scholarly journals IMPROVING THE PROVISION OF SURGICAL CARE TO THE CIVILIAN POPULATION WITH GUNSHOT WOUNDS TO THE CHEST IN CONDITIONS OF LOCAL ARMED CONFLICT

2021 ◽  
Vol 22 (1) ◽  
pp. 70-75
Author(s):  
V. V. Masljakov ◽  
A. Р. Chuprina ◽  
К. G. Kurkin
Keyword(s):  
Medical Care ◽  
Armed Conflict ◽  
Surgical Care ◽  
Gunshot Wounds ◽  
Medical Personnel ◽  
City Hospital ◽  
Not Given ◽  
Civilian Population ◽  
Medical Institutions ◽  
The City

The aim of the study is to improve the organization and provision of surgical care to civilians with gunshot wounds to the chest in the context of armed conflict on the example of the Chechen campaign.Materials and methods. The work is based on the analysis of medical care provided to 106 wounded with gunshot wounds to the chest from the civilian population in the period from 1991 to 2000. Medical care was provided on the basis of the surgical hospital of the city hospital No. 9 in Grozny.Results and discussion. Found that providing medical care to wounded with gunshot wounds of the chest when massive flow in terms of actual hostilities rendered by the forces and means of civil hospitals, has a certain specificity. It is due to the fact that in such conditions, in contrast to military medical organizations, there are no stages of evacuation, often the wounded are delivered by non-specialized and unsuitable vehicles on destroyed roads, while they are not given or given insufficient pre-medical care. In such conditions, the workload of medical personnel of civil medical institutions associated with the provision of medical care increases. In this regard, in our opinion, it is necessary to develop measures aimed at improving the algorithm aimed at minimizing various errors that occur in civilian medical institutions during the mass admission of wounded. 

The development of health care in Siberia in the 18th — first half of the 19th century

2019 ◽  
Vol 5 (2) ◽  
pp. 121-132
Author(s):  
Ekaterina V. Shulyak
Keyword(s):  
Health Care ◽  
Medical Care ◽  
Political Development ◽  
Medical Personnel ◽  
Military Hospital ◽  
Genetic Method ◽  
Industrial Enterprises ◽  
Medical Institutions ◽  
Russian State ◽  
Folk Remedies

Development of health care of Siberia in the 18<sup>th</sup>&nbsp;— first half of the 19<sup>th</sup> century was closely connected with economic and political development of the Russian state. Before the medical personnel emergence in Siberia its population received medication only in the form of folk remedies. Development of its territory, insanitary conditions of life of Siberians, constant contingent of exiled to the indigenous people, and severe climate contributed to the spread of such diseases as smallpox, syphilis, and others.<br> The first medical institutions of Siberia were military hospital and infirmaries. In the days of reign of the Empress Anna Ioannovna, the city medical care started developing, and thanks to an initiative of the industrial enterprises owners&nbsp;— medical care for miners. After the establishment of the Public Charity Orders in Siberia, hospitals under their jurisdiction began to function in Tobolsk, Irkutsk, and Tomsk. A worthy contribution to the development of local medical institutions was made by donators Tolstopyatov, Bednyagin, Chupalov, and others. However, deficiency of financing, hospitals, and the medical personnel couldn’t adequately satisfy the needs of Siberian inhabitants in medical care.<br> The purpose of the article is to analyse the condition of public health, causes of morbidity and mortality of the population, as well as the process of medical care development in Siberia the turn of the 18<sup>th</sup> century by means of a historical and genetic method.

scholarly journals Treatment and evacuation work of evacuation hospitals in the Saratov region in the period from July 1943 to June 1945

2018 ◽  
Vol 20 (4) ◽  
pp. 261-264
Author(s):  
V A Sokolov ◽  
Yu A Murylev ◽  
D K Yakimov ◽  
V Yu Murylev
Keyword(s):  
Final Stage ◽  
Medical Personnel ◽  
Medical Institute ◽  
Published Data ◽  
Civic Duty ◽  
Industrial Enterprises ◽  
Medical Institutions ◽  
Great Patriotic War ◽  
Red Army ◽  
The City

