Medico-Biological and Socio-Psychological Issues of Safety in Emergency Situations最新文献

{"title":"Extensive traumatic detachment of soft tissue after accident: clinical experience of a multidisciplinary hospital","authors":"Y. V. Yurova, E. Zinoviev","doi":"10.25016/2541-7487-2023-0-2-63-74","DOIUrl":"https://doi.org/10.25016/2541-7487-2023-0-2-63-74","url":null,"abstract":"Relevance. Each case of traumatic skin detachment is specific due to localization and severity of lesions, as well as the decision-making algorithm of treatment remains a subject of discussion. Nowadays the Ministry of Health of the Russian Federation has not produced clinical recommendations or standards for the treatment of such trauma patients. The scope of examination, treatment methods, and efficiency criteria in such injuries are very controversial. Due to errors in the diagnosis of traumatic detachment, difficulties and complications arise during plastic closure of such wound defects.Objective. The study objective is to demonstrate clinical observations of our multidisciplinary hospital in the treatment of patients with traumatic skin detachment, to assess factors affecting surgery outcomes, to propose an algorithm for the treatment of patients with traumatic skin detachment.Materials and methods. 20 patients with traumatic skin detachment underwent wound defect closure upon admission according to Krasovitov surgery. Here the results of 3 clinical cases are presented. Types of traumatic skin detachment, timespan between the injury and start of surgical treatment were analyzed to identify the factors affecting graft healing.Results and discussion. The study reports 33 % of unfavorable treatment outcomes in multidisciplinary hospital. To improve the results, strategy for the management of traumatic skin detachments was proposed. Patients operated according to these recommendations reported satisfactory treatment results.Conclusion. Active introduction a dedicated algorithm for traumatic skin detachment diagnosis and treatment in clinical practice and high-tech methods allowed to achieve significant improvement in immediate and long-term treatment outcomes.","PeriodicalId":36526,"journal":{"name":"Medico-Biological and Socio-Psychological Issues of Safety in Emergency Situations","volume":"57 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76069328","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}

{"title":"Specific xenon-based gas mixtures used for stress correction therapy in patients exposed to lethal force scenarios","authors":"I. Ushakov, A. S. Kal’manov, Y. Bubeev","doi":"10.25016/2541-7487-2023-0-1-59-67","DOIUrl":"https://doi.org/10.25016/2541-7487-2023-0-1-59-67","url":null,"abstract":"Introduction. Stress reaction in deadly scenarios is a systemic response of human body to the impact of extreme and acute psychotraumatic factors. The condition is associated with complete or partial loss of ability to perform tasks and can lead to the development of post-traumatic stress disorder. Therefore, new effective means and methods of stress correction in lethal force scenarios is a most urgent challenge for catastrophe medicine.The objective is to estimate the therapeutic efficacy of xenon gas mixtures in the treatment of different categories of employees exposed to occupational hazards, including acute stress.Methodology. A randomized controlled experimental study was conducted, involving 48 employees of law enforcement bodies and rescue operations professionals. Acute stress disorders were treated using a course of oxygen-xenon gas mixture inhalations (oxygen – 75 %, xenon – 25 %). Comprehensive medical and psychological examination allowed to monitor treatment efficiency.Results and discussion. Oxygen-xenon gas mixture inhalations contributed to normalization of systemic hemodynamics, improved parasympathetic activity and reduced sympathetic nervous system activity, leading to a significant reduction in the level of anxiety and improvement of psychopathological symptoms.Conclusion. The obtained findings provide extra evidence showing that xenon-based gas mixtures are a promise as a stress correction tool in patients exposed to lethal force scenarios and acute occupational hazard.","PeriodicalId":36526,"journal":{"name":"Medico-Biological and Socio-Psychological Issues of Safety in Emergency Situations","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75235788","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}

