ORGANIZATION AND TACTICS OF DISASTER MEDICINE SERVICE
1. Porotikov V.T., Kryukov A.P. 15th anniversary of the Far Eastern Centre for Disaster Medicine
Background and formation of the Far Eastern Centre for Disaster Medicine are presented. Main lines of its activity are considered: medical and health relief operations in emergency, urgent and advisory medical care delivery to population, training of disaster medicine service specialists. The results of the Centre’s activity for a number of years have been analyzed.
Key words: Far Eastern Centre for Disaster Medicine, medical and health relief operations in emergency, disaster medicine service, urgent and advisory medical care
2. Avdeeva V.G., Balakhontsev A.P., Fedotkin O.V. Long-term trends of development of disaster medicine service in Perm region
The paper discusses trends of Perm region disaster medicine service development aimed at modernization of human life rescue system, health support and population protection in emergency. Quality control program of emergency medical care delivery «03-Service» to population of Perm region is presented. The program comprises issues concerning ways of legal norms and standards development of emergency medical care service, its logistic support in accord with uniform standards, development of personnel policy in emergency medical care service.
Key words: cooperation, coordination, support, medical personnel training, emergency medical care, development, territorial service for disaster medicine, control
3. Belousov A.I., Bazanov S.V., Potapenko L.V. Operational experience of Territorial Centre for Disaster Medicine in Ivanovo region
Operational experience of Territorial Centre for Disaster Medicine (TSDM) in Ivanovo region in cooperation with emergency medical station of Ivanovo is presented. This experience may be useful for the work of small in numbers TSDM which do not have on their staff emergency response and secondary medical care teams.
Key words: Ivanovo region, information network, monitoring, unitied dispatcher/duty service, emergency medical care delivery, quick-response control group, emergency medical care station, Territorial Centre for Disaster Medicine, emergency
4. Porotikov V.T., Mamykin V.I., Singur A.B., Katik A.A. Preparation of Far Eastern Centre for Disaster Medicine for operations in response to chemical pollution of the river Amur and threat to population poisoning
The paper decribes an experience of activity of Far Eastern Centre for Disaster Medicine on preparation to medical and health response operations in transboundary emergency of chemical pollution of the river Amur. The procedures performed have been analyzed, as well as enlisted personnel, allocated resources, organization of cooperation and information sharing between ministries, institutions, agencies participating in prevention of the threat of emergency occurrence in Khabarovsk region.
Key words: Far Eastern Centre for Disaster Medicine, medical and health after-effects, the river Amur, transboundary emergency, Khabarovsk region, chemical pollution
SANITARY-ANTIEPIDEMIC (PREVENTION) MEASURES IN EMERGENCIES
5. Butaev T.M., Gadzhieva G.K., Kabolova Z.Z. Sanitation and epidemic support of population exposed to terrorist attacks in North Ossetia–Alania Republic
Problems of organization and control over epidemic support in emergency in North Ossetia–Alania Republic are considered. Operation of the specialists of the State Sanitation and Epidemic Service Centres in emergencies in 2002–2004 in the Republic have been analyzed.
Key words: humanitarian cargo, epidemic regimen, terrorist attack, epidemic situation
6. Penzev A.A., Saveliev D.A. Experience of antiepidemic and antiepizootic procedures in avian flu foci of Omsk region
Organizational, antiepidemic and antiepizootic procedures in avian flu foci in Omsk region are considered. They are realized by public health service, Territorial Centre for Disaster Medicine (TCDM), Russian Consumer Surveillance Service, EMERCOM and bodies of executive power of different subordination in Omsk region. The role and place of TCDM and its subdivisions in the complex preventive system of counteraction to avian flu are emphasized.
Key words: veterinary service, pandemia, antiepizootic procedures, avian flu prophylaxis
20 YEARS AFTER CHERNOBYL ACCIDENT
7. Iljin L.A., Lyaginskaya A.M., Vasilenko I.Yu., Osipov V.A., Ermalitsky A.P., Savkin M.N., Grachev M.I., Avetisov G.M. Problems of iodine prophylaxis in Russia in case of radiation accident
The authors describe validity of the principles of the existing iodine prophylaxis in this country, levels of intervention and adopted doses of protective preparations from the point of view of modern knowledge. They state that possibility of cancer diseases progress may be reduced or even totally prevented using iodine prophylaxis, and to the larger extent using it in combination with other protective measures; the main principle of iodine prophylaxis must be an achievement of a maximum effect using minimum doses of potassium iodide for each age cohort.
Key words: potassium iodide, iodine prophylaxis, radioactive iodine, thyroid gland
8. Buldakov L.A. Present health state of the persons exposed to effects of the Chernobyl accident
The health state of the persons exposed to effects of the Chernobyl accident for a 20 year-old period has been analyzed. Differencies in the frequency of thyroid gland cancer of males, females and children are observed.