The experience of organizing the treatment of wounded and sick military men of the Red army in Saratov at the final stage of the Great Patriotic War is studied. Priority tasks that were solved in conditions of the location of medical institutions in the deep rear are given. The structure of injuries and injuries with which soldiers and officers of the Red Army were sent from the front to the evacuation hospitals of the city and the region was investigated. Attention is drawn to the change the severity and location of wounds, depending on the progress of our units towards Germany. The factors that contributed to the successful treatment and return to the system of heavy contingents of the wounded and sick are indicated. The importance of the initiative work, which was carried out by medical personnel of evacuation hospitals on the development and introduction of new methods to improve the effectiveness of medical measures in everyday clinical practice, was stressed. Published data on the number of beds that were transferred from the Saratov hospital base in the army. In addition, evacuation hospitals and the Saratov Medical Institute were those institutions of which, even at the final stage of the war, medical personnel were sent for service to the front. At the same time, many honorably and honorably fulfilled their civic duty to the Motherland. Examples of patronage over hospitals from industrial enterprises and public organizations of Saratov and the region are given. A brief overview of the treatment and prophylactic tasks, which were solved in the interests of the civilian population of the city and the region, is given.

scholarly journals Surgical tactics for victims of gunshot wounds of the diaphragm specialized stage of medical care in conditions of a modern armed conflict

2019 ◽  
Keyword(s):  
Surgical Treatment ◽  
Medical Care ◽  
Comparison Group ◽  
Care Delivery ◽  
Abdominal Cavity ◽  
Surgical Care ◽  
Gunshot Wounds ◽  
Main Group ◽  
Lung Capacity ◽  
Combat Injuries

Introduction. The diaphragm gunshot wounds are serious combat injuries. The main functions of the diaphragm are to change the intra-abdominal pressure and the outflow of lymph and blood from the abdominal cavity due to the constant contraction and relaxation. Therefore, when it is injured at the same time with a powerful painful impulse, cardiopulmonary disorders quickly arise. Purpose: To improve the results of surgical treatment of patients with gunshot wounds through the introduction of new video endoscopic technologies at the stage of specialized surgical care. Materials and methods. The article analyzes the features of specialized surgical care in 64 patients with gunshot wounds who were treated at the surgical clinic of the Military Medical Clinical Center of the Northern Region (III level of medical care). New minimally invasive methods are proposed to improve the outcomes of surgical treatment of victims with diaphragm gunshot wounds at level III of health care delivery. Results. Thus, the use of video thoracoscopic technique in the surgical treatment of the diaphragm wound and its suturing in the proposed method allowed to improve the results of treatment by increasing the average value of diaphragmatic excursion in deep breath in the main group to 3.73 ± 0.31 cm, whereas in the comparison group 2.21 ± 0.38 cm. The severity of the pain syndrome on the of Visual Аnalogue Scale 5 days after surgical treatment was 5.2 ± 2.3 points in the injured main group, 6.7 ± 2.1 points in the comparison group. The ratio of vital lung capacity to the required vital lung capacity in the main group was 75.3 ± 2.2%, in the comparison group 64.1 ± 1.7%. Conclusions. The use of video thoracoscopy increases the efficiency of the diagnosis of gunshot wounds of the diaphragm. The use of laser imaging and fluorescence diagnosis of diaphragm wounds ensure the adequacy of the removal of paravulary necrotic tissues. The suturing of the wounds in accordance with the anatomical and functional structure of the diaphragm with the use of plaques improves the immediate postoperative results of surgical treatment.

