Research objective. To conduct a comparative analysis of the financial provision for emergency medical care in inpatient settings according to the tariffs of the compulsory medical insurance system with the actual costs of providing it. Materials and methods. An analysis was conducted of data from medical organizations participating in the provision of emergency medical care in inpatient settings, regarding the tariffs charged for medical care provided within the framework of the Territorial Program of Compulsory Medical Insurance of St. Petersburg for 2024 and the first half of 2025. General tariff agreements, the procedure for forming and applying tariffs, the cost of clinical- statistical groups of diseases, and their components were studied. For comparison, materials received from a medical organization regarding the costs of emergency care provided in inpatient settings were processed. Results. In 2025, a clinical- statistical group of diseases st36.048 «Daytime hospitalization for diagnostic purposes» was formed, the cost of which in St. Petersburg is 5,987.9 rubles. When modeling the costs of providing emergency medical care in inpatient settings, the financial costs per case of treatment during daytime hospitalization amounted to 6,135.58 rubles, which is only 2.5% higher than the cost of the clinical- statistical group of diseases st36.048 «Daytime hospitalization for diagnostic purposes». Conclusion. The introduction of the new clinical- statistical group of diseases st36.048 «Hospitalization for less than 24 hours for diagnostic purposes» into the Program of State Guarantees for the Free Provision of Medical Care to Citizens for 2025 and for the planning period of 2026 and 2027 allows for the provision of medical care in emergency medical care beds, reimbursing the costs incurred by the medical organization.

Introduction. The work of emergency medical care specialists is one of the most difficult among medical professions, which is associated with the impact of a number of unfavorable (harmful and dangerous) factors. The purpose of the study: to study the labor intensity of emergency medical care personnel: the daily workload of emergency medical care teams in the Russian Federation for the period 2010–2023. Materials and methods. The materials of federal state statistics were used —  form No. 30 for the Russian Federation, 2010–2023. Normative, legal, statistical and analytical methods were used. Research results. The average daily workload of emergency medical teams is 10.6±1.9 patients (calls) per day, it is significantly higher in general- purpose teams (medical teams providing assistance to the child population (11.5±6.2 patients) and paramedic teams (11.0±1.8 patients)), among specialized teams —  pediatric (10.2±3.0 patients) and cardiology (9.2±2.3 patients) teams, the rest have a significantly lower daily workload (6.2–6.4 patients). At the same time, the workload is uneven. A tendency towards a decrease in the workload was noted for all types of teams, according to general indicators —  by 1/4 (–24.9%); in general- purpose medical teams (–46.5%), including when providing medical care to the child population (–80.7%); a reliable decrease in the daily workload of all types of specialized teams (by 29.6–50.2%) was noted. Conclusion. Currently, there are no approved standards for the number of ambulance teams; these issues are decided by the regions themselves, based on the needs for organizing a regional health care system, taking into account demographic and medical- social indicators, climatic, geographical and infrastructural conditions, as well as financial, economic, logistical and human resources.

The activities of emergency medical workers are closely related to high psycho- emotional and physical stress. Such a connection has a direct impact on professional activities: the effectiveness of medical services, success in achieving professional heights, including the quality of life. It is worth noting that the productivity of professional activities exponentially depends on the adequacy of the individual›s mental states. Purpose. Psychological analysis of the dependence of the level of personal and situational anxiety of medical workers of general- purpose mobile emergency medical teams on the work experience in the emergency care system and the level of education, in order to assess the productivity and effectiveness of medical services. Materials and methods. The material for the study was the results of a survey (according to the author›s questionnaire) of 121 emergency medical workers of the city of Ufa in substations located in different areas of the city. Anxiety analysis was carried out using the standard Spielberger–Khanin method. Results. Analysis of the level of personal anxiety showed a sharp increase in this indicator (p<0.05) for paramedics with work experience from 4 to 10 years (41.4±3.89 Spielberger–Khanin scale) and doctors with work experience over 10 years (41.0±2.02 Spielberger–Khanin scale). The level of situational anxiety is most pronounced (p<0.05) for doctors with more than four years of work experience (20.0±0.02 vs 19.4±3.70 (paramedics & nurses) [comparison from 4 to 10 years] and 23.4±2.82 vs 18.4±1.99 (paramedics); 19.5±2.71 (nurses) [comparison over 10 years] Spielberger–Khanin scale). For paramedics, there is an insignificant increase (9.4%) in the reactive anxiety indicator in comparison with up to 3 years of work and the period of work from 4 to 10 years, with a subsequent decrease (9.5%) with work more than 10 years. Conclusions: Research of personal and situational anxiety in close connection with the most important parameters of education and work experience for emergency medical workers allows to individualize and unify the approach to stabilizing the anxiety indicators of medical workers of general mobile teams. In addition, to more accurately identify the necessary methods for correcting emerging risks and, as a result, to improve the productivity and efficiency of medical services provided by emergency medical workers in the Russian Federation and abroad.

