Pub Date : 2022-09-30DOI: 10.24884/2072-6716-2022-23-3-37-42
V. V. Masljakov, S. A. Sidel'nikov, A. V. Savchenko, A. Y. Belov, S. Kapralov, A. E. Burekeshev
The work includes 30 patients with thermal burns of I–II degree, the area of which amounted to 15–20%, living in Saratov for the period from 2011 to 2021. All injuries were obtained in everyday conditions by ingesting hot liquid on various parts of the body. The average age was 28±5 years. There were 19 men (63,3%), 11 women (36,7%) people. Anti-shock measures were carried out for all victims, including the introduction of polyglucin infusion therapy, the imposition of aseptic bandages, and pain relief. The first group (main) included patients who were given narcotic analgesics as pain relief, the second (comparison) included victims who were given non-drug analgesics as pain relief. Based on the results obtained, it was concluded that the use of narcotic analgesics at the prehospital stage leads to the early cessation of pain syndrome, the prevention of the development of traumatic shock and improves the results of treatment of such victims.
{"title":"The importance of adequate pain relief to reduce complications of thermal burns at the prehospital stage","authors":"V. V. Masljakov, S. A. Sidel'nikov, A. V. Savchenko, A. Y. Belov, S. Kapralov, A. E. Burekeshev","doi":"10.24884/2072-6716-2022-23-3-37-42","DOIUrl":"https://doi.org/10.24884/2072-6716-2022-23-3-37-42","url":null,"abstract":"The work includes 30 patients with thermal burns of I–II degree, the area of which amounted to 15–20%, living in Saratov for the period from 2011 to 2021. All injuries were obtained in everyday conditions by ingesting hot liquid on various parts of the body. The average age was 28±5 years. There were 19 men (63,3%), 11 women (36,7%) people. Anti-shock measures were carried out for all victims, including the introduction of polyglucin infusion therapy, the imposition of aseptic bandages, and pain relief. The first group (main) included patients who were given narcotic analgesics as pain relief, the second (comparison) included victims who were given non-drug analgesics as pain relief. Based on the results obtained, it was concluded that the use of narcotic analgesics at the prehospital stage leads to the early cessation of pain syndrome, the prevention of the development of traumatic shock and improves the results of treatment of such victims.","PeriodicalId":37398,"journal":{"name":"Sklifosovsky Journal Emergency Medical Care","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87589224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-30DOI: 10.24884/2072-6716-2022-23-3-24-32
N. V. Davydov
The objective. To substantiate the use of the Estimated Continuous Cardiac Output technology for the assessment and correction of the volemic status in obese patients during routine hernia repair of the anterior abdominal wall under spinal anesthesia. Subjects and methods. The study included 40 patients who underwent hernia repair of the anterior abdominal wall under spinal anesthesia. Inclusion criteria: body mass index of more than 30–40 kg/m2, physical status according to ASA II or III, no history of indications of diabetes mellitus, myocardial infarction, stroke, malignant neoplasm. Exclusion criteria: refusal of the patient, contraindications to spinal anesthesia. The patients were randomly divided into 2 groups of 20 people. Patients of both groups were comparable in age, gender, and physical status. Group 1 patients underwent preoperative evaluation, as well as monitoring of the effectiveness