{"title":"Improved body resistance and mental health in students undergoing hypoxic training wearing insulating gas masks","authors":"A. O. Pyatibrat, V. V. Ziambetov, N. S. Tsikunova, R. K. Nazyrov, A. G. Shibaeva","doi":"10.25016/2541-7487-2023-0-1-100-108","DOIUrl":"https://doi.org/10.25016/2541-7487-2023-0-1-100-108","url":null,"abstract":"Relevance. Improving mental health of professionals working in extreme environments are an urgent step towards improved health of the urban population.Objective. The aim is to evaluate the long–term efficiency of hypoxic training wearing a filter gas mask in terms of mental health.Methods. Mental health assessment was carried out using Spielberger–Khanin questionnaire and the Lusher test. The correlation between the indicators showing changes in the level of anxiety, vital lung capacity and the number of trunk lifts were calculated for the two groups of students, each including 50 participants. Group 1 used a filter gas mask while doing physical exercises within their hypoxic training, whereas Group 2 performed similar amount of exercises without wearing a gas mask.Results and discussion. Group 1 showed a significant decrease in the level of anxiety and a trend towards having less students with future pursuits and hopes for the best. By the end of the study, moderate negative correlations of reactive anxiety with an increase in the vital lung capacity (r = –0.43; p < 0.05) and the number of trunk lifts in supine position (r= –0.37; p < 0.05) was found in Group 1. Factor analysis in both groups revealed restructured functional body reserves during physical training.Conclusion. Hypoxic training in students throughout the academic year allowed to significantly increase the vital lung capacity, physical resilience, satisfaction, pursuits and positive perception of the future, while reducing the level of anxiety.","PeriodicalId":36526,"journal":{"name":"Medico-Biological and Socio-Psychological Issues of Safety in Emergency Situations","volume":"51 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83403707","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}

{"title":"Transportability Assessment Scale (TAS) and transportation associated mortality (TAS–mortality) critical patients and patients with emergency-related injuries","authors":"D. Shelukhin, S. Aleksanin, V. Rybnikov, A. I. Pavlov","doi":"10.25016/2541-7487-2023-0-1-78-86","DOIUrl":"https://doi.org/10.25016/2541-7487-2023-0-1-78-86","url":null,"abstract":"Relevance. The existing traditional tools (scales) to assess severity of the patient’s condition and death probability do not take into account a set of crucial parameters for the upcoming medical evacuation.The objective is to develop the Transportability Assessment Scale (TAS) and transportability-associated mortality (TAS-mortality) tool to evaluate critical patients and patients injured in emergency situations (ES) of all age groups at different stages of medical evacuation using all types of transportation, followed by inpatient treatment.Methods. In total, we analyzed N=217 clinical cases of medical evacuation using different types of transportation in combination with either traditional intensive care (n=149, control group) or ECMO (n=68, trial group) due to refractory respiratory and/or circulatory insufficiency in all age groups. Once the patients embarked on medical evacuation, they were immediately split in groups to assess their condition while transportation and within the next 72 hours (associated period). A new scale (formula) to assess patient’s transportability and probability of mortality, including in the ECMO setting, was formulated based on the following statistical techniques: one-factor forecasting, risk classes of disorder development and logistic regression modeling applied to such target indicators as “death”, “transportation negative impact on patient’s condition” and other factors. Most significant factors were further embedded in the new transportability and probability of death assessment scale (formula).Results and discussion. The Transportability Assessment Scale (TAS) was developed using logistic regression model measuring the impact of transportation on the patient’s condition: y = exp(37∙ x1 + 6∙ x2 + 20∙ x3 +16∙ x4 + 21∙ x5 + 27∙ x6 – 27∙ x7) / 1+ exp(37∙ x1 + 6∙ x2 + 20∙ x3 +16∙ x4 + 21∙ x5 + 27∙ x6 – 27∙ x7), where: у – transportability assessment of patient; x1 (PaO2/FiO2 ≤ 110); x2 (Age ≥ 65 years); x3 (VIS ≥ 4 points); x4 (PaCO2 ≥ 55 mm Hg); x5 (SvO2 ≤ 60 %); x6 (HR∙ ≥ 127 beats per minute); x7 (ECMO application). Depending on the evacuation conditions, correction factors were as follows: x1 – 0.75 if the patient is to be transported by plane, x6 – 0.65 if the patient’s body weight is less than 10 kg. The results were translated into a 100-point scoring system: patients scoring up to 30 points were available for evacuation; 30 to 70 indicated evacuation to be performed in ongoing intensive care setting; over 70 indicated impossibility of evacuation until the patient is stabilized and subcompensated. We also developed the new TAS-mortality 100-point scale: y = exp(29∙ x1 + 16∙ x2 + 11∙ x3 + 10∙ x4 + 9∙ x5 + 7∙ x6 + 7∙ x7 + 6∙ x8 + 4∙ x9 + 1∙ x10,) / 1+ exp(29∙ x1 + 16∙ x2 + 11∙ x3 + 10∙ x4 + 9∙ x5 + 7∙ x6 + 7∙ x7 + 6∙ x8 + 4∙ x9 + 1∙ x10), where: y – probability of outcome – death; x1 (lactate ≥ 8 mmol/L), x2 (age ≥ 65 лет), x3 (creatinine ≥ 300 µmol/L), x4 (duration of mechanical ventilation ≥ 7 days), x5 ","PeriodicalId":36526,"journal":{"name":"Medico-Biological and Socio-Psychological Issues of Safety in Emergency Situations","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86484522","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}

