The article is about the evolution of emergency medical system and patient`s triage from the birth in medieval battles to the creation of the Civil medicine emergency departments. It describes the principles of ED working and necessity of ED for Russian Health Care.

The author of article suggests to specify the reasons for a call of an emergency medical service established by the current legislation, having divided them into 5 categories of urgency and having established for each category the rules of the direction of a mobile team of an emergency medical service on a call.

On pre-hospital period, 179 patients with hypertension were evaluated for efficacy, safety, and duration of therapeutic effect after administration of Mocsonidine and two Mocsonidine generics. Moconidine and both generics were effective for hypertensive. Potency of Mocsonidine, as well as the development of antihypertensive effect was higher than that one of both generic medications. The profile of the adverse effects was similar in the three groups.

Comparative efficacy of urapidil in comparison with standard drugs used in patients with hypertensive crises, acute violation of cerebral circulation. Shows a more rapid achievement of blood pressure to the target numbers, as well as the advantage of using urapidil the prehospital stage as the drug of first choice.

The causes and frequency of occurrence of stroke hypo - and hyperdiagnostic in pre-admision period in Smolensk were analyzed in the article. The clinical data of 339 patients, admitted to the Red Cross Hospital with diagnosis «stroke», and 26 patients, for whom diagnosis «stroke» was missed by emergency doctors, were analyzed. There is detailed analysis of the symptoms, which were the reasons for the stroke hyperdiagnostic and the list of the diseases, tooken by the stroke by mistake. In the group of the stroke hypodiagnostic neurological symptoms, underestimated in the pre-admittion period were analyzed. The investigation shows, that in the half of all the cases the diagnosis of stroke is not based on any objective reasons; approximately in 50% cases the reasons for diagnostic mistakes were wrong interpretation of the clinical manifestation without paying attention to the patient’s anamnesis. For patients with the missed diagnosis of the stroke in pre-admittion period general syndrome of CNS affection dominated.

The article validates the rational respiratory technique of management of cardiogenic shock at the prehospital stage. We conducted a retrospective study of 60 patients with cardiogenic shock due to ischemic heart disease, assisted at the emergency medical care station in Moscow from 2009 to 2011 using various methods of respiratory support (HF ventilation, CPAP and oxygen support) in the complex therapy. It has been found, that HF ventilation is the most appropriate method of ventilatory support in patients with cardiogenic shock.

Application of the standard analgeziya at pre-hospital and stationary stages not always led to stabilization of a condition of victims in road accidents to what testify adaptation reaction tension. The offered technique of an analgeziya promotes improvement of adaptation opportunities of an organism of patients of the studied group that allows to reduce terms of stay of patients in a hospital on average by 7 koyko-days.

In the article discusses the pathogenensis, clinical and diagnosis of heavy poisoning by thallium in the early phase of the intoxication. As well as importance of differential diagnosis, because symptoms of intoxication are very variety and not specific. Alopecia is a specific symptom of thallium poisoning develop in two weeks, but in the heavy intoxication the mortality result cames considerable early. It is important to early carrying out chemical-toxicology analysis of biological materials (urine, serum) of patients.

The article describes various types of triage scales used in emergency departments in different countries. A comparative analysis is performed. The rationale for creating such instruments in Russian hospitals is given.

205 MRCC-Russia MEDEVAC SAR-operations through 2009-2013 illustrate the structure and underlying causes of health problems in seafarers and actualizes challenges, objectives and priorities for Russian Rescue and Emergency Services at Sea.

On the basis of inspection and treatment of 356 victims with the extremely severe combined injury, shock of the III degree and the negative forecast for life it is proved that at the heart of modern strategy of treatment of the extremely severe combined injury are full antishock treatment in the conditions of travmotsentr of the I level, expansion of operational activity at the combined fractures of bones by their early external fixing, modern prevention and treatment of sepsis, carrying out late rekonst-ruktivno- recovery interventions after its full knocking over, nutritive and metabolic therapy. Use of new medical and diagnostic approaches at the extremely severe combined injury allowed to reduce the frequency of infectious complications (sepsis, heavy sepsis, septic shock) by 32,4%, noninfectious - for 31,7%, and alethality - for 24%.

It was evaluated the results of treatment 64 patients with spontaneous pneumothorax. In 35 cases (control group) medical care was realized by traditional methods and in 29 - using thoracoscopy (study group). The confidence index of determine the causes of spontaneous pneumothorax in study group was 96,6% (in control group did not exceed 11,4%). Effective implementation of the measures algorithm innovative therapeutic and diagnostic measures in patients with SP, available not only in the hospitalization of such patients in a hospital, specialized in the provision of IP in the pathology Profile «thoracic surgery», but also in other medical institutions where it is possible to perform the vehicle. This information should be taken into account in the routing of patients with a joint venture in the course of providing them with emergency medical care.

Article contains epidemiologic and 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. Diagnoses were confirmed in autopsy. Some predictors of the future myocardial rupture were established, as activation of systemic inflammation among them.