of correction of volemic status using EsCCO technology. Intraoperative infusion therapy was prescribed to patients of group 2 based on the doctor’s experience, blood pressure, heart rate and formulas for calculating the infusion load. Statistical analysis of the data obtained was performed using MS Excel, Statistica 10. To test the hypothesis of the normality of the distribution of a random variable, the Shapiro-Wilk test was used. Under conditions of normal distribution of quantitative indicators, descriptive statistics were used for statistical data analysis: mean value (M); standard deviation (SD); 95% confidence interval of standard deviation (C1). The Student’s t-test was used to analyze the differences between quantitative characteristics. The differences were considered significant at p<0.05. Results. The greatest decrease in systolic blood pressure by 4 minutes (from 122.8 to 117.5 mm Hg, by 4.3%) was revealed among group 1A patients, by 2 minutes (from 120.6 to 115.4 mm Hg, by 4.3%) among group 2 patients by 4 minutes (from 123.4 to 107.2 mm Hg, by 13.1%) from spinal anesthesia. The most pronounced change in heart rate relative to baseline data among group 1A and group 1B patients was noted at 2 minutes after intrathecal administration of bupivacaine (from 72.4 to 76.2, by 5% and from 74.6 to 78.4, by 4.8%, respectively) with a gradual return to parameters that are close to the baseline, and among patients in group 2, a sharp jump in heart rate from 73.8 to 83.3 (by 11.4%) was noted at 2 minutes. Heart rate continued to increase and by 6 minutes reached an average of 86.0, which is 14% higher than the original value. In all three groups of the study, the greatest deviation from the baseline was found at 6 minutes after the administration of bupivacaine with a further gradual return to slightly larger parameters than the base[1]line. Significant changes in SI were detected at 6 minutes from the execution of the neuroaxial block among all patients of this study. For group 1A, they ranged from 3.89 to 5.25 l/min/m2 (by 27.6%), for group 1B patie
我们的目标。目的:验证脊髓麻醉下肥胖患者常规前腹壁疝修补术中使用预估连续心输出量技术评估和校正容血状态的可行性。研究对象和方法。该研究包括40例在脊髓麻醉下行前腹壁疝修补术的患者。纳入标准:体重指数大于30-40 kg/m2，身体状况按ASA II或III级，无糖尿病、心肌梗死、脑卒中、恶性肿瘤等适应症史。排除标准:患者拒绝，脊髓麻醉禁忌症。患者被随机分为两组，每组20人。两组患者在年龄、性别和身体状况上具有可比性。第一组患者接受术前评估，并监测使用EsCCO技术校正血容量状态的有效性。2组患者根据医生经验、血压、心率及输液负荷计算公式进行术中输液治疗。使用MS Excel, Statistica 10对所得数据进行统计分析。为了检验随机变量分布的正态性假设，使用夏皮罗-威尔克检验。定量指标在正态分布条件下，采用描述性统计方法对统计数据进行分析:均值(M);标准差(SD);95%置信区间标准差(C1)。使用学生t检验来分析数量特征之间的差异。p<0.05认为差异有统计学意义。结果。1A组患者收缩压下降幅度最大，为4分钟(从122.8到117.5 mm Hg，下降4.3%)，2组患者收缩压下降幅度最大，为4分钟(从120.6到115.4 mm Hg，下降4.3%)，为4分钟(从123.4到107.2 mm Hg，下降13.1%)。与基线数据相比，1A组和1B组患者在鞘内给予布比卡因后2分钟的心率变化最明显(分别从72.4到76.2，分别增加5%和从74.6到78.4，分别增加4.8%)，并逐渐恢复到接近基线的参数，而在2组患者中，心率在2分钟内从73.8急剧上升到83.3(增加11.4%)。心率继续增加，6分钟达到平均86.0，比原始值高14%。在所有三组研究中，与基线的最大偏差出现在布比卡因给药后6分钟，随后逐渐恢复到比基线略大的参数[1]。在本研究的所有患者中，在执行神经轴阻滞后6分钟检测到SI的显著变化。对于1A组，其范围为3.89至5.25 l/min/m2(27.6%)，对于1B组患者，其范围为3.88至5.1 l/min/m2(23.9%)，对于2组患者，其范围为3.84至5.45 l/min/m2(29.5%)。结论。估计连续心输出量技术可以有效地评估和纠正肥胖患者在脊髓麻醉下行前腹壁疝修补术时的容血状态。
