Sklifosovsky Journal Emergency Medical Care最新文献

{"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":null,"pages":null},"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}

{"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":null,"pages":null},"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}

{"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":null,"pages":null},"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}

{"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":null,"pages":null},"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}

{"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":null,"pages":null},"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}

{"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":null,"pages":null},"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}

{"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":null,"pages":null},"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}

{"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":null,"pages":null},"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}

{"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":null,"pages":null},"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}

{"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":null,"pages":null},"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}