Great experience with treatment and a comprehensive investigation of the severe combined trauma allowed the authors to choose six basic principles to be followed in diagnosing and treatment of this surgical pathology whose peculiarity is the phenomenon of mutual aggravation of the injuries. Following these principles, especially at surgical hospitals, promotes complete diagnosing, choice of the rational treatment policy in order to avoid medical errors and severe posttraumatic and postshock complications and to improve the outcomes. The authors prove expediency of organization of the multifield specialized centers for treatment of patients with the severe combined traumas.
The analysis of emergency surgical care in medical institution of Moscow for the last 20 years is presented in the article. There were 912 156 patients with acute appendicitis, strangulated hernia, perforated gastro-duodenal ulcer, gastro-duodenal bleeding, acute cholecystitis, acute pancreatitis, acute intestinal obstruction on treatment during this period. It was observed reduction overall and postoperative mortality. It was concluded that positive results are caused by development of material and technical base, transition on clock mode of diagnostic units, increase of patients? number hospitalized in department of intensive care for operation training and after it, using of modern diagnostic and therapeutic methods, edit documents regulating of health facilities activity according to medicine development.
The article deals with the analysis of quality of training of paramedical personnel in the medical colleges of Kursk oblast during last ten years. It is established that during last decade the number of graduates of the Kursk medical college has a tendency to decrease. If in 2001 the college graduated 169 medical nurses, 44 feldshers, and 30 midwives (243 in total) then in 2011 graduated 121 medical nurses, 64 feldshers (185 in totals). The number of college entrants with 11th grade is decreasing against the background of increasing of number of college entrants with 9th grade. Basically, the educational institutions are completed with graduates of rural schools whose resources are limited. The graduates from urban schools have no intent to acquire the profession of medical nurse. Hence, in Kursk oblast under annual decrease of number of paramedical personnel concurrently decreases number of graduates of medical colleges. This situation makes quite problematic the making up of manpower resource both in nowadays and in near-term outlook.
The article considers the results of functioning of the Surgut station of emergency medical care concerning redirection of calls of acute medical care service because of emergency conditions in territorial medical organizations in 2013-2016. The analysis demonstrated that the redirection of 10% of overall calls resulted in decreasing of day load of emergency medical care team from 15.8 calls in 2013 up to 13.3 calls in 2016. The timely qualified medical care support resulted in increasing of number of successful reanimation activities that testifies the increase of efficiency of emergency medical care service in case of life-threatening conditions.
Studies of the systems of medical care for patients with acute disorders of brain circulation indicate that well-organized "stroke" service promotes morbidity decrease, lowers neurological deficit expression and restriction of social and daily activities. At the same time, there are essential differences in the scope of the medical care, which a patient can receive in different countries and no consensus on the most optimal system of medical scope for patients with stroke at different stages. The recent statistical reviews confirm that a patient admitted to specialized stroke departments has a less chance to die or to be a handicap. The article analyzes current systems service for patients with acute disorders of brain blood circulation in the United States, Europe and Russia.