{"title":"Evaluation and control of correction of volemic status using estimated continuous cardiac output technology for elective hernioplasty in obese patients","authors":"N. V. Davydov","doi":"10.24884/2072-6716-2022-23-3-24-32","DOIUrl":"https://doi.org/10.24884/2072-6716-2022-23-3-24-32","url":null,"abstract":"The objective. To substantiate the use of the Estimated Continuous Cardiac Output technology for the assessment and correction of the volemic status in obese patients during routine hernia repair of the anterior abdominal wall under spinal anesthesia. Subjects and methods. The study included 40 patients who underwent hernia repair of the anterior abdominal wall under spinal anesthesia. Inclusion criteria: body mass index of more than 30–40 kg/m2, physical status according to ASA II or III, no history of indications of diabetes mellitus, myocardial infarction, stroke, malignant neoplasm. Exclusion criteria: refusal of the patient, contraindications to spinal anesthesia. The patients were randomly divided into 2 groups of 20 people. Patients of both groups were comparable in age, gender, and physical status. Group 1 patients underwent preoperative evaluation, as well as monitoring of the effectiveness of correction of volemic status using EsCCO technology. Intraoperative infusion therapy was prescribed to patients of group 2 based on the doctor’s experience, blood pressure, heart rate and formulas for calculating the infusion load. Statistical analysis of the data obtained was performed using MS Excel, Statistica 10. To test the hypothesis of the normality of the distribution of a random variable, the Shapiro-Wilk test was used. Under conditions of normal distribution of quantitative indicators, descriptive statistics were used for statistical data analysis: mean value (M); standard deviation (SD); 95% confidence interval of standard deviation (C1). The Student’s t-test was used to analyze the differences between quantitative characteristics. The differences were considered significant at p<0.05. Results. The greatest decrease in systolic blood pressure by 4 minutes (from 122.8 to 117.5 mm Hg, by 4.3%) was revealed among group 1A patients, by 2 minutes (from 120.6 to 115.4 mm Hg, by 4.3%) among group 2 patients by 4 minutes (from 123.4 to 107.2 mm Hg, by 13.1%) from spinal anesthesia. The most pronounced change in heart rate relative to baseline data among group 1A and group 1B patients was noted at 2 minutes after intrathecal administration of bupivacaine (from 72.4 to 76.2, by 5% and from 74.6 to 78.4, by 4.8%, respectively) with a gradual return to parameters that are close to the baseline, and among patients in group 2, a sharp jump in heart rate from 73.8 to 83.3 (by 11.4%) was noted at 2 minutes. Heart rate continued to increase and by 6 minutes reached an average of 86.0, which is 14% higher than the original value. In all three groups of the study, the greatest deviation from the baseline was found at 6 minutes after the administration of bupivacaine with a further gradual return to slightly larger parameters than the base[1]line. Significant changes in SI were detected at 6 minutes from the execution of the neuroaxial block among all patients of this study. For group 1A, they ranged from 3.89 to 5.25 l/min/m2 (by 27.6%), for group 1B patie","PeriodicalId":37398,"journal":{"name":"Sklifosovsky Journal Emergency Medical Care","volume":"85 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83474261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-21DOI: 10.24884/2072-6716-2022-23-2-59-68
A. L. Ershov
{"title":"Exacerbation of chronic obstructive pulmonary disease: what does an EMS physician need to know about this","authors":"A. L. Ershov","doi":"10.24884/2072-6716-2022-23-2-59-68","DOIUrl":"https://doi.org/10.24884/2072-6716-2022-23-2-59-68","url":null,"abstract":"","PeriodicalId":37398,"journal":{"name":"Sklifosovsky Journal Emergency Medical Care","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74271686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-21DOI: 10.24884/2072-6716-2022-23-2-80-82
A. Editorial
.
