№ 1 (2023)

Summary. The experience of work of FSO “SSC – Federal Medical and Biophysical Center named after A.I. Burnazyan” of FMBA of Russia to provision of radiation-hygienic measures in the support of works to elimination of nuclear researching objects in Arctic zone of the Russian Federation and to provision of radiation safety of people who live near these objects was presented.

As a result of provision of radiation-hygienic measures the following tasks were solved:

– to define the priority directions for regulation in the radiation safety the radiological threats were assessed;

– a detailed analysis of radiological situation in the temporary storage points (TSP) of its spent nuclear fuel (ISNF) and nuclear waste (NW), on their yards and in the monitoring zones and in the areas of people living was done;

– the measures for providing of radiation safety of stuff and people who live near radiation dangerous objects (RDO) were kept;

– a culture of safety during a monitoring and control of risks of stuff professional reliability violation was ensured.

– an expertise of the projects of documents about a rehabilitation of polluted areas was completed;

Summary. Investigation purposes – to make reasonable a usage of equipment report card of specialized medical-nurses teams (MNT) of Service of disaster medicine (SDM) of Altay region (Service), made for elimination of medical-sanitary consequences of emergency situations (ES), including cases of conducting antiterrorists operations; to teach specialists, according to crated situation exercises, from Service a skills of medical sorting conduction of victims and injured with gunshot and shrapnel wounds in the conditions of field medical sorting point (FMSP).

Materials and methods of investigation. Investigation materials – normative legal acts in the spere of organization and conducting of antiterrorists exercises with attracting of forces and means of SDM, including material of inter-department work group which leads by deputy Governor of Altay region. Legislative and regulatory framework were analyzed. Experience of conducting a command-staff exercises (CSE) and elimination of medical-sanitary losses, including losses in case of antiterrorists operations, was researched. It allowed to assess a system of medical treatment provision and to develop a complex of measures for Service improvement. During summarizing of exercises results of the intermediaries reference was analyzed.

Investigation results and their analysis. During the exercise to eliminate a medical-sanitary consequences of ES a work of Service forces and measures in pre-hospital periods was organized; FMSP was deployed; Ensuring of temporary medical points for providing round-the-clock urgent medical help in the points of temporary placement (PTP) of population by the forces of SDM was provided for; Provision of psychological help was ensured by specialists from Altay region clinical psychiatrist hospital named after Y.K. Ardman. In addition, members of unregular former of Altay region bureau of forensic medical examination were on alert. This way, all forces and measures of SDM were ready for the elimination of medical-sanitary consequences of ES according to the plan for municipal formers.

Summary. Investigation purpose – to analyze and summarize data about medical-sanitary consequences of major emergency situations (ES) in the world for last 10 years (2012–2021).

Materials and methods of the investigation. An object of investigation – data base about major ES in the world (The Emergency Events Database, EM-DAT: OFDA/CRED) [https://public.emdat.be/]. Average annual data is presented by median, upper and lower quartiles (Me [q25; q75]). Risks of injury, illness or death because of ES were calculated for 1 million people (10–6). Analysis of dynamic of changing medical-sanitary indicators of consequences of major ES in the world were provided by analysis of dynamic series with calculating of 2nd stage polynomial trend and determination coefficient.

Investigation results and their analysis. From 2012 till 2021 in EM-DAT data base 5533 major ES were presented, including 877 natural disasters, 1814 technogenic disasters. With low determination coefficients polynomial trends show, as rule, a tendency of ES number reduction, decreasing of risks of injury, illness and appearance of ES with medical-sanitary consequences.

Summary. The main issues of provision of medical help and treatment with usage of tele-medical technologies (TMT) were considered, including victims in emergency situations (ES), in medical treatment organizations (MTO) of Federal Medical and Biological Agency (FMBA of Russia). Noticed that an experience of conducting of tele-medical consultations (TMC) which was made in All-Russian Center of Disaster Medicine “Zashchita” (was handed over to FMBA of Russia in 2020) allowed to increase number of MTO of FMBA of Russia which are participated in conducting of medical consultation by the scheme “doctor-doctor”. Underlined that 2020-2021 became the key years for development of tele-medical consultations system of FMBA of Russia because of a necessity of:

– organization and conducting of urgent and emergency TMC for patient with diagnosed COVID-19 and pneumonia;

– development and putting into service of centralized subsystem “Telemedical consultations” of Unified departmental medical informational-analytic system of FMBA of Russia.

In addition, those years Federal State Budget Organization “Science medical researching center of otorhinolaryngology” (SMRCO) of FMBA of Russia was involved in federal project “Development of network of national medical researching centers” on the profile “Otorhinolaryngology” which implies a conducting of tele-medical consultations science-practical events (lectures, seminars) for “anchor” MTO of subjects of the Russian Federation on the profile of curation.

A conclusion was drown: usage of Federal tele-medical system allowed medical specialists of FMBA of Russia and Ministry of Health of Russia, MTO of other federal departments of executive power to make distance interaction between each other during a provision of medical treatment with usage of tele-medical technologies and to add these technologies to clinical practice.

Summary. Investigation purpose – to research the conditions of organization and provision of specialized medical treatment on the profile “surgery (combustiology)” basing on the data from informational-analytic system “Combustiological treatment in Russia”.

Material and methods of the investigation. In the basis of research – reports from 120 medical treatment organizations (MTO) in the year 2021 and some date from previous years reports.