PATIENTS’ SATISFACTION WITH THE QUALITY OF MEDICAL SERVICES AT DIFFERENT STAGES OF THE PROJECT “LEAN HOSPITAL” IN TOMSK REGION

2019 ◽  
Vol 33 (4) ◽  
pp. 154-157 ◽  
Author(s):  
A. A. Solovyev ◽  
N. V. Kopysova
Keyword(s):  
Call Center ◽  
Medical Information ◽  
Medical Personnel ◽  
Medical Information System ◽  
Medical Services ◽  
City Hospital ◽  
Medical Institutions ◽  
Tomsk Region ◽  
Insufficient Number

The purpose of the study was to analyze the state of satisfaction of the population in the provision of medical services and to observe the changes taking place in this area in connection with the start of the national project “Lean Polyclinic”. The studies were conducted in the form of a questionnaire survey of patients of two medical institutions, namely: the Regional Public Health Institutions “Children’s City Hospital No. 2” and “B. I. Alperovich City Clinical Hospital No. 3”.The material of the study was the responses on paper of the interviewed patients. The average indicators of patient satisfaction with the received medical services were determined by means of statistical calculations. The survey was conducted at the start of the project in May‑July of 2017 and again in October‑December of 2017.Results. The initial survey revealed the presence of such problems as insufficient number of automated workplaces; heavy workload of the doctor when working in the Medical Information System of the Tomsk Region; imperfection of the card filing cabinet; insufficient number of racks for storing outpatient cards, front-office and back-office were located in the same room and did not have a partition, which created noise and interfered with the work of call-center operators; the need to contact the registry to get the outpatient card when the visit was previously assigned; difficult orientation of patients in the clinic; long-term preventive examination of children aged 1 year; mixed flows of healthy and sick patients; and lack of personnel. The repeated survey reflected the changes that occurred in connection with the start of the “Lean Polyclinic” project: the number of detected violations tended to decrease, which indicated the improvement in the quality of services and the improvement in the organization of medical personnel work.Conclusion. Thus, the present study established that the use of lean production technologies contributed to the quality of medical services and it had a beneficial effect on the processes of organizing the work of medical institutions. 

scholarly journals Features of the functioning of the neurological department of the city hospital and the neurological center of specialized course outpatient treatment (SCAL)

1998 ◽  
Vol XXX (1-2) ◽  
pp. 61-62
Author(s):  
V. A. Rudnev ◽  
М. Y. Berdichevsky ◽  
N. N. Chirva
Keyword(s):  
Medical Care ◽  
High Mortality ◽  
Outpatient Treatment ◽  
Vascular Diseases ◽  
City Hospital ◽  
Prevention And Treatment ◽  
The City ◽  
The Brain ◽  
Specialized Course

The problem of prevention and treatment of vascular diseases of the brain is becoming more and more important every year due to the prevalence of the disease, the severity of disorders, high mortality and disability. Therefore, the issues of organizing medical care for such a contingent of patients are very relevant.

scholarly journals Clinical and Epidemiological analysis of the structure of combat surgical injury during Antiterrorist operation / Joint Forces Operation

2021 ◽  
Vol 2 (2) ◽  
pp. 5-13
Author(s):  
I. P. Khomenko ◽  
S. O. Korol ◽  
S. V. Khalik ◽  
V. Yu. Shapovalov ◽  
R. V. Yenin ◽  
...  
Keyword(s):  
Medical Care ◽  
Armed Conflict ◽  
Pleural Cavity ◽  
Abdominal Cavity ◽  
Armed Conflicts ◽  
Pelvic Cavity ◽  
Surgical Trauma ◽  
Epidemiological Analysis ◽  
Civilian Population ◽  
Joint Forces

I Introduction. In generalizing the experience of providing medical care to the wounded in armed conflicts, a special place belongs to the analysis of the magnitude and structure of casualties, which depend on the conditions, forms and methods of hostilities. The purpose. Conduct a clinical and epidemiological analysis of the proportion of gunshot and mine injuries in the structure of combat surgical trauma during the Anti-terrorist operation / Joint Forces operation. Materials and methods. The total number of wounded as a result of the armed conflict in eastern Ukraine in the period from 2014 to 2019 was more than 41 thousand people, from them killed among the civilian population – 3350 people and 4100 – servicemen. Results. It was proved that the wounded with non-severe combat surgical trauma are 36.5%, severe – 48.9%, extremely severe – 14.6%. Shrapnel wounds were received by 35.3%, bullet wounds – 48.3%, mine injuries – 16.6%. Isolated combat surgical trauma was found in 16.8%, multiple – in 34.3%, combined – in 48.9% of the wounded. Impenetrable combat surgical trauma was diagnosed in 63.7% of the wounded, penetrating into the pleural cavity – in 17.2%, in the abdominal cavity – in 16.0%, in the pelvic cavity – in 3.1%. Conclusions. In the structure of sanitary losses of the surgical profile during the ATO / OOS, the wounded with injuries of the extremities are 56.7%, with injuries of the chest – 10.1%, abdomen – 5.1%, pelvis – 3.0%.

