Nº 4 (2023)

Summary. Objectives of the study are as follows: on the basis of studying and analyzing methodological approaches to assessing the severity of human losses in terrorist acts committed with the use of conventional means of destruction to develop proposals for further improvement of these methodological approaches; to assess the severity of human losses being the result of terrorist attacks committed on the territory of Russia in 1999-2005.

Materials and research methods. The materials of the research are normative and methodical documents regulating the procedure of assessment of human losses in emergency situations, including terrorist acts; reports of territorial centers for disaster medicine about terrorist acts committed on the territory of Russia in 1999-2005; data of survey maps and expert evaluation of the subject of the research; scientific works and publications devoted to methods of assessment of severity of consequences of emergency situations and terrorist acts. The following scientific methods were used in the study: content analysis method, method of expert evaluation, statistical and analytical methods.

Results of the study and their analysis. The results of the study of methodological approaches to assessing the severity of human losses in terrorist attacks and other emergencies are presented. Reasoned proposals are made to improve the methodological approaches to assessing the severity of human losses in terrorist acts and to use a comprehensive integral methodological approach for this purpose. The results of the research have shown that the existing technologies of determining the severity of human losses in terrorist attacks do not allow to have objective and complete reliable data on the injured, on the volume and specificity of work performed by medical workers in providing medical care and medical evacuation in the course of saving lives and preserving health of the injured in terrorist attacks. Using the proposed complex integral methodological approach, an assessment of the severity of human losses in terrorist acts committed on the territory of Russia in 1999-2005 is given.

Summary. The aim of the study is to justify and to develop a set of measures to improve the educational process in the discipline of “Disaster medicine” for students in the specialty “Medical business” of medical school with the further formation of their professional competencies required to perform professional activities in emergency situations of natural and man-made nature.

Materials and research methods. Materials of the study were the electronic logs of registration of students’ training in “Disaster medicine” working program at the Altai State Medical University of the Ministry of Health of Russia in the period from February 1, 2021 to June 30, 2023. For statistical analysis we used categorical variables presented in the form of extensive indicators and percentages. Statistical processing of data was performed using the package of applied statistical programs “Statgraphics”.

Results of the study and their analysis. The analysis of the research results showed that the integrated approach to the process of training students in disaster medicine allowed to significantly increase the level of their knowledge, as well as their ability to summarize and to evaluate the information obtained on the basis of the study of non-standard situations.

Summary. The data are considered on conducting telemedicine consultations in 2021-2022 under “doctor – doctor” scheme with participation of attending physicians and consulting physicians of medical organizations (MO) of the Federal Medical and Biological Agency (FMBA of Russia). The division of telemedicine consultations by medical profiles, forms and types is given. The conclusion is made: ensuring the availability and quality of medical care with the use of telemedicine technologies in remote interaction between medical specialists is directly related to the possibility of conducting telemedicine consultations with the participation of medical specialists of MOs of different departmental affiliation in the presence of common information space, including under the conditions of liquidation of medical and sanitary consequences of emergency situations.

Summary. The aim of the study is to analyze the data on mortality, structure of injuries, terms of hospitalization, routing of patients and organization of medical care for children injured in armed conflicts and terrorist acts.

Materials and research methods. A systematic review was performed in accordance with the recommendations of the PRISMA protocol. A comprehensive search was conducted in PubMed, ScienceDirect, E-library, and GoogleScholar databases for the period from 1995 to 2022. The search revealed 2995 publications, of which 25 papers were included in the quantitative analysis according to the inclusion criteria.

Results of the study and their analysis. We analyzed 54205 cases of medical care for children injured in 15 armed conflicts and 48 terrorist attacks between 1988 and 2020. The average age of the injured children was 9.7 years; the proportion of children in the total mass of the injured was 12.7%. The average percentage of bed days in children was 10.9%; the average duration of hospitalization was 7.4 days; 82% of patients required surgery; the pediatric mortality rate was 7.6%. The most common mechanisms of injury in children were shrapnel and explosive wounds; the most frequent cause of death was craniocerebral trauma.

Summary. The aim of the study is to investigate the peculiarities of sanitary aviation work in the Republic of Sakha (Yakutia) during the COVID-19 pandemic. Materials and research methods. The subject of the study is the work of the Disaster Medicine Service of the Republic of Sakha (Yakutia); the object of the study is the volume and structure of sanitary tasks performed during the spread of the new coronavirus infection COVID-19. Research methods were analytical methods, methods of expert evaluation and mathematical analysis. Results of the study and their analysis. A comparative analysis of the main performance indicators of the Republican Center for Disaster Medicine of the Republic of Sakha (Yakutia) in 2020-2022 is presented. The results of the study indicate that during the spread of a new coronavirus infection COVID-19 the air ambulance service of the Republic worked with increased workload. Under the conditions of COVID-19 pandemic, emergency medical care and medical evacuation of not only patients with severe form of new coronavirus infection, but also of patients with other nosologic forms of diseases requiring emergency medical intervention were provided. The conclusion about the acute urgency of using sanitary aviation in vast sparsely populated areas of other regions is made.

Summary. The aim of the study is to evaluate the possibility of using the technology of emergency superdeep hypothermia (ESH), which consists in rapid cooling of vital organs (up to 10 °C) and the whole body (up to 20 °C), in the conditions of simulation of stage treatment of the wounded with traumatic cardiac arrest (TCA) during the annual tactical-special military-medical exercise “Ochag” in the training center of the Military Medical Academy named after S.M. Kirov.

Materials and research methods. A mobile resuscitation and surgical team consisting of two surgeons, one anesthesiologist-surgeon, an anesthesia nurse, and an operating room nurse was formed for the study, which was placed in a reinforced concrete bunker located slightly away from the main evacuation routes for the wounded (simulants). The personnel of the team, represented by the staff of the Special Medical Unit (SMU) of the Military Medical Academy, was reinforced by a surgeon trained in the use of extracorporeal membrane oxygenation and experienced in the use of this technology in the clinic in order to practice new technologies. The main tasks of the team included: primary surgical care of seriously wounded patients in case of a small incoming flow and primary medical and sanitary care in case of mass admission of the wounded.

Results of the study and their analysis. The results of the study showed the potential possibility — primarily from the point of view of logistics and organization — of medical evacuation of a casualty in the state of ESH between the deployed stages of medical care. In the course of the experiment it was established that the duration of medical evacuation in hypothermic circulatory arrest should be less than 120 min. It is concluded that it is necessary to carry out additional research to determine the optimal parameters of the application of the ESG technique for the rescue of victims with TCA.

Summary. The objectives of the study are to examine the international experience in the sphere of normative-legal regulation of the practice of remote counseling of eyewitnesses of an event by first aid emergency dispatchers, to assess the existing legal prerequisites for the introduction of the first aid dispatcher service in our country and to determine the priority directions of improvement of the domestic normative-legal base in order to create conditions for the successful implementation of the practice in the Russian Federation at the federal level.

Materials and research methods. A search of scientific literature on the topic of the study in Russian and English by combinations of keywords was performed in 2023. Additional search was carried out in the bibliographic lists of the publications included in the review. The search and analysis of normative legal acts of the Russian Federation was carried out with the help of reference legal systems Garant and ConsultantPlus.

Results of the study and their analysis. The authors have formulated and proposed for discussion by the professional community a number of normative proposals aimed at the systematic organization and ensuring the effective implementation of first aid dispatcher service practice in the Russian Federation at the federal level.