Key words: radiation dose, radioactive nuclides, thyroid gland cancer, Chernobyl accident
CLINICAL ASPECTS OF DISASTER MEDICINE
9. Gvetadze L.G., Kavtaradze G.V., Kwachadze T.K. Some aspects of association of psychoemotional disorders and gastrointestinal tract pathology of the injured in emergency
233 gastroenterological patients who were expos-ed to acute stress or suffered from chronic stressful situations were examined using a psychosocial inventory, method of a fixed attitude, questionnaries and tests. Severe socioeconomic environment where the patients live, severe psychological background, presence of psychopathological syndromes have been revealed. Personality characteristics and total adaptation background – prevalence of a dynamic type of a fixed attitude in combination with attitude weakness, right-sided interest of pair-organs functioning (hands, legs, organs of vision and hearing) in the distal areas have been established. The present assessment technique of the patients with a gastrointestinal pathology makes it possible to select psychoemotional parameters attributable to formation of gastroenterologic pathology, to determine personality characteristics defining an adaptation process.
Key words: study technique, gastrointestinal tract pathology, the injured in emergency, psychoemotional disorders
10. Kudrich L.A., Zhukov S.V. Long-term effects on teenagers health of their stay in the area of a complicated emergency
The article presents the results of the study of the effects on teenager health of their stay in a complicated emergency area. Main mathodological approaches are analyzed. Criteria for evaluating teenegers’ microsocial and psychological health are proposed.
Key words: complicated emergency area, microsocial health, long-term effects, teenagers, psychological health
11. Zhigunov A.K., Aslanov A.D., Kudryavtsev B.P., Mizaushev B.A., Logvina O.E., Oitov T.Kh. Diagnostics and medical management of the patients with concomitant injuries and trauma of extremities at a prehospital stage
New approaches intended for emergency medical care physicians are presented. They consider diagnostics and medical management of the patients with severe concomitant injuries and trauma of extremities at a prehospitl stage. At the beginning of evacuation efforts must be directed not at detection and elimination of morphological injuries but at life-threatening consequences of the injuries. Estimate of the quality of 102 patients transport immobilization has been conducted, as well as quality of 84 dressings in splints, including ladder, inflatable, etc. New approaches to anesthesiology and resuscitation in the emergency medical care have been suggested.
Key words: diagnostics, prehospital stage, infusion therapy, artificial pulmonary ventilation, trauma of extremities, emergency medical care, concomitant injury
12. Romanov V.V., Konin A.P. Medical aspects of radiation terrorist attacks at passenger facilities of railway transport and metro
Urgent problems of prevention and response to medical and health after-effects of radiation terrorist attacks (RTA) at passenger facilities of railway transport and metro are considered. The characteristic properties of RTA sites necessary to be taken into consideration in medical management of the victims are presented. Basic requirements for medical procedures to the victims affected by radiation, as well as requirements for radiation protection and radiation control of passenger facilities of railway transport and metro are formulated.
Key words: protective measures, railway transport, response to medical and health after-effects, medical and prophylactic measures, medical care, metro, passenger facilities, radiation terrorist attack, radiation terrorism
13. Yakhikhazhiev S.K., Kyudryavtsev B.P. Surgical management of abdominal gunshot injuries in central district hospital located in the zone of permanent local armed conflict
The experience of surgical management of abdominal gunshot injuries in a central district hospital located in the zone of permanent local armed conflict is presented (LAC). The conclusions have been drawn concerning the specific character of such management in a territorial medical facility in LAC.
Key words: zone of local armed conflict, abdominal gunshot injuries, surgical management, central district hospital
14. Preobrazhensky V.N., Alimov O.A., Zadorozhko M.G. State of immunity in forced migrants from the Chechen Republic
The indices of specific and non-specific immunity of the forced migrants from the Chechen Republic have been presented for the first time. It is proved that these people manifest pronounced changes of cellular immunity by way of reduction of T-lymphocytes primarily at the expense of T-helpers, and of humoral immunity – at the expense of A-immunoglobulin increase and G-immunoglobulin reduction. A considerable reduction of phagocytal activity, increase of immune complex titers, reduction of activity of microbidal systems as far as factors of non-specific protection are observed. All the above mentioned led to a great increase of pyoinflammatory diseases. It is proved that application of IRS-19 immune corrector facilitated correction of otolaryngological disorders and improvement in the course of these diseases.
