ORGANIZATION AND TACTICS OF DISASTER MEDICINE SERVICE

1. Stazhadze L.L., Potapov V.I., Buk T.N., Lagutin A.S. Performance Data on Medical Care Provision to Emergency Situations Casualties by Hospitals of Emergency Medical Care Service of Moscow

Some performance data on medical care provision to emergency situations casualties by hospitals of the Emergency Medical Care Service (EMCS) of Moscow are furnished. The analysis of materials relating to hospital allocation, emergency situation types, patient medical status and outcomes is carried out. The main functions of the new subsystem «The Hospital Stage» of the automated information system «EMCS-Preparedness» are presented.

Key words: emergency situation casualties, hospitals of emergency medical care service, subsystem «The Hospital Stage» of «EMCS-Preparedness» system

2. Apechkin N.N., Nurieva Eh.G. Capabilities of Municipal Health Services of Risk-Zone Cities of Republic of Tatarstan in Rendering Emergency Medical Care to Disaster Victims (Expert Assessment)

Resources availability at health care facilities of municipalities in earthquake-prone zones in the territory of the Republic of Tatarstan as well as their preparedness for work in emergency situations are studied. The capabilities of health service to render emergency health care to victims with mechanical and burn traumas resulting from fuel-air mixture explosion are defined and the scope of sanitary losses is estimated.

Key words: emergency preparedness of health care facilities, estimation of sanitary losses, hazard zones in Tatarstan, resources availability at municipal health care facilities

3. Avetisov G.M., Batrak N.I., Lishakov V.I. Training, Planning and Organization of Iodine Prophylactrics of Population – the Task of Territorial Level of Disaster Medicine

Provisions on organization of cooperation of federal executive bodies, country’s atomic energy authority, executive bodies of subjects of the Russian Federation, local authorities and a nuclear plant operating entity in case of radiation accident at a plant are presented. The main tasks and functions of Ministry of Health and Social Development as well as of the Federal Medical Biological Agency and Rospotrebnadzor (sanitary inspection) under its jurisdiction in carrying out rescue work and emergency measures in radiation accident zone are analyzed. The course and results of the drills to probe the main points of the provisions are discussed.

Key words: Federal Medical Biological Agency, main tasks and functions, Ministry of Health and Social Development of Russia, radiation accident zone, rescue work and emergency measures, Rospotrebnadzor


CLINICAL ASPECTS OF DISASTER MEDICINE

4. Kopysova V.A., Kaplun V.A., Tsaj D.A., Nysambaev S.Z., Zolotukhin A.V., Kutkov A.A. Osteosynthesis in Patients with Trochanteric Fractures

In performing osteosynthesis in 90 patients with extraarticular fractures of thighbone proximal segment to prevent screws migration and bone fragments redislocation the external constructions were fixed with shape-memory effect ring-shaped tightening clamps. Interfragmentary compression of bone fragments was done with S-shaped and ring-shaped tightening clamps.

The fixation of the affected segment was done with a rod-shaped device, an intramedullary nail, an angle plate, and a modified Bogdanov’s pin. Treatment results of 57 patients were examined and in 46 of them (80,7%) limb functions were recovered and was attained the life quality as prior to trauma.

Key words: osteosynthesis, patients with extraarticular fractures of thighbone proximal segment, shape-memory effect constructions

5. Verigo E.N., Gundorova R.A., Susaykova M.S., Kudinova N.G. Specifics of Urgent Care of Victims of Emergency Situations with Ophthalmic Trauma

The contribution is dedicated to the issues of diagnostics, treatment tactics and methods in case of ophthalmic traumas at the stage of emergency specialized medical care that allow to shorten rehabilitation period length and to lessen frequency of complications and alleviate their severity.

Key words: eye traumas, urgent care

6. Girsh A.O., Stukanov M.M., V.N.Lukach, Volkova K.G., Gorin P.A., Trifonov S.B., Kulichenko M.Yu., Khrapov S.A. Experience of Use of Principle of Balanced Infusion Therapy of Hemorrhagic Shock at Prehospital Stage

The authors present the results of prehospital treatment of hemorrhagic shock patients with balanced isotonic salt crystalloid solution of 4% oxypolygelatin. They also evaluate the influence of the solution on plasma and vascular-trombocyte hemostasis. It is established that optimized and balanced infusion therapy of hemorrhagic shock cases attain stabilization of the system hemodynamics and favours overall amelioration. Moreover balanced infusion therapy of the cases do not induce negative parameter changes either in plasma and vascular-trombocyte hemostasis, or in electrolytic balance.