The purpose of the study. To assess the readiness to provide first aid to victims by eyewitnesses of the incident, from the point of view of the employees of the ambulance station of the city of Krasnoyarsk. Materials and methods. A special questionnaire was developed for the study, including ten questions. The survey involved 213 employees of the ambulance station of the city of Krasnoyarsk (KGBUZ «Krasnoyarsk Ambulance Station») —  47 doctors and 166 paramedics. Results and discussion. According to the surveyed employees of the Krasnoyarsk emergency medical service station, eyewitnesses of the incident are largely unprepared to provide first aid to victims. Only 2.3±2.07% of respondents noted that they often encountered eyewitnesses providing first aid to incidents, the majority (68.1±6.39%) answered «rarely», 20.2±5.50% —  «sometimes», 9.4±4.00% —  «never». Eyewitnesses of the incident were most active in providing first aid in case of injuries (17.1±5.42% of respondents answered «often») and in case of various non-specific conditions (pain syndrome, high blood pressure, temperature, etc.) —  for these cases, the answer «often» was indicated by 15.0±5.14% of respondents. At the same time, only in 16.3±5.73% of cases were the measures taken useful for the victim and had a positive effect on the further work of the medical team. In out-of-hospital circulatory arrest, effective chest compressions were performed only in 5.8±3.98% of cases. This is due to both ignorance of the theoretical foundations of first aid measures and the inability to perform the necessary actions efficiently, as well as an unwillingness to provide any assistance. Thus, 55.9±7.83% of respondents claim that citizens are not consciously interested in first aid courses, considering this activity a waste of time. The overwhelming majority of the surveyed emergency medical workers (91.2%) believe that the population of the Russian Federation needs to be trained in first aid skills. Forming an active position in this regard among the population is the task of the medical community, requiring organizational solutions at the federal and regional levels. Conclusion. It is necessary to form a unified system for organizing and monitoring the training of the population in first aid skills, involving in this work the management bodies of all levels of the health care system, educational medical organizations, the creation of an institute of freelance specialists in first aid to the population, called upon at the local level, in specific regions, to solve the problems of performing this work. These measures will significantly contribute to the achievement of the target indicators voiced in the Concept of First Aid Development in the Russian Federation until 2035 and, ultimately, will significantly increase the chances of saving the life and preserving the health of the victim.

Long distances, as well as the length of the Orenburg region, actualize the work of the department of emergency counseling and medical evacuation in case of emergencies and injuries. The purpose of the study is to analyze the work of the department of emergency counseling and medical evacuation in the Orenburg region in the period from 2021 to 2023. Research objectives. To analyze the activities of the specialists of the department of advisory care and medical evacuation; to clarify the rationality and calculation of the need for specialists; to establish the structure of evacuated patients from medical organizations in the region by nosological forms. Materials and methods of research. Reports on the work of the Department of Emergency Advisory Assistance and Medical Evacuation of the Orenburg region for the period from 2021 to 2023. The results of the study. For a number of years, there has been a shortage of medical personnel in the Orenburg region, which has significantly affected the work of the department of emergency counseling and medical evacuation (ECP and ME), and has led to an increase in requests for emergency medical advice by 46.1%. In the structure of providing emergency counseling to the population, patients with burn injuries occupy the leading place, traumatology patients are in the second place, and patients with cardiovascular pathology are in the third place. Conclusions. The provision of medical care using ground transport has increased by 2 times, and air transport by 1.2 times. For the rational use of air ambulance transport, it is necessary to take control of each case (departure and departure to the territory) on the reasonableness of involving emergency medical advice specialists with organizational decision- making.