{"title":"Disaster medicine: analysis of research papers by Russian investigators based on artificial intelligence methods (2005–2021)","authors":"K. Chernov, S. D. Misyurin, V. A. Glukhov, S. A. Durnev","doi":"10.25016/2541-7487-2023-0-1-109-119","DOIUrl":"https://doi.org/10.25016/2541-7487-2023-0-1-109-119","url":null,"abstract":"","PeriodicalId":36526,"journal":{"name":"Medico-Biological and Socio-Psychological Issues of Safety in Emergency Situations","volume":"87 2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78053085","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}

{"title":"PTSD development and dynamics","authors":"V. Shamrey, V. M. Lytkin, K. V. Barazenko, S. Zun","doi":"10.25016/2541-7487-2023-0-1-68-77","DOIUrl":"https://doi.org/10.25016/2541-7487-2023-0-1-68-77","url":null,"abstract":"Relevance. The prevalence of post-traumatic stress disorder ranges from 1 to 12 % among the general population and reaches 30 % among the population affected by various emergencies, which makes the PTSD problem ever more relevant considering the special military operation in Ukraine.Objectives. The aim is to study and describe the main clinical approaches to the treatment of PTSD.Methods. The clinical and bibliographic method were used to perform a comparative analysis of academic research papers published in 2008 to 2022.Results and discussion. Treatment of PTSD requires an interdisciplinary approach with a particular focus on individually specific psychotherapeutic methods, as well as administration of selective serotonin reuptake inhibitors (SSRIs) as antidepressants. We analyzed clinical and diagnostic aspects of combat PTSDs, their pathology, origin, treatment options and challenges for discussion. Currently, combat PTSDs are acquiring extra relevance.Conclusion. While trying to investigate the development of clinical PTSD manifestations, the focus is shifted from syndrome-associated parameters towards understanding PTSD as an integral disorder of psychogenic origin with polysyndromic and multisystemic characteristics.","PeriodicalId":36526,"journal":{"name":"Medico-Biological and Socio-Psychological Issues of Safety in Emergency Situations","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79721679","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}

{"title":"The results of the use of transport extracorporeal membrane oxygenation in sudden circulatory arrest","authors":"V. Teplov, D. M. Prasol, O. Reznik, E. A. Tsebrovskaya, V. V. Kolomoytsev, N. D. Arkhangel’skiу, S. Bagnenko","doi":"10.25016/2541-7487-2023-0-1-53-58","DOIUrl":"https://doi.org/10.25016/2541-7487-2023-0-1-53-58","url":null,"abstract":"Relevance. The timely use of extracorporeal membrane oxygenation within resuscitation measures for patients with refractory circulatory arrest is becoming a routine rescue practice in the world, making it possible to increase the efficiency of resuscitation measures up to 30 %; however, this technology is not widespread in Russia, despite the fact that without extracorporeal mechanical support, the effectiveness of cardiopulmonary resuscitation is no more than 9 %.Objective. Analysis of the experience of using transport venoarterial extracorporeal membrane oxygenation (ECMO) within extended cardiopulmonary resuscitation in case of out-of-hospital circulatory arrest in inpatient emergency department.Methods. Analysis of the experience of using transport ECMO within extended cardiopulmonary resuscitation in case of out-of-hospital circulatory arrest in inpatient emergency department.Results and Discussion. Of the 16 cases of extracorporeal cardiopulmonary resuscitation, effective circulation was restored in 37.5 % (6 out of 16) of cases. In these cases, the duration of extended cardiopulmonary resuscitation outside the medical organization was significantly lower, (50.8 ± 4.2) minutes versus (65.6 ± 4.6) minutes. In the group of patients with ineffective extended cardiopulmonary resuscitation, there was a significant increase in troponin (1820 ± 164) versus (473 ± 180) ng/l and D-dimer (17 566 ± 429) versus (13 122 ± 628) µg/l (FEU).Conclusion. Transport ECMO technology, which is used for extracorporeal cardiopulmonary resuscitation in patients with out-of-hospital refractory circulatory arrest, allows the use of a wide range of diagnostic and therapeutic procedures, including percutaneous coronary interventions. The analysis revealed the need to reduce the duration of resuscitation by ambulance teams on the spot in favor of extended CPR in motion using an electromechanical device for chest compressions.","PeriodicalId":36526,"journal":{"name":"Medico-Biological and Socio-Psychological Issues of Safety in Emergency Situations","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80355848","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}