Key words: forced migrants, immunity, IRS-19, otolaryngological diseases
15. Sakhno V.I., Magomedova A.Z. Estimation of diagnostic pitfall frequency of the urgently hospitalized therapeutic patients
The paper analyzes the concurrence of a diagnosis made by a medical facility (first-aid station, outpatient clinic, obstetrical post, etc.) that referred emergency therapeutic patients to hospital, an admission department of a central clinical hospital (CCH), with a final diagnosis; a number of diagnoses concurrence at admission (admission department of CCH), clinical and final diagnoses. These data may be applied for the estimate of the frequency of diagnostic pitfalls made by physicians of the medical facility that referred the patient, physicians of admission and secondary care departments of CCH.
Key words: municipal level, diagnostic pitfall frequency, urgently hospitalized therapeutic patients, stages of hospitalization
16. Goncharov S.F., Prostakishin G.P., Kekelidze Z.I., Sarmanaev S.Kh., Moskovkin A.S., Alimkhodzhaev A.Yu., Dalsaev M.A., Akhyadov U.B., Khamatov A.S. Mass morbidity in the Chechen Republic: toxic or psychogenic?
The paper gives analysis of the data concerning mass morbidity of presumably chemical origin. The pathological state is described that progressed in 81 patients. Their states were extrapolated to the modern conceptions describing general signs of acute chemical injuries. The conclusion is made about a sociogenic pathological state of the patients.
The algorithm of such patients management in emergency is suggested.
Key words: diagnostics, mass affection, chemical injury, sociogenia, disaster medicine
17. Stazhadze L.L., Spiridonova E.A., Lachaeva M.A., Zharov V.V., Potyomkin A.M., Krugovykh E.A., Botolova E.N. Pathogenetic aspects and specific therapy for closed heart injury in emergency
Specific nature of closed chest injuries taking place in explosions, technogenic and natural disasters, terrorist attacks, as well as pathogenetic aspects of blunt heart injury occurence as a result of a blast are considered. Critical care of the victims with a closed heart injury at a prehospital stage in emergency is demonstrated.
Key words: arterial pressure, prehospital stage, closed chest injury, critical care, artificial pulmonary ventilation, blunt heart injury, emergency, electrocardiogram
18. Antonov V.M., Gorsky A.N., Kukushkin N.A., Anfinogenov A.L., Zherlitsyna L.G. Organization of activity of mobile neonate resuscitation team on the basis of Territorial Centre for Disaster Medicine in Yaroslavl region
In 2002 a specialized neonate resuscitation team was set up as a result of joint activity of Yaroslavl neonatal department and a clinical department of Territorial Centre for Disaster Medicine in Yaroslavl region. The tasks of the team are the following: medical/consultative assistance and transportation of neonates from different hospitals in the region. Since the onset of its work annual increase of the visits to sick nonates has been recorded, more than 80% of the infants have been transported to the specialized centres in Yaroslavl. Delivery of a secondary medical care made it possible to reduce neonate mortality level fourfold, and neonate mortality index from 13.2% in 2001 to 10.6% in 2004.
Key words: medical/consultative assistance, neonate mortality, neonatal resuscitation, specialized neonate resuscitation team, Territorial Centre for Disaster Medicine
19. Shamov S.A., Tsygankov B.D., Shulyak Yu.A., Tyuneva A.I. Possibility of xenon application in medical care delivery to the injured in emergency
Pharmacological properties of xenon are given. Data of its application in a narcological practice as an analgetic and antipsychotic are enumerated. The drug is recommended for application as an analgetic and antipsychotic preparation in delivery of medical care to the injured in disasters and emergencies at a prehospital stage.
Key words: anesthesia, xenon, reactive psychotic state
20. Nikolenko V.K., Buryachenko B.P. Specific pattern of secondary endoprosthesis of hip joint
The paper describes technique of secondary endoprosthesis of a hip joint, its specific pattern, adjustment and validity of the use of a necessary implant. A special attention is given to a complex treatment of patients with purulent complications following endoprosthesis.
Key words: implant, secondary endoprosthesis, hip joint
21. Kudryavtsev B.P., Vtorenko V.I., Shishlo V.K., Biryulya A.O. Efficacy of rocefin parenteral introduction in prophylaxis and treatment of pyoinflammatory complications of extremity gunshot wounds
Efficacy of rocefin parenteral introduction in prophylaxis and treatment of pyoinflammatory complications of extremity gunshot wounds has been analyzed. All types of such introduction are considered: intravenous, endolymphatic, lymphotropic. The conclusion has been made stating that rocefin endolymphatic introduction can be successfully used as a «starting» antibiotic in complex prophylaxis and treatment of pyoinflammatory complications of extremity gunshot wounds.
Key words: pyoinflammatory complications, treatment, extremity gunshot wounds, parenteral introduction, prophylaxis, rocefin