Email this article Analysis of Performance in Routine Of Daily Activities of the Operational Administrative Service of the Moscow Department of Health in Providing Quality Medical Care to Population in 2017-2021
- Authors: Veklich A.V.1, Gumenyuk S.A.1, Fedotov S.A.1, Evelson L.S.1, Vechorko V.I.2
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Affiliations:
- Moscow Territorial Scientific and Practical Center for Disaster Medicine (TSEMP) of the Moscow City Health Department
- City Clinical Hospital No.15 named after O.M.Filatova of the Moscow City Health Department
- Issue: No 2 (2022)
- Pages: 36-41
- Section: Public Health and Healthcare
- URL: https://bakhtiniada.ru/2070-1004/article/view/360229
- DOI: https://doi.org/10.33266/2070-1004-2022-2-36-41
- ID: 360229
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Abstract
Abstract. The aim of the study was to improve the results of treatment of patients with severe combined trauma of the organs of several cavities (skull, thoracic and abdominal cavities, retroperitoneal space) and of the musculoskeletal system.
Materials and research methods. The study involved 72 patients treated between 2013 and 2017 in a Level I trauma center established at the Republican Clinical Hospital of the Ministry of Health of the Kabardino-Balkarian Republic.
The Injury Severity Score (ISS) index was used to determine the severity of injury; “department of military field surgery, condition, admission” scale was used to assess the state of the injured.
Results of the study and their analysis. Analysis of the findings showed the following: in severe combined injuries the main causes of death are: shock, cerebral edema and dislocation, posttraumatic pneumonia, multiple organ failure, acute respiratory failure, pulmonary embolism and DIC syndrome.
The most satisfactory treatment outcomes can be achieved only with the use of a care tactic based on the principles of staged surgical treatment “Damage control”.
The time frame and the sequence of surgical treatment of injuries depend on their severity, degree of life threatening and prevailing injury.
About the authors
A. V. Veklich
Moscow Territorial Scientific and Practical Center for Disaster Medicine (TSEMP) of the Moscow City Health Department
Email: dr.anna@bk.ru
Doctor-Methodologist of Operational and Administrative Service of Centre of Emergency Medical Care Moscow
S. A. Gumenyuk
Moscow Territorial Scientific and Practical Center for Disaster Medicine (TSEMP) of the Moscow City Health Department
Email: dr.anna@bk.ru
Moscow
S. A. Fedotov
Moscow Territorial Scientific and Practical Center for Disaster Medicine (TSEMP) of the Moscow City Health Department
Email: dr.anna@bk.ru
Moscow
L. S. Evelson
Moscow Territorial Scientific and Practical Center for Disaster Medicine (TSEMP) of the Moscow City Health Department
Email: dr.anna@bk.ru
Moscow
V. I. Vechorko
City Clinical Hospital No.15 named after O.M.Filatova of the Moscow City Health Department
Email: dr.anna@bk.ru
Moscow
References
- Men’shikov A.A., Bondarenko A.V., Shemakh Ye.A. Operativnoye Vosstanovleniye Karkasa Grudnoy Stenki u Bol’nykh Politravmoy s Mnozhestvennymi i Fragmentarnymi Perelomami Reber = Surgical Restoration of the Chest Wall Frame in Patients with Polytrauma with Multiple and Fragmentary Rib Fractures. Materials of the IX All-Russian Congress of Traumatologists-Orthopedists. V.2. St. Petersburg Publ., 2018 P. 460-462 (In Russ.).
- Nazarov Kh.N., Linnik S.A. Profilaktika I Lecheniye Oslozhneniy Perelomov Dlinnykh Kostey Nizhnikh Konechnostey pri Sochetannykh i Mnozhestvennykh Travmakh = Prevention and Treatment of Complications of Fractures of the Long Bones of the Lower Extremities with Combined and Multiple Injuries. Materials of the IX All-Russian Congress of Traumatologists-Orthopedists. V.2. St. Petersburg Publ., 2018. P. 478-480. (In Russ.).
- Porkhanov V.A., Baryshev A.G., Blazhenko A.N., Shevchenko A.V., Mukhanov M.L., Shkhalakhov A.K., Polyushkin K.S. Results of Treatment of Patients with Polytrauma in a Multidisciplinary Clinic. Khirurgiya. Zhurnal im. N.I. Pirogova = Pirogov Journal of Surgery. 2018;12:82-85 (In Russ.).
- Barashov A.Yu., Pronskikh A.A. Ways to Reduce Complications and Mortality in Patients with Polytrauma in Level 1 Hospitals. Sbornik Tezisov IX S’yezda Travmatologov Ortopedov. Collection of Abstracts of the IX Congress of Traumatologists. V.1. Saratov Publ., 2010. P. 89 (In Russ.).
- Goncharov S.F., Bystrov M.V., Kudryavtsev B.P., et al. The Problem of Multiple and Associated Injury (Polytrauma), the Ways of Solution and the Role of Disaster Medicine Service. Politravma = Polytrauma. 2016;2:23-26 (In Russ.).
- Miziev I.A., Baksanov Kh.D., Zhigunov A.K., Akhkubekov R.A. Hospital Mortality in Combined Injury and the Ways of Its Reduction. Zdorov’ye i Obrazovaniye v XXI Veke. 2018;12:116-119 (In Russ.).
- Joyce M.F., Gupta A., Azocar R.J. Acute Trauma and Multiple Injuries in the Elderly Population. Curr. Opin. Anaesthesiol. 2015;28:145–150.
- Meek R.N., Vivoda E.E., Pipani S. Compozison of Mortality of Patients with Multible Iniuries According to Type of Fracture Treatment. A Retrospective Age- and Iniurymached Series. Injury. 1986;17;1:2–4.
- Kalinkin O.G., Gridasov Ye.I., Kalinkin A.O., Shevchenko V.T. Opyt Lecheniya Bol’nykh s Sochetannoy Travmoy Organov Neskol’kikh Polostey i Oporno–Dvigatel’noy Sistemy = Experience in the Treatment of Patients with Concomitant Trauma to the Organs of Several Cavities and the Musculoskeletal System. Diagnostika i Lecheniye Politravm = Diagnostics and Treatment of Polytrauma. Conference Proceedings. Leninsk-Kuznetskiy Publ., 1999. P. 196-197 (In Russ.).
- Mukhametzhanov KH., Shakenov D.I., Ivanov V.V., Grubin M.A. Cherepno-Mozgovaya Travma, Sochetannaya s Povrezhdeniyami Grudnoy Kletki i Organov Bryushnoy Polosti = Craniocerebral Trauma, Combined with Injuries of the Chest and Abdominal Organs. Lecheniye Sochetannykh Travm i Zabolevaniy Konechnosti = Treatment of Concomitant Injuries and Diseases of the Limb. All-Russian Anniversary Scientific and Practical Conference. Moscow, 30 September-1 October, 2003. Moscow Publ., 2003. P. 230-231 (In Russ.).
- Reviel of Patients with Multiple Inquiries Treatment at University Hospital Kuala-Lumpur. J. Trauma. 1984;24:526–521.
- Watt I. McA Ledingtam I. Mortality Amongst Multiple Trauma Patients Admitted to an Intensive Therapy Unit. Anaesthesia. 1984;39;10:973–981.
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