The mute of road accidents in work of an emergency medical service at a pre-hospital stage is presented. Data of the St. Petersburg Scientific Research Institute of Emergency Medicine of I. I. Dzhanelidze on ef- ficiency of delivery of the victims who came to the antishock operational are of special interest - terms of their hospitalization in most cases were beyond «gold hour» that defined efficiency of the subsequent medi- cal actions and a final outcome of treatment.

The article is devoted to the problem of emotional burnout of the St. Petersburg`s ambulance personnel. Expressiveness of a syndrome in the context of professional development with an interval in 11 years (2004 and 2015) is considered. The article presents a comparative analysis of the intensity of the syndrome in the ambulance personnel. Shows the specific manifestation of the syndrome in the gender aspects, subject to qualification differences. Selected stress factors that contribute to the formation a syndrome of burnout.

Results of analysis of admission diаgnoses in 348 patients of cardiological departments of SPb Insnitute for Emergency Medical Care n.a. I. I. Dzhanelidze with lead clinical diagnosis «acute heart failure» submitted. We obtained 82 versions of primary diagnosis and only 26% of them really reflected presence of acute heart failure. Diagnoses were ranged into 6 groups. Reasons for misdiagnoses were analyzed.

HE DATA OF 233 PATIENTS WITH ACUTE CORONARY SYNDROME WHO WERE PRESCRIBED TICAGRELOR IN THE COMPOSI- TION OF DUAL ANTIPLATELET THERAPY AT THE PREHOSPITAL PHASE. PRESENTED RESULTS WERE CONSISTENT WITH THE DATA FROM ATLANTIC STUDY, WHICH DEMONSTRATED THAT TICAGRELOR CAN BE USED IN THE PREHOSPITAL PHASE OF TREATMENT IN PATIENTS WITH ACUTE CORONARY SYNDROME.

The paper presents a study of morphological manifestations of abdominal trauma, based on the results of forensic analysis of 289 children’s and 227 adults’ corpses. A comparative evaluation of the frequency of different single stomach lesions and the total number of them was provided for three age-based subgroups of children and a group of adults who had the two most common types of blunt polytrauma - road accidents (hit by car, run over by car and injury while staying onside a car) and a fall from a height. It was found that when a fatal blunt abdominal polytrauma occurs, abdominal injuries (also taking into account the skin lesions) in children are less common than in adults. Abdominal cavity and retroperitoneal space injuries in both groups were observed with the same frequency. However, in cases of abdominal injuries children have significantly smaller amount of damage then adults. The least amount of damage was observed in the subgroup of children under 3 years of age. Damages of the muscles and ligaments that fixate the internal organs while shock loads - (falling from a height or being hit by car) are more common in children than in adults.

The causes of hyperkalaemia are present increased entry of potassium, elevated transfer of potassium from intra to extracellular space and disturbance of excrement. Renal insufficiency in combine of apparent lowering of daily diuresis is the most frequent condition for hyperkalaemia. Emergency correction of hyperkalaemia must direct to all tree causes of maintenance of hyperkalaemia.

Convulsive disorder is a heavy unpredictable reaction to the external and internal stimuli and requires an immediate aid. The degree of hypoxia plays the significant role in the case of children’s spasms. The spasm may be caused by the hypoxia or may cause it themselves. The article provides guidelines for the pre- hospital emergency medical aid for children with the convulsive disorder.

The military action in 1916. Brusilovsky breakthrough. The stages of medical evacuation in the First world war. Assessment system help the wounded V. A. Oppel. Suggestions V. A. Oppel about combining the evacuation of the wounded with the active assistance.

The article describes in detail the clinical and morphological variants lesions of the gastrointestinal tract in the syndrome of multiple organ failure developing in the early and late phase of acute pancreatitis.

Article contains clinical information about 81 case of postinfarction myocardial rupture occurred in Saint- Petersburg Research Institute of Emergency Care n.a. I. I. Dzhanelidze in 2009-2012 years. Diagnoses were confirmed in autopsy. Some predictors of the future myocardial rupture were established, as activation of systemic inflammation among them.

The experimental preclinical study, which evaluated the impact of the diode 980 nm laser on porcine liver tissue simulating human laryngeal tissue, was carried out. Visual and morphological assessment of degree of coagulation necrosis of the lazered tissue and of reversible damage to surrounding tissues was performed. Based on these results the optimal diode laser mode on human laryngeal tissue was identified.

The article contains results of markers of stress from the operations of high-class trauma patients who were combined general anesthesia with the use of a ventilator. In result of studies a comparative analysis of the level of T-lymphocytes, ACTH, TSH, thyroxine, cortisol with the definition of their correlation. In particular, determined the adequacy of anesthesia and evaluation of adaptational possibilities of the organism in the conditions of highly traumatic surgery.

The article includes research 499 hospitalizations of women of reproductive age (18 to 49 years) with suspected “acute abdomen”. 359 cases were analyzed retrospectively. The data obtained allowed to specify the structure of the pathology most frequent diagnostic errors in these patients. As a result of this work, the existing diagnostic algorithm was clarified and brought into line with the requirements of standards for specialized medical care on profiles “surgery” and “Obstetrics and Gynecology”. Prospective study involving 140 volunteers showed the effectiveness of the proposed scheme diagnostics.

Cardiogenic pulmonary edema is a life-threatening condition that is frequently encountered in standard ambulance practice. Treatment should focus on fluid redistribution with aggressive preload and afterload reduction rather than simply on diuresis. Some specific medications and noninvasive positive pressure ventilation (CPAP, BiLevel) have been shown to be safe and rapidly effective in improving patients symptoms andimprove outcomes.