．
{"title":"21st ALL-RUSSIAN CONGRESS — ALL-RUSSIAN SCIENTIFIC AND PRACTICAL CONFERENCE WITH INTERNATIONAL PARTICIPATION “EMERGENCY MEDICAL CARE-2022”","authors":"A. Editorial","doi":"10.24884/2072-6716-2022-23-2-80-82","DOIUrl":"https://doi.org/10.24884/2072-6716-2022-23-2-80-82","url":null,"abstract":"<jats:p>.</jats:p>","PeriodicalId":37398,"journal":{"name":"Sklifosovsky Journal Emergency Medical Care","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87227492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-21DOI: 10.24884/2072-6716-2022-23-2-69-77
A. Bagdasaryan, M. Andreeva, A. A. Sirunyants, A. I. Remizova, N. Fedicheva
Introduction. Hemostasis disorders presented in the form of thrombosis in various vascular territories are one of the main causes of death against the background of COVID-19. Their threat persists even after recovery as part of the post-COVID syndrome. Recent studies demonstrate that the development of thromboin-flammatory syndrome is possible not only in the lungs. At the same time, the frequency of revealed venous thrombosis is 10–35% and 60% according to autopsy data. One of the localizations of venous thrombosis in COVID-19 may be the portal system. Portal vein thrombosis is a rarely diagnosed disease that remains asymptomatic for a long period, which makes its timely diagnosis difficult. At the same time, the prognosis for PVT is mostly unfavorable with deaths occurring in half of the cases.The purpose of the study is to demonstrate the features of diagnosis and treatment of PVT on the example of a clinical case in a patient who had a mild coronavirus infection.Description of clinical case. The article describes a clinical case of diagnosis and successful treatment of extended thrombosis of the portal, splenic and superior mesenteric veins against the background of direct anticoagulant therapy and thrombolysis by means of the percutaneous transhepatic portal access. The disease in patient K.V.A., 49 years old who had a moderate coronavirus infection (liver disease and congenital thrombophilia as a cause of thrombosis are excluded) was complicated by spleen infarcts, hydroperitoneum, partial small bowel obstruction.Conclusion. This clinical case is of interest for the possibility of a successful combination of anticoagulant and regional thrombolytic therapy without surgical intervention in complicated thrombosis of the portal vein and its tributaries in a patient in the post-COVID period, and also dictates the need for a personalized approach to the duration and choice of doses of anticoagulant therapy after a COVID-19 infection.
{"title":"Portal vein thrombosis as a manifestation of post-COVID syndrome: a case study","authors":"A. Bagdasaryan, M. Andreeva, A. A. Sirunyants, A. I. Remizova, N. Fedicheva","doi":"10.24884/2072-6716-2022-23-2-69-77","DOIUrl":"https://doi.org/10.24884/2072-6716-2022-23-2-69-77","url":null,"abstract":"Introduction. Hemostasis disorders presented in the form of thrombosis in various vascular territories are one of the main causes of death against the background of COVID-19. Their threat persists even after recovery as part of the post-COVID syndrome. Recent studies demonstrate that the development of thromboin-flammatory syndrome is possible not only in the lungs. At the same time, the frequency of revealed venous thrombosis is 10–35% and 60% according to autopsy data. One of the localizations of venous thrombosis in COVID-19 may be the portal system. Portal vein thrombosis is a rarely diagnosed disease that remains asymptomatic for a long period, which makes its timely diagnosis difficult. At the same time, the prognosis for PVT is mostly unfavorable with deaths occurring in half of the cases.The purpose of the study is to demonstrate the features of diagnosis and treatment of PVT on the example of a clinical case in a patient who had a mild coronavirus infection.Description of clinical case. The article describes a clinical case of diagnosis and successful treatment of extended thrombosis of the portal, splenic and superior mesenteric veins against the background of direct anticoagulant therapy and thrombolysis by means of the percutaneous transhepatic portal access. The disease in patient K.V.A., 49 years old who had a moderate coronavirus infection (liver disease and congenital thrombophilia as a cause of thrombosis are excluded) was complicated by spleen infarcts, hydroperitoneum, partial small bowel obstruction.Conclusion. This clinical case is of interest for the possibility of a successful combination of anticoagulant and regional thrombolytic therapy without surgical intervention in complicated thrombosis of the portal vein and its tributaries in a patient in the post-COVID period, and also dictates the need for a personalized approach to the duration and choice of doses of anticoagulant therapy after a COVID-19 infection.","PeriodicalId":37398,"journal":{"name":"Sklifosovsky Journal Emergency Medical Care","volume":"46 22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80520546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-21DOI: 10.24884/2072-6716-2022-23-2-83-84
I. A. Sazanova
.