Establishing the Criteria for the Quality of Elderly Medical Care From the Multiple Perspectives

2018 ◽  
Vol 9 (4) ◽  
pp. 44-54
Author(s):  
Wan-I Lee ◽  
Chun-Chi Chen ◽  
Yu-Bin Huang
Keyword(s):  
Medical Care ◽  
Physical Environment ◽  
Older Patients ◽  
Medical Personnel ◽  
Care Process ◽  
Medical Services ◽  
Multiple Perspectives ◽  
Medical Decisions ◽  
Medical Institutions

In 1993, Taiwan has transformed into an aged society. Compared with general patients, older patients differ considerably in body functionality, mentally, and mobility-wise. The primary customers of medical institutions are adult patients in Taiwan, and the needs of older patients are often ignored; however, older patients visiting the case hospital in this study accounted for nearly 30% of the total number of outpatients. This indicates that the needs of older patients are a matter requiring the serious attention of medical personnel. This is a common issue for all countries that were entered an aging structure of the population. This study investigated the attention paid by supervisors and medical personnel involved with medical decisions to the quality of medical services received by older outpatients. An analytic hierarchy process (AHP) was employed to interview 10 experts in older medical care providing age-friendly medical care at the case hospital, medical staff including senior physicians, nursing department supervisors, administration department supervisors, and certified managers. The results indicate that the supervisors and medical personnel considered the “communication and services” provided to older patients during their medical treatments to be the most crucial factor in their treatment process, rating it twice as important as the next most important criteria, the care process and physical environment. Medical personnel paid great attention to communicate with and servicing older patients; listening to their needs and concerns was deemed the most critical, followed by being able to empathize with them to solve problems. Asking patients about their problems when they visited the hospital was considered the most crucial aspect of the care process; in the physical environment, it was spatial planning and traffic flow design. The results of this study enable other countries' medical institution managers and relevant competent authorities to gain insight into the attention paid by front-line employees in promoting age-friendly medical care. If supervisors and medical personnel involved with medical decisions share a similar attitude toward promoting medical service quality, government authorities and medical institutions can implement and enhance an age-friendly medical treatment environment for older patients, as well as increase quality of patient-centered medical services.

scholarly journals Shelling, Sniping and Starvation: The Law of Armed Conflict and the Lessons of the Siege of Sarajevo

2010 ◽  
Vol 41 (2) ◽  
pp. 149
Author(s):  
KJ Riordan
Keyword(s):  
Armed Conflict ◽  
Cautionary Tale ◽  
Traditional Methods ◽  
Civilian Population ◽  
Criminal Convictions ◽  
Law Of Armed Conflict ◽  
The Law ◽  
The City

This article looks at the siege of Sarajevo conducted from April 1992 to February 1996, which resulted in the loss of thousands of lives and great suffering to the civilian population of the city. It also resulted in criminal convictions for Bosnian Serb commanders Stanislav Galić and Dragomir Milosević. Given the fact that sieges have been a common form of warfare from antiquity to the present day, and are likely to remain so, these convictions and the heavy sentences that accompanied them must provide a cautionary tale for commanders who may in future be required to undertake such an operation. This article examines the traditional methods of warfare associated with the successful prosecution of a siege and contrasts them with the detailed and onerous provisions of the law of armed conflict. It ponders the question of what a modern commander must do to conduct a siege which is both lawful and successful.