The article presents a description of the victims and an analysis of the provision of emergency medical care to victims of road accidents that occurred on the regional highways of the Sukhobuzimsky district of the Krasnoyarsk Territory. The aim of the study was to analyze road traffic injuries in the Sukhobuzimsky district of the Krasnoyarsk Territory, the volume and quality of emergency medical care provided at the pre-hospital stage. Materials and methods of the study. According to the criteria for describing a series of cases, a retrospective analysis of the medical documents of 108 victims of road accidents in the Sukhobuzimsky district of the Krasnoyarsk Territory, who were injured in various degrees of severity, was carried out. The call cards (registration form No. 110/u) for road accidents of the Department of the NSR of the Sukhobuzimskaya RB KGB were analyzed. The inclusion criteria were: male and female gender; age 18 years and older; the presence of a traffic injury resulting from an accident on the roads of the Sukhobuzimsky district of the Krasnoyarsk Territory. Results. It is established that the structure of road accidents that occurred on the territory of the Sukhobuzimsky district is not quite typical for the territory of the Krasnoyarsk Territory and the Russian Federation as a whole. Most of the accidents that occurred in the Sukhobuzimsky district occurred in the spring and summer period, which is directly related to the increase in the number of cars on the roads and increased activity of both drivers and pedestrians during the warmer months. The accidents that occurred in the study area are mostly related to car collisions, with pedestrian collisions in second place; motorcycle injuries account for the rest. Having studied the characteristics of those injured in road accidents in the Sukhobuzimsky district, it should be noted that the majority (68.4%) of those injured in road accidents are men aged 35.9±2.23 years with alcohol in their blood (64.5%), a significant part of whom had polytrauma (15.3%), which was accompanied by shock in 70.5%. In the group of victims with polytrauma and shock phenomena of varying severity, participants in accidents that occurred on the highway of regional significance accounted for 53.3% and 45.5%, respectively. The above illustrates the fact that accidents occurring on the Yenisei Tract regional highway are characterized by a large number of victims and the severity of their injuries, which correlates with the intensity of the traffic flow on the highway. Conclusion. Assessing the volume of emergency medical care provided at the prehospital stage to victims of road accidents in the district, it was revealed that the standard time for NSR teams to reach the victims did not match, an inadequate choice of analgesic was determined, taking into account the severity of the victim’s condition, the choice of dosage and route of its administration, a limited approach to the use of infusion therapy, oxygen therapy, GCS and sedation was identified. It is necessary to strengthen postgraduate education in emergency medical care for victims of road accidents.

Purpose of the study. Conduct an assessment and comparative analysis of the professional competencies of performing medical manipulations in the provision of medical care in emergency and urgent forms of surgical doctors of city polyclinics of the Moscow Department of Health, included in the composition of non-staff mobile medical formations of civil defense, and surgical doctors of emergency hospital complexes of the city of Moscow. Materials and methods. The study was conducted on the basis of a study of the subjective opinion of doctors about their professional competencies in performing medical procedures of medical care in emergency and urgent forms in accordance with the list of procedures developed by the authors of the study. Data collection was carried out using an anonymous questionnaire survey method, using questionnaires specially developed by the authors. The sample size of outpatient clinic doctors was 169 people, and emergency medical complex doctors —  62 people. Statistical processing of primary materials was carried out according to algorithms developed by the authors of the study. Results. An analysis of the opinions of doctors from city polyclinics showed that 61,5±1,0% of respondents possess professional competencies according to the established list, while the share of doctors from emergency medical complexes was 83,9±1,2%, which is significantly higher by 1,4 times. A comparative analysis of the opinions of doctors showed that the proportion of doctors in emergency medical centers who have the skills to perform medical procedures is statistically higher than the proportion of specialist doctors in city polyclinics for the entire range of procedures, with a reliable difference of 1,2–2,7 times. Conclusion. Doctors of emergency medical complexes have an undeniable advantage in having the necessary professional competencies for the successful provision of primary medical and sanitary care in emergency and urgent forms during the elimination of medical and sanitary consequences of a large- scale emergency situation in peacetime and wartime. The results of the study can serve as a scientific basis for changing the type of medical organization —  the creator of a mobile medical formation for an emergency stationary complex in the city of Moscow.

