toxicological analysis, diagnostic features and provision of emergency medical care outside a medical organization and at the stage of specialized medical care, hospitalized with acute poisoning with barbituric acid derivatives in the center for the treatment of acute poisoning of a multidisciplinary hospital. Materials and methods of research. The medical records of 1005 patients admitted to the Acute Poisoning Center of the State Budgetary Institution of St. Petersburg Research Institute of Emergency Medicine named after I. I. Dzhanelidze in 2021–2023 with the diagnosis: «Acute barbiturate poisoning» were analyzed. ICD-10 rubric: T42.3: A statistical and chemical-toxicological study was conducted upon admission of patients to the hospital and dynamically after intensive care. The results of the study. According to the Acute Poisoning Center of the State Budgetary Institution of St. Petersburg Research Institute of Emergency Medicine named after I. I. Dzhanelidze, the number of patients with acute poisoning with barbituric acid derivatives was: 372  admitted (of  which 14 patients died) in 2021; 282 patients with acute poisoning (2 died) in 2022; in 2023, out of 351 admitted with acute poisoning of this pathology, two died. All admitted patients were in critical condition with severe disorders of vital organs. Conclusion: acute poisoning with barbituric acid derivatives occupies one of the leading places among acute poisonings of chemical etiology both in frequency and in the number of adverse outcomes. Characterized by severe medical, social and economic consequences. Timely, full and high-quality medical care at the stage of emergency medical care outside a medical organization to patients with poisoning with barbituric acid derivatives has a significant impact on the course and prognosis of the disease. Scientific and practical significance lies in the generalization of modern ideas about the mechanism of toxic action of acute poisoning with barbituric acid derivatives, principles of diagnosis and intensive care. The materials can be used in clinical guidelines.

Aim. To research the factors and processes leading to the development of alcoholic delirium, present modern methods of diagnosis, prevention and treatment of this condition. Materials and methods. In the during of the research, an analysis of publications on the topic methods of diagnosis and treatment of alcohol disease, alcohol withdrawal syndrome and alcohol delirium was carried out. For this purpose, the online resources eLibrary and PubMed published over the past 10 years were used. Results. The research presented relevant approaches to the diagnosis, prevention and treatment of alcoholic delirium. Conclusion. Currently, much attention is being paid to the problem of alcohol abuse and the treatment of long-term consequences of alcohol dependence (AD). Uncontrolled alcohol intake leads to an increase in morbidity and increasesthe number of deaths among the working population. Knowledge by doctors and paramedics of emergency medical care of the pathogenesis, the basics of diagnosis and the principles of emergency medical care for patients with AAS and AD will reduce the risk of severe life-threatening complications. These patients require emergency medical care at the prehospital stage and immediate hospitalization in the intensive care unit (ICU) for therapeutic measures, continuous monitoring and maintenance of vital body functions.

Goal. To identify the significance of the timing of discharge of patients from the hospital after percutaneous coronary angioplasty on the incidence of restenosis and ischemic events. Materials and methods of research. We analyzed archival histories from 2021 to 2023; during this period, 1347 coronary artery stentings were performed; during the same period, 176 (13.1%) patients were re-hospitalized. Thus, the study included 176 patients: 111 (63.1%) men and 65 (36.9%) women. Results. The study showed that out of176 cases of complications, in the group with early discharge on days 1–3, there were initially 27.5% more of them, acute myocardial infarction (AMI) was observed more often by 25% (p<0.05), and hospital mortality from AMI, by 33.3% (p<0.05) than in patients with discharge of 4 days or more. Conclusions. Our non-randomized prospective study showed that early discharge from the hospital on the 1–3 day after stenting leads to the development of an adverse emergency event in patients with coronary heart disease. Acute myocardial infarction developed 25% (p<0.05) more often, and hospital mortality from acute myocardial infarction by 33.3% (p<0.05) than in patients with discharge on the 4th or later day.

Aim. To analyze national and foreign scientific publications dedicated to aspects of treatment of seizure syndrome (SS) in children and adolescents at the prehospital stage. Materials and methods. A total of 26 international and national sources dealing with issues relevant to SS were analyzed, including 10 papers published in the last 5 years. Results. At the prehospital stage, children and adolescents with SS should undergo an objective examination, restoration of patency of the upper respiratory tract, respiratory support and stabilization of hemodynamics. The drugs of choice for the relief of SS are benzodiazepines, with the ineffectiveness of which valproic acid is used. In case of hypoglycemia, hyperthermia and cerebral edema, symptomatic drug therapy is performed. Conclusion. The analysis of the literature is of practical importance for emergency physicians in providing emergency care to children with SS at the prehospital stage.