{"title":"Armed attacks in educational institutions: social, psychological and informational problems of education security in Russia and abroad","authors":"V. V. Glebov, V. Shevtsov, D. Efremova","doi":"10.25016/2541-7487-2023-0-1-87-99","DOIUrl":"https://doi.org/10.25016/2541-7487-2023-0-1-87-99","url":null,"abstract":"Relevance. The history of armed attacks on educational institutions originated in the United States, but in recent decades this social phenomenon has spread widely to other countries, including Russia. Mass social tragedies associated with deaths of the youth cause great concern among all groups of population and require comprehensive prevention measures.The objective of the study is to identify social environmental factors that shape school shooter mentality, as well as to explore various strategies to prevent attacks in educational institutions of different levels (kindergartens, schools, universities).Methods. Armed attacks in educational institutions are the focus of our research. The material includes published research data (articles, dissertations and monographs) in English and Russian. The set of methods included generalizing conclusions published by peer investigators regarding the considered matter. Bibliographic databases (i.e. Federal State Institution “Russian State Library”, library platforms of Lomonosov Moscow State University and Peoples’ Friendship University of Russia) and scientific networks (ResearchGate, Web of Knowledge, Scopus, Google Scholar, Academia.edu, Mendeley) were used to explore research data. The findings present over 127 thousand publications regarding meta-analysis of armed attacks and mass shooting that occurred in educational institutions, as well as their social, psychological, cultural, and informational implications.Results and Discussion. The analysis of data regarding armed attacks in educational institutions demonstrates a very specific phenomenon that belongs to a specific type of crimes. Findings show that mass shootings of schoolchildren and students occur annually in the United States, apparently due to the free circulation of firearms and the cult of the guns. From 1974 to 1921 the US witnesses over 50 major armed attacks causing over a hundred deaths. In China, this problem is also substantial due to the country’s rapid and profound social changes (reforms, gender imbalance and demographic policy). Cold arms (knives, hammers) is the major weapon of assault in China, which caused deaths of at least a hundred children. In Europe, school shooting is not a critical problem, with only few cases reported by a few countries (Germany, Denmark and Finland). Russia shows no increase in the number of armed attacks using firearms or cold arms. In general, such incidents occur annually (1 to 4 violence cases) and are associated with slumped standards of living, increased aggression, social and psychological maladaptation among the population. To solve this problem, an integrated approach is needed, which could bring together technical and social aspects. The technical aspects imply broader use of video surveillance security systems and barriers, as well as regular profound inspections of school grounds (the venue and inside the school building). However, preventive measures should effectively provide for the s","PeriodicalId":36526,"journal":{"name":"Medico-Biological and Socio-Psychological Issues of Safety in Emergency Situations","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84947165","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}