Severe hypothermia (decrease in internal temperature below +28 °C) is a life–threatening condition requiring coordinated staged intensive care, which has its own characteristics. The purpose of this review and analysis of our own practical experience is to increase the awareness of doctors of visiting teams and inpatient emergency departments (SMP) in matters of diagnosis, clinic and modern approaches to the treatment of patients with severe hypothermia.

Introduction. Inhalation of supplemental oxygen is an important treatment modality for patients in critical condition. Non-rebreather mask with a reservoir is used to maintain a high oxygen concentration in the airway, due to presence of one-way valves system. The bag valve mask (Ambu bag) has a structurally similar valve system and reservoir. Objective of the study. Comparing of volumetric concentrations of oxygen in the respiratory tract during oxygen inhalation through a non-rebreathing mask with a reservoir and through an bag-valve mask with a reservoir. Materials and methods. In 22 volunteers, oxygen was inhaled through a non-rebreathing mask with a reservoir and with a bag-valve-mask with a reservoir. The volumetric concentration of oxygen in exhaled air was measured after 3 minutes of inhalation. The data were compared with the initial level of oxygen concentration in exhaled air, as well as with the data after inhalation through an oxygen cannula. Results. The oxygen concentration maintained in airway during inhalation with a bag-valve-mask with a reservoir is comparable to concentration after inhalation through a non-rebreathing mask with a reservoir, 62.42±14.58% and 57.22±11.18%, respectively (p=0.19). After performing correlation analysis, a positive relationship was found between the volume concentration of oxygen in exhaled air during inhalation through a non-rebreathing mask with a reservoir and through a bag-valve mask with a reservoir (r=0.28; p=0.05). Conclusion. Inhalation of supplemental oxygen via a bag-valve mask with reservoir may be a reasonable solution when a non-rebreathing mask with a reservoir is not available in low-resource settings, such as a mass casualty incident.

Atrial fibrillation (AF) and atrial flutter (AFL) remain the most common forms of cardiac rhythm disturbances in elderly patients, leading to important considerations regarding the management of this patient population, particularly concerning paroxysmal forms of AF and AFL: the selection of effective and safe antiarrhythmic agents for the termination of paroxysms. The objective of the study, under the principle of patient- centered care, was to conduct a comparative analysis of the effectiveness and safety of Refralone and Amiodarone in elderly patients with paroxysmal AF /AFL. Materials and methods. The study involved 58 patients aged 65 years and older with stable hemodynamics and preserved cognitive function, who underwent pharmacological cardioversion for paroxysms of AF or AFL with an attempt to restore sinus rhythm (SR) using Refralone (31 patients) and Amiodarone (27 patients), assessing the clinical, ECG effectiveness, and safety of these medications. Results. The study findings demonstrated a high effectiveness of Refralone in terminating paroxysms of AF /AFL in elderly patients, achieving a success rate of 100% compared to 77.7% for Amiodarone (p<0.05), with the use of lower doses and less time required to restore SR. Refralone also showed advantages in safety: it did not provoke bradyarrhythmias or hypotension, whereas these adverse effects were observed with Amiodarone. Furthermore, episodes of hypoglycemia were recorded in elderly patients with type 2 diabetes when treated with Amiodarone. Both drugs proved to be safe concerning ventricular activity.

Objective: to review current national and international literature on the diagnosis and emergency management of pediatric arrhythmias in the prehospital setting. Materials and methods. An analysis of 21 literary sources was conducted, including clinical guidelines, studies, and reviews published in recent years, with a focus on prehospital strategies for managing arrhythmias in children. Results. Cardiac rhythm disturbances in children can be life-threatening, especially in the presence of hemodynamic instability. In the prehospital phase, it is crucial to rapidly perform clinical and instrumental diagnostics, classify the type of arrhythmia, and initiate timely treatment. Effective methods include vagal maneuvers, administration of adenosine, atropine, epinephrine, as well as synchronized cardioversion and defibrillation when indicated. Conclusion. Knowledge of diagnostic and treatment algorithms for pediatric arrhythmias in the prehospital setting significantly improves survival rates and reduces the risk of complications. The findings are of practical relevance for emergency medical service physicians and pediatric intensivists.