．
{"title":"We Remember You, Vladislav Adamovitch! On The 95th Anniversary Of The Birthday Of The University Doctor Honorary, Honored Scientist Of The Russian Federation Vladislav Adamovich Mikhailovich (1927–2018)","authors":"I. A. Sazanova","doi":"10.24884/2072-6716-2022-23-2-83-84","DOIUrl":"https://doi.org/10.24884/2072-6716-2022-23-2-83-84","url":null,"abstract":"<jats:p>.</jats:p>","PeriodicalId":37398,"journal":{"name":"Sklifosovsky Journal Emergency Medical Care","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74994981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-21DOI: 10.24884/2072-6716-2022-23-2-52-58
I. Ivanov
Purpose of the study. Тo analyze the dynamics of traumatism, mortality and lethality from injuries with sharp objects in Leningrad — St. Petersburg, taking into account economic processes, regulation of the alcoholic beverages market and the capabilities of the ambulance service.Materials and methods. The work is based on archival material of the St. Petersburg State Budgetary Healthcare Institution “Bureau of Forensic Medicine” for 1978–2020.Results and discussion. For 43 years in the evolution of traumatism, mortality and lethality from injuries from sharp objects, periods have been traced: pre-crisis (1978–1990), crisis with phases of rise (1991–1993), turning-point (1994) and recession (1995–2004), exit from the crisis or the beginning of stabilization (2005–2011), post-crisis stabilization (2012–2020). The dynamics of statisti cal indicators was influenced by the anti-alcohol campaign (1985), the destabilization of the alcohol market and the elimination of the state monopoly on alcohol (1990–1992), the restoration of state regulation of the turnover of alcoholic products (1993), and the restriction of alcohol consumption (since 1995), financial and economic crises (1991, 1998, 2008–2009), improvement of the emergency medical service (2004, 2013).Conclusions. Economic crises were accompanied by negative dynamics of traumatism. The destabilization of the alcoholic beverages market was accompanied by an increase in traumatism and mortality. The well-organized work of the ambulance service ensures an acceptable level of lethality and mortality.
{"title":"Dynamics of traumatism, mortality and lethality in damage by sharp objects in Leningrad – St. Petersburg in 1978–2020","authors":"I. Ivanov","doi":"10.24884/2072-6716-2022-23-2-52-58","DOIUrl":"https://doi.org/10.24884/2072-6716-2022-23-2-52-58","url":null,"abstract":"Purpose of the study. Тo analyze the dynamics of traumatism, mortality and lethality from injuries with sharp objects in Leningrad — St. Petersburg, taking into account economic processes, regulation of the alcoholic beverages market and the capabilities of the ambulance service.Materials and methods. The work is based on archival material of the St. Petersburg State Budgetary Healthcare Institution “Bureau of Forensic Medicine” for 1978–2020.Results and discussion. For 43 years in the evolution of traumatism, mortality and lethality from injuries from sharp objects, periods have been traced: pre-crisis (1978–1990), crisis with phases of rise (1991–1993), turning-point (1994) and recession (1995–2004), exit from the crisis or the beginning of stabilization (2005–2011), post-crisis stabilization (2012–2020). The dynamics of statisti cal indicators was influenced by the anti-alcohol campaign (1985), the destabilization of the alcohol market and the elimination of the state monopoly on alcohol (1990–1992), the restoration of state regulation of the turnover of alcoholic products (1993), and the restriction of alcohol consumption (since 1995), financial and economic crises (1991, 1998, 2008–2009), improvement of the emergency medical service (2004, 2013).Conclusions. Economic crises were accompanied by negative dynamics of traumatism. The destabilization of the alcoholic beverages market was accompanied by an increase in traumatism and mortality. The well-organized work of the ambulance service ensures an acceptable level of lethality and mortality.","PeriodicalId":37398,"journal":{"name":"Sklifosovsky Journal Emergency Medical Care","volume":"122 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90284100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-20DOI: 10.24884/2072-6716-2022-23-2-44-51
G. E. Koguashvili, L. Ganieva, A. V. Berdnikova, V. I. Nurullina, E. N. Alekseeva, G. Khakimova, N. V. Nazarova, S. M. Ryabov, L. R. Diyarova, A. Timofeeva
Introduction. The Children’s Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan in Kazan is a hospital with 1,180 beds, designed for planned and emergency care throughout the Republic of Tatarstan. In stationary medical institutions there are 5 intensive care units, ambulance transport services with numerous resuscitation vehicles, and an air ambulance service. Every year, more than 10,000 (up to 15,000) planned surgical interventions are performed at the hospital, and almost all patients of varying severity are treated at the institution. As in all world practice, despite the high level of professionalism of nursing staff and doctors, the widespread use of modern peripheral and central venous catheters, ultrasound equipment and other devices to assist in catheterization, the rate of unsuccessful catheterization attempts remains quite high, especially in the emergency segment. medical care.Tasks: systematization of knowledge on intraosseous vascular access (IVA), analysis of the work performed. At the current stage of providing medical care to the pediatric population, our hospital maintains a protocol for vascular access in pediatrics and has developed an internal protocol for intraosseous access to analyze the work done, take into account complications and evaluate its effectiveness.Materials and methods. An analysis was carried out for the installation of intraosseous vascular access for two-year periods, starting from 2015. This article considers the period of 2017–2018, for which the most complete data were collected. During this period, 58 protocols were recorded in children of various age groups with various pathologies in a critical situation.