{"title":"The composition of nosologies and occupational injury risks in officers of the Federal Fire Service of the Ministry of Emergency Situations of Russia (2012–2021).","authors":"V. Evdokimov, E. V. Bobrinev, A. A. Vetoshkin, A. A. Kondashov","doi":"10.25016/2541-7487-2023-0-1-13-41","DOIUrl":"https://doi.org/10.25016/2541-7487-2023-0-1-13-41","url":null,"abstract":"Relevance. Professional firefighters are exposed to high levels of physical and emotional stress which impacts their functional reserves and makes the susceptible to erroneous actions and occupational traumas. The objective is to assess the decade-long (2012 to 2021) risk of occupational injuries and to establish its correlation with nosologies of external causes under Chapter XIX of the International Classification of Diseases and Related Health Problems, 10th Revision (ICD-10).Methods. We analyzed occupational injuries across different categories among Federal Fire Service (FFS) officers of the EMERCOM of Russia (emergency response squads, prevention, technical and administrative workforce), their causes (technical, organizational, psychophysiological and hazardous fire-related factors), and performed occupational activities (firefighting, training, sport or daily activities). Based on the ICD-10, injury risks and exposure of particular body areas to external factors were calculated per 10,000 people according (×10–4).Results and Discussion. Over a 10 year’s timespan, 1,769 occupational injuries have been registered among Federal Fire Service officers EMERCOM of Russia. The occupational injury rate for firefighters was (9.19 ± 0.54)•10–4 injuries/(person•year), which was statistically significantly lower (p < 0.001) than for male workforce employed in Russian economy sectors – (16.50 ± 1.09)•10–4. The overall average diagnose per injury rate was 1.5, including 1.7 in firefighting and other emergency response activities, 1.4 in combat training activities, and 1.5 in routine activities. The weighted average risk of body injuries was (11.96 ± 0.89)•10–4 injuries/(person•year); in particular, cumulative injury risk rate was (10.01 ± 0.83)•10–4 responsible for 83.6% of the total value, with burns (1.39 ± 0.23)•10–4 (equal to 11.6%), poisoning by combustion products (0.39 ± 0.09)•10–4 (equal to 3.3%), heat fainting (0.18 ± 0.04)•10–4 (equal to 1.5%) respectively. The congruent risk trends for occupational injuries, industrial head and body injuries, including burns, are positive and statistically significant, which suggests the trends are driven by identical (unidirectional) parameters. For determination coefficients of different significance, the polynomial trend of body injuries risk shows a downward trend of data reduction; the risk of burns resembles an inverted U-curve; while the risk of poisoning by combustion products demonstrates an increase in indicator values. Risks of injuries to the head (S00–S09 in ICD-10) showed rank 1 of significance among occupational body lesions in the entire cohort of firefighters, reaching the level of (2,49 ± 0,32)•10–4 injuries/(person•year) equal to 20.8 % of all occupational injuries; knee and shin injuries were assigned rank 2 (S80-S89) – (1.87 ± 0.24)•10–4 equal to 15.6 %; ankle and foot area were assigned rank 3 (S90–S99) – (1.11 ± 0.15)•10–4 equal to 9,3 %; rank 4 injuries were injuries of the thorax (S20–","PeriodicalId":36526,"journal":{"name":"Medico-Biological and Socio-Psychological Issues of Safety in Emergency Situations","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91345225","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}

{"title":"Application of damage control tactics in combat injuries of limbs at the advanced stages of medical evacuation in modern war settings (literature review)","authors":"P. Seliverstov, Y. Shapkin","doi":"10.25016/2541-7487-2023-0-1-42-52","DOIUrl":"https://doi.org/10.25016/2541-7487-2023-0-1-42-52","url":null,"abstract":"Relevance. Limb injuries occupy the first place in the structure of modern combat injuries and are one of the main reasons for the decline in fitness for military service and disability. In the conditions of conducting largescale hostilities, the role of the advanced stages of medical evacuation, where surgical care is provided according to the principles of damage control, increases. Features of the tactics of damage control in combat injuries of the extremities determine the need for special training of military surgeons.The objective is to consider the features and effectiveness of the provision of surgical care according to the principles of damage control in combat injuries of the extremities at the advanced stages of medical evacuation in armed conflicts of the last two decades (in the countries of the Middle East and Africa, Afghanistan, Ukraine).Methodology. A search was made for scientific articles in the PubMed database and the Scientific Electronic Library (eLIBRARY.ru), published from 2013 to 2023.Results and Discussion. Modern combat trauma of the extremities is characterized by a high frequency of vascular damage, extensive destruction of soft tissues and bones from the impact of damaging factors of explosive ammunition. Surgical interventions for combat injuries of the extremities (external fixation of bone fractures with rod devices, ligation or temporary vascular shunt of damaged vessels, fasciotomy, amputation) were the most frequent of all operations performed at the advanced stages of medical evacuation during modern military conflicts. The volume of surgical interventions corresponded to the first stage of orthopedics and vascular control of injuries and was determined by the severity of the condition of the wounded, the degree of ischemia and severity of limb injuries, and the medical and tactical situation.Conclusion. Assistance at the advanced stages of medical evacuation according to the principles of orthopedics and vascular damage control can significantly reduce the frequency of amputations and improve the functional results of treatment for combat injuries of the extremities.","PeriodicalId":36526,"journal":{"name":"Medico-Biological and Socio-Psychological Issues of Safety in Emergency Situations","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74849574","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}