Key words: 4% oxypolygelatin, hemorrhagic shock, infusion therapy, plasma and vascular-trombocyte hemostasis

7. Puras Yu.V., Talypov A.Eh., Krylov V.V. Risk Factors of Failure in Patients with Severe Concomitant Craniocerebral Injury

An analysis of risk factors of surgical result in 272 injured with heavy craniocerebral trauma is done. The data were obtained from clinical laboratory evaluation of all the patients. The most significant adverse predictors were correlated with literature findings.

Key words: concomitant craniocerebral injury, outcome prognosis, risk factors

8. Balnykov S.I., Gorskiy A.N. Use of Percutaneous Interventions under Ultrasonography in Medical Care of Patients with Pancreatonecrosis

The experience is analyzed of use of percutaneous interventions under ultrasonography in case of acute parapancreatic fluid collections by doctors of a temporary team of the Territorial center for disaster medicine of Jaroslav Oblast treating patients with pancreatonecrosis.

It is found that percutaneous punctures and drainage with pancreatonecrosis patients should be used at the stage of qualified medical care and in surgeries of central regional hospitals. Puncture procedures are diagnostics methods in case of acute pancreatitis and its infectious complications. Drainage of parapancreatic fluid collections in case of more than half patients with mild clinical course either helps to attain full recovery without surgery or leads to pancreatic fistula formation. These procedures are inefficient with severe acute pancreatitis and the patients should be moved as soon as possible to intensive care units of oblast capitals.

Key words: pancreatonecrosis, percutaneous interventions under ultrasonography, territorial center for disaster medicine

9. Beganova T.V., Preobrazhensky V.N., Kovalyova N.Yu., Gunkina I.V., Filippova G.E. Modern Approaches to Cardiovascular Disease Risk Factors for People in Hazardous Occupations

Examination of 567 persons in hazardous occupations with diagnosed obesity (as defined by WHO criteria) was carried out. It is proved that besides physical inactivity – diet, insulin resistance, arterial hypertension and hypoleptin are risk factors. A corellation between the risk-factor complex and cardiovascular disease is proved (up to 35%) and early prophylaxis of these factors is recommended.

Key words: obesity, people in hazardous occupations, prophylaxis of cardiovascular diseases, risk factors of cardiovascular diseases

10. Pogodin Yu.I., Bochenkov A.A., Pyatibrat A.O., Panov P.B., Andriyanov A.I. Functional Nutrition in Rehabilitation of Military Personnel after Missions under Extreme Conditions

Biochemical, clinical and psychophysiological tests reveal inadequacy of nutrition and energy composition of food rations of military personnel of power structures when acting outside their regular stations. The need for items of functional nutrition to enhance the efficiency of rehabilitation of personnel after such missions is substantiated. A complex of products for functional nutrition aimed at alimentary rehabilitation is developed and an assessment of its efficiency is done.

Key words: extreme conditions, functional nutrition, military personnel, nutritional supplements, performance efficiency, rehabilitation

11. Igonin V.A., Zuev V.K.,Usmanov D.M. Specific Features of Clinical Course of Pneumonia and its Influence on Outcome of Victims with Ballistic Abdominal Wounds

The results of the study of clinical course of pneumonia in victims with ballistic abdominal wounds are presented. It is shown that pneumonia was the most frequent complication of penetrating abdominal wounds in 193 victims (31.6%). Blurring of clinical implications is the peculiarity of pneumonia in patients with abdominal wounds, and in patients with lethal outcome the fatality depended on peritonitis severity and blood loss volume.

Key words: ballistic abdominal wounds, pneumonia


MEDICAL ASPECTS OF ROAD TRAFFIC SAFETY

12. Kurbanov K.M., Gadzhiev A.N., Tagirova G.K. Accidents on Automobile Roads and Efforts to Mitigate Severity of their Consequences in Republic of Dagestan

Materials on road traffic accidents in the Republic of Dagestan and their medical and sanitary consequences are presented. The work of Dagestan Center for disaster medicine in medical support of road traffic safety in the Republic is described. The main directions of further activity in realization of the Federal target program “Improvement of Road Safety in 2006-2012” in the Republic of Dagestan are charted.

Key words: Dagestan Center for disaster medicine, medical and sanitary consequences, Republic of Dagestan, road traffic accidents

13. Special Tactical Training Exercises on Organization of Medical Care Rendering to Victims of Road Traffic Accidents on Boundaries of Areas of Responsibility of Medical Facilities


ACTUAL PROBLEMS OF SPECIALIZED (AEROMEDICAL) EMERGENCY MEDICAL CARE

14. Tsap N.A., Popov V.P., Chernyadiev S.A., Karlov A.A., Ogarkov I.P. Integration Model of Organization of Emergency Surgical Service Rendering to Children. From Experience of Sverdlovsk Oblast

A model is presented of organization of emergency surgical and resuscitation care delivery to children based on integration of personnel, diagnostic and treatment, information and consultative, medical evacuation capabilities of children’s multi-field clinical hospitals and the territorial center for disaster medicine (TCDM) of Sverdlovsk Oblast. An analysis is done of sanitary task performance, of structure of sanitary task packages in different parts of the Oblast, of the work of mobile pediatric consultative, treatment and evacuation teams, of efficiency of implementation of the cooperation model between the TCDM and the regional pediatric surgical service.