{"title":"Experience of using intraosseous access in a multidisciplinary hospital (Children’s Republican Clinical Hospital of Kazan, Ministry of Health of the Republic of Tatarstan)","authors":"G. E. Koguashvili, L. Ganieva, A. V. Berdnikova, V. I. Nurullina, E. N. Alekseeva, G. Khakimova, N. V. Nazarova, S. M. Ryabov, L. R. Diyarova, A. Timofeeva","doi":"10.24884/2072-6716-2022-23-2-44-51","DOIUrl":"https://doi.org/10.24884/2072-6716-2022-23-2-44-51","url":null,"abstract":"Introduction. The Children’s Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan in Kazan is a hospital with 1,180 beds, designed for planned and emergency care throughout the Republic of Tatarstan. In stationary medical institutions there are 5 intensive care units, ambulance transport services with numerous resuscitation vehicles, and an air ambulance service. Every year, more than 10,000 (up to 15,000) planned surgical interventions are performed at the hospital, and almost all patients of varying severity are treated at the institution. As in all world practice, despite the high level of professionalism of nursing staff and doctors, the widespread use of modern peripheral and central venous catheters, ultrasound equipment and other devices to assist in catheterization, the rate of unsuccessful catheterization attempts remains quite high, especially in the emergency segment. medical care.Tasks: systematization of knowledge on intraosseous vascular access (IVA), analysis of the work performed. At the current stage of providing medical care to the pediatric population, our hospital maintains a protocol for vascular access in pediatrics and has developed an internal protocol for intraosseous access to analyze the work done, take into account complications and evaluate its effectiveness.Materials and methods. An analysis was carried out for the installation of intraosseous vascular access for two-year periods, starting from 2015. This article considers the period of 2017–2018, for which the most complete data were collected. During this period, 58 protocols were recorded in children of various age groups with various pathologies in a critical situation.","PeriodicalId":37398,"journal":{"name":"Sklifosovsky Journal Emergency Medical Care","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86896347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-20DOI: 10.24884/2072-6716-2022-23-2-38-43
I. Barsukova, A. I. Makhnovskiy, V. V. Stozharov, O. Ergashev, A. Miroshnichenko, R. Minnullin, I. Kim, L. S. Sudyina
Objective. The purpose of the study: to substantiate the economic orientation of emergency medical care in a hospital in the profile of “obstetrics and gynecology».Materials and methods. In 1367 patients of the St. Pete rsburg I. I. Dzhanelidze Research Institute of Emergency Medicine with a follow-up period of up to three days, a comparative analysis of the use of specialized medical services and emergency medical services tariffs was carried out.Results. Тhe use of tariffs for emergency medical care allows you to get a superior financial effect, the maximum effect from the use of tariffs for specialized medical care is 2.7 times (p<0.01).