scholarly journals Organizational problems and possible ways of its resolve when providing emergency surgical care to patients with comorbid status in a highly specialized medical institution

2020 ◽  
Vol 7 (2) ◽  
pp. 64-74
Author(s):  
I. M. Khokhlova ◽  
V. B. Kozhevnikov ◽  
K. N. Movchan ◽  
B. S. Artyushin ◽  
E. V. Bartashevich ◽  
...  
Keyword(s):  
Medical Care ◽  
Critical Limb Ischemia ◽  
Soft Tissues ◽  
Surgical Care ◽  
Limb Ischemia ◽  
Medical Organization ◽  
Surgical Infection ◽  
Results Of Treatment ◽  
Medical Institutions ◽  
Main Activity

Purpose of the study. To demonstrate the difficulties of objective interpretation of providing medical care to patients with critical limb ischemia.Materials and methods. The results of treatment of more than 29 thousand patients of one of the highly specialized medical organizations of St. Petersburg were studied, in which the main activity of the staff is the examination of patients with surgical infection of soft tissues (particularly, the critical limb ischemia).Results. It has been ascertained that, despite the unconditional success of providing medical care to patients with critical limb ischemia, a high frequency of unsatisfactory treatment results for this category of patients remains (in 2017, among 685 patients of the specialized department of the highly specialized medical organization, the proportion of cases of performing high amputations of limbs and mortality, respectively, was 11,7% (80) and 2,6% (18)). It has been demonstrated on clinical examples that the pronounced comorbidity of critical limb ischemia patients and the severity of their general condition (combined with organizational difficulties in providing them with providing medical care in conditions of highly specialized medical organization) contribute to the formation of complications (up to lethal outcomes) of not only the underlying, but also concomitant diseases. Difficulties in providing medical care of adequate quality in life-threatening conditions for patients of highly specialized medical organization in cases of critical limb ischemia necessitate a wider interaction between specialists in narrow and multidisciplinary hospitals as part of the emergency surgery service.Conclusion. When creating specialized medical centers outside of multidisciplinary medical institutions, the possibilities should be provided for the regulated involvement of highly professional consultants with a reasonable algorithm for routing patients in cases of the need for their emergency re-hospitalization to other medical institutions.

scholarly journals Organization of the treatment of the wounded and sick in medical institutions in Saratov during The Great Patriotic War. Deployment of evacuation hospitals in the initial period of the war (June 1941 - June 1942)

2018 ◽  
Vol 20 (2) ◽  
pp. 226-233
Author(s):  
V A Sokolov ◽  
Yu A Murylev ◽  
V Yu Murylev ◽  
D K Yakimov
Keyword(s):  
Initial Period ◽  
Medical Personnel ◽  
Clinical Work ◽  
Medical Institute ◽  
First Year ◽  
Medical Institutions ◽  
Great Patriotic War ◽  
Quality Of Medical Care ◽  
State Defense ◽  
The City

The issues of the deployment of hospitals in the city of Saratov in the initial period of the Great Patriotic War are considered. The article briefly describes the decisions of the State Defense Committee, which initiated the reorganization of the civil health of our country for the solution of the tasks of wartime. The medical-geographical factors that determined the expediency of deploying evacuation hospitals in Saratov and the region are indicated. The great role of leading specialists in clinics and departments of the Saratov Medical Institute in the deployment and specialization of evacuation hospitals was underscored. Their management of day-to-day clinical work and advice helped not only to maintain the high quality of medical care provided to the wounded and sick, but also contributed to the growth of the professional skills of physicians who do not have sufficient experience in treating a variety of combat pathologies. The statistics on the number of hospital beds in Saratov hospitals is given. Data on the structure of the wounded in the first year of the war for treatment in medical institutions of the city and the region are presented. The efforts made by party and city authorities to increase the capacity of the Office of the45th local evacuation center are highlighted. The importance of the problem of retraining, additional specialization, training of new medical personnel is shown. Using a variety of time and content of training programs allowed to significantly staff the deployed evacuation hospitals at the expense of residents of the city and the region.

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