Key words: emergency surgical and resuscitation care for children in Sverdlovsk Oblast, integration model, territorial standard


EDUCATION AND TRAINING OF PERSONNEL

15. Pogodin Yu.I. Nikolaevsky E.E. Formation of Sectoral System of Training and Upgrading of Specialists in Mobilization Preparedness of Health Service and in Disaster Medicine

Level of training of medical specialists of health service is one of the factors of its augmenting the service’s readiness for functioning in mass casualty events.

To solve the problem, in accordance with the decision of the Ministry of Health Service and Social Development of Russia, chairs of mobilization preparedness and disaster medicine were set up at the state institutions of higher and additional professional education in place and on the basis of the discontinued chairs of military and extreme medicine. To form full-fledged chairs it is necessary to enhance teaching methods, to elaborate study guides, to create educational infrastructure and facilities, to lay down the guidelines of scientific research.

Key words: chairs of mobilization preparedness and disaster medicine, educational programs, medical care of population, scientific research, student body

16. Sakhno I.I., Matveichuk V.S. Results of Postgraduate Training of Healthcare Specialists at All Russian Center for Disaster Medicine «Zaschita» in Disaster Medicine in 2009 and Tasks of its Perfection in 2010

The educational activity of ARCDM «Zaschita» in 2009 was aimed at perfection of knowledge of Russia’s healthcare specialists in disaster medicine specialty. As many as 539 people enhanced their skills in 39 educational cycles. A special attention was paid to training of health workers in rendering first aid to victims of road traffic accidents. It is planned to run 31 educational cycles for workers in different areas of medicine in 2010.

Key words: educational programs in disaster medicine, first-aid skills, further education cycles for medical workers

17. Popov A.V., Baranova N.N. Training of Specialists of Aeromedical Teams at Center of Aeromedical Evacuation and Emergency Medical Care in 2009

Work of the department of methodological support of aeromedical teams training in 2009 is shown and plans for the coming year are presented. The problems unsolved at present time are highlighted.

Key words: aeromedical evacuation, aeromedical team, All Russian Center for Disaster Medicine, department of methodological support, teaching programs, training course


SANITARY-ANTIEPIDEMIC (PREVENTION) MEASURES IN EMERGENCIES

18. Konyshev I.S., Pravilnikova N.V., Kochetkov A.V., Kazansky A.G., Zakharov V.A., Zheleznyak V.N. On Elaboration of Intellectual Support System for Decision Making in Liquidation of Consequences of Bioterror Attacks

Bioterror countermeasures call for rapid and well coordinated actions of different levels of medical service. To meet the challenge the Scientific research institute for communication and command has elaborated a program of intellectual support of decision making for medical services leaders assuming responsibility for measures for liquidation of consequences of bioterror acts. Expert systems are worked out for identification and assessment of infection dissemination risks, for detecting the major routes and factors of biological agents transmission, for bioterror attack verification. A system is prepared for information on and estimation of medical and sanitary consequences of bioterror acts and assets necessary for their liquidation.

Key words: bioterrorism, intellectual support system, liquidation of consequences of bioterror acts, terrorism means

19. Akimkin V.G., Galin L.L. The Issues of Safety Control in Medical Waste Handling

The organization of handling of medical waste is presented. The classification of waste, its collection, interim storage, transportation and decontamination are discussed.

Key words: medical waste classification, medical waste, organization of medical waste handling


SHORT REPORTS

20. Nurieva Eh.G., Apechkin N.N. Study of Natural Risk Factor of Emergency Situations as the Major Casualty Threat to Population of the Republic of Tatarstan

21. Kardanov A.V., Akin’shin A.V. Participation of Specialists of Kabardino-Balkar Center for Disaster Medicine in Rendering Medical Care to Victims of a Road Traffic Accident with Grave Consequences


INFORMATION

22. «Traffic Safety Forum 2009» November 17–20,2009

23. Medical Care for Victims of Earthquake in Indonesia


CONFERENCES, SIMPOSIA, MEETINGS, EXHIBITIONS

24. All-Russia Research and Practice Conference on Perfection of Medical Care Rendering to Victims of Road Traffic Accidents

25. Methodological Seminar on Medical Care Rendering to Victims of Road Traffic Accidents with Use of Helicopters