目标。本研究的目的:在"妇产科"概况中证实医院急诊医疗的经济导向。材料和方法。对圣彼得堡I. I. Dzhanelidze急救医学研究所的1367名患者进行了长达三天的随访，对专科医疗服务和急救医疗服务收费的使用情况进行了比较分析。Тhe在紧急医疗护理中使用关税可以获得优越的财务效果，在专业医疗护理中使用关税的最大效果是2.7倍(p<0.01)。
{"title":"Economic aspects of hospitalization of patients according to the profile “obstetrics and gynecology” emergency hospital","authors":"I. Barsukova, A. I. Makhnovskiy, V. V. Stozharov, O. Ergashev, A. Miroshnichenko, R. Minnullin, I. Kim, L. S. Sudyina","doi":"10.24884/2072-6716-2022-23-2-38-43","DOIUrl":"https://doi.org/10.24884/2072-6716-2022-23-2-38-43","url":null,"abstract":"Objective. The purpose of the study: to substantiate the economic orientation of emergency medical care in a hospital in the profile of “obstetrics and gynecology».Materials and methods. In 1367 patients of the St. Pete rsburg I. I. Dzhanelidze Research Institute of Emergency Medicine with a follow-up period of up to three days, a comparative analysis of the use of specialized medical services and emergency medical services tariffs was carried out.Results. Тhe use of tariffs for emergency medical care allows you to get a superior financial effect, the maximum effect from the use of tariffs for specialized medical care is 2.7 times (p<0.01).","PeriodicalId":37398,"journal":{"name":"Sklifosovsky Journal Emergency Medical Care","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78953623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-06-20DOI: 10.24884/2072-6716-2022-23-2-31-37
R. Mukhametshin, N. Davidova
Purpose: to analyze the structure of the reasons for non-transportability during pretransport therapy of newborns and its relationship with the outcomes of the hospital stage.Materials and methods. А cohort study of 604 cases of a transport team visits for 564 newborn hospitalized in medical organizations of the Sverdlovsk region. In the studied sample, according to the tactical decision of the transport team, subgroups of transportable (n=497) and non-transportable patients (n=46) were identified. Anamnesis data, the structure of the causes of non-transportability, and the outcomes of the hospital stage were analyzed.Results. Тhe main causes of non-transportability were respiratory failure (86.96%) and circulatory failure (43.48%), in 50% of cases a combination of two or more reasons was observed. The presence of two causes of non-transportability significantly increases the risk of death (RR=4.09 [2.01–8.32]) and 7-day mortality (RR=5.14 [1.78–14.85]). The combination of circulatory failure and respiratory failure significantly increases the risk of death (RR=7.76 [4.39–13.71]) and 7-day mortality (RR=12.2 [5.12–29.08]).Conclusion. Respiratory failure and circulatory failure predominate in the structure of the reasons for the non-transportability of newborns. The greatest growth of total and 7-day mortality is observed with a combination of respiratory failure and circulatory failure.
{"title":"Structure of causes of non-transportability of newborns","authors":"R. Mukhametshin, N. Davidova","doi":"10.24884/2072-6716-2022-23-2-31-37","DOIUrl":"https://doi.org/10.24884/2072-6716-2022-23-2-31-37","url":null,"abstract":"Purpose: to analyze the structure of the reasons for non-transportability during pretransport therapy of newborns and its relationship with the outcomes of the hospital stage.Materials and methods. А cohort study of 604 cases of a transport team visits for 564 newborn hospitalized in medical organizations of the Sverdlovsk region. In the studied sample, according to the tactical decision of the transport team, subgroups of transportable (n=497) and non-transportable patients (n=46) were identified. Anamnesis data, the structure of the causes of non-transportability, and the outcomes of the hospital stage were analyzed.Results. Тhe main causes of non-transportability were respiratory failure (86.96%) and circulatory failure (43.48%), in 50% of cases a combination of two or more reasons was observed. The presence of two causes of non-transportability significantly increases the risk of death (RR=4.09 [2.01–8.32]) and 7-day mortality (RR=5.14 [1.78–14.85]). The combination of circulatory failure and respiratory failure significantly increases the risk of death (RR=7.76 [4.39–13.71]) and 7-day mortality (RR=12.2 [5.12–29.08]).Conclusion. Respiratory failure and circulatory failure predominate in the structure of the reasons for the non-transportability of newborns. The greatest growth of total and 7-day mortality is observed with a combination of respiratory failure and circulatory failure.","PeriodicalId":37398,"journal":{"name":"Sklifosovsky Journal Emergency Medical Care","volume":"106 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73647863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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