Investigation results and their analysis. In 2021 in the Russian Federation a specialized treatment for victims with burns was provided in 63 burns departments/centers, including 7 children departments/centers, and on profiled burns bunks in surgical and combustiological departments. Summary there were 44886 patients with burns and their consequences got treatment. More than 79% of adults and 95% of children with burns entered the stage of specialized treatment at the time less than 72 hours after injury. Average duration of patients stay on the bunks was 17,8 bunk-days – for adults and 11,0 bunk-days – for adults, Summary lethality among the adults was in average number for the Russian Federation 7,7%; among the children – 0,3%.

A conclusion was made that improvement of organization and provision of medical treatment on all stages of medical evacuation and treatment of victims with burns allow to improve the nearest and far results of this category of patients treatment.

Summary. Investigation purpose – a planning of stationary department of urgent medical treatment (SDUMT) work in conditions of massive influx of technogenic emergencies (ES) victims.

Methods and materials of the investigation. To make the virtual models of (SDUMT) the Flexsim HealthCare software was chosen. The software allows to conduct a processive modeling of predictable work. A work of two stationary urgent medical treatment departments was recreated. The first was SDUMT of university clinic of the First Saint-Petersburg state medical university (FSPAMU) named after academic I.P. Pavlov of Ministry of Health of Russia (model-1) with average (23±2 patients per day) patient influx. The second was SDUMT of city urgent medical treatment hospital №25 of the city of Volgograd (model 2) with average (145±3 patients per day) patient influx. In addition, a retrospective analysis of technogenic ES happened in 45 Russian subjects in 2017-2022 was conducted. A prognosis of specified SDUMT work in conditions of massive emergency victims influx was planned to conduct basing on the up written analysis.

Investigation results and their analysis. As a result of the experiments an optimal SDUMT staff was defined. The role of this staff in conditions of massive technogenic emergency victims influx was assessed.

Summary. Investigation purposes – a researching of psychophysiological features and an opportunity of inattention and fatigue prevention in car drivers distracted for electronic devices.

Materials and methods of the investigation. An analysis of 45 publications in Russian and English found using Cyberleninka, PubMed, Elibrary, ScienceDirect data bases was conducted.

Investigation results and their analysis A distraction of car drivers for electronic devices make them instant fatigued because of attempts of combining of driving and with unrelated to it actions. A distraction for mobile phone can stimuli all forms of attention looses – auditory, visual, biomechanical, cognitive. A conclusion was made that nowadays algorithms for attention tiredness / distraction analysis in car drivers are not distributed enough.

Summary. Investigation purpose – to research and assess an interim results of sanitary aviation development strategy realization in Omsk area.

Materials and methods of the investigation. Investigation materials: accounting forms filled in “Disaster medicine centers monitoring” system (smk.minzdrav.gov.ru) by specialists of territorial canter of disaster medicine (TCDM); report form of industry statistic monitoring №56 “An information about an activity of medical organizations which implement an urgent medical treatment provision and medical evacuation conducting on mobile work forms, including organizations having an emergency consulting medical treatment departments” in 2021; Omsk area TCDM work reports.

Investigation methods – analytic, statistic

Investigation results and their analysis. Changings which happened during improvement of complex of systematic approaches to the organization of emergency form medical treatments provision for population in Omsk area were analyzed. A comparative analysis of avia-medical crews of TCDM work indicators during emergency medical treatment provision with a usage of sanitary aviation in daily and emergency modes were analyzed.

Summary. Investigation purpose – to compare an effectivity and safety of implementation of schemes of analgesia based on nefopam and tramadol in conditions of medical evacuation by sanitary vehicles with mine-explosion trauma (MET); to determine a possibility of its usage as an alternative for drugs analgetic.

Materials and methods of the investigation. Calls maps (form 110/u) of crews of Center of sanitary aviation and urgent medical treatment of All-Russian Center of Disaster Medicine “Zashchita” of Federal State Budget Organization “SSC – Federal Medical Biophysical Center named after A.I. Burnazyan” of FMBA of Russia. Patients were divided into 2 groups. Each group contained 8 people. A scheme with nefopam and non-steroid anti-inflammation medicines (NSAIM) was used for analgesia in the first group. There was a scheme with tramadol and NSAIM in the second group.

Investigation results and their analysis.

Summary. Investigation purpose – to evaluate the opportunity, efficiency and safety of usage of national polyurethane foam composition (PFC) during acute experiment taken in the frameworks of conducting of tactical-special exercises (TSE).

Materials and methods of the investigation. Tactical-special military-medical exercises “Ochag” are conducted annually and directed to testing of advanced health care technologies which are perspective for saving solders life and health. For modeling of tactical conditions a time coordinate system of troop system of evacuation of injured was created – from the time of provision medical treatment on artificial battlefield on the frameworks of tactical medicine till the time of provision of primary medical-sanitary treatment in medical platoon and providing of surgery in the frameworks of tactical control of injures in surgical room deployed in a tent of medical company.

Investigation results and their analysis. All animals survived till the end of the experiment, internal hemorrhaging was resolved. Till the 90th minute of experiment an appearance of small values of substances included in the developed foam was noticed in a series of blood analyzes.

This way the first experience of this technology usage during medical treatment provision in tactical time range was got. For assess of this PFC a conducting of pre-clinical and clinical researches was planned.