Organization of provision of specialized medical care for polytrauma in multidisciplinary hospital

2021 ◽  
pp. 34-41
Author(s):  
A. V. Shabunin ◽  
E. P. Rodionov ◽  
D. N. Grekov ◽  
A. A. Malyshev ◽  
E. A. Evdokimov

Technical progress facilitates to a significant increase in injuries and the severity of traumatic injuries. When providing treatment for patients with polytrauma in a multidisciplinary hospital the leading place is taken by the organization of the work of the hospital’s medical personnel, the development and implementation of standards for the guidelines specialized medical care to victims. The main priority of surgical intervention in polytrauma is to bleeding control, and staged treatment with final surgical correction after stabilization of the victim’s condition in 24–36 hours after the injury. An important role is played by standardized transfusion therapy for preventing the development of the lethal triad. Practice shows that a multidisciplinary approach is the cornerstone of providing specialized medical care for patients with polytrauma.

2020 ◽  
pp. 30-33
Author(s):  
E. V. Panina ◽  
M. V. Pugachev ◽  
A. G. Shchesiu

The article shows that in the daily activities of nursing staff of functional diagnostics departments (offices), it is necessary to strictly observe the requirements and rules for the prevention of infections associated with medical care, especially during the COVID-19 pandemic. The types of personal protective equipment (PPE) of medical personnel (MP), as well as current effective methods of disinfection, rules for collecting medical waste in a complex epidemiological situation are presented.


Author(s):  
Ekaterina V. Shulyak

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.


2017 ◽  
Vol 11 (1) ◽  
pp. 768-776 ◽  
Author(s):  
Nastaran Sargazi ◽  
M. Philpott ◽  
A. Malik ◽  
M. Waseem

Rheumatoid arthritis is a polyarthropathy affecting approximately 1% of the population worldwide. Wrist involvement is observed around 75% of patients, resulting in substantial disability and morbidity. A multidisciplinary approach to management of such patients is undertaken to prevent disease progression, many go on to develop debilitating disease requiring surgical intervention. Total wrist arthroplasty and arthrodesis are the main options available for those with end-stage disease, with arthroplasty preferred due to its ability to preserve a good degree of wrist function. Where complications occur with total wrist arthroplasty, salvage surgery with arthrodesis can be considered, however this requires satisfactory bone stock to enable stable fusion of the joint following arthroplasty. We report our experience of Ulna strut allografts in wrist arthrodesis in the management of failed total wrist arthroplasty.


Author(s):  
Yu. L. Shevchenko ◽  
O. E. Karpov ◽  
V. O. Sarzhevskiy ◽  
S. A. Fateev ◽  
P. S. Vetshev ◽  
...  

Organizational aspects of specialized including high-tech oncological medical care in a multi-field hospital are shown. A 10-year experience of the Pirogov National Medical and Surgical Center regarding optimization of the treatment of cancer patients is reported. Effectiveness of oncological care organization in a multi-field hospital is preliminary concluded. It is emphasized that multidisciplinary approach is essential for selecting a personalized program of cancer treatment in these patients. The need for further searching for ways to improve the diagnosis and treatment of cancer patients by accumulating and analyzing large clinical material is marked.


2014 ◽  
Vol 2 (1) ◽  
pp. 46-56 ◽  
Author(s):  
Alexandr Sergeevich Iova ◽  
Irina Alexandrovna Krukova ◽  
Dmitriy Alexandrovich Iova

This article deals with the actual problem of present-day traumotology - improvement of rendering of medical care for patients with polytrauma. The new technology “Pansonoscopy” is presented, which is the minimally invasive and widely available method of fast imaging of the “whole body” of the patient in any medical situations. It permits to detect the most frequent and dangerous traumatic injuries (cranial, thoracal, abdominal, skeletal, etc.) applying portable ultrasound scanners in real-time mode. The guarantee of imaging of the intracranial injuries, pos sibility realization of ultrasound examination by clinician on his own, and possibility of online medical consultations to experts (sonologist) - are fundamently new. This technology is destined for the large sections of practitioners, what render medical care for patients with polytrauma.


2021 ◽  
Vol 65 (4) ◽  
pp. 310-317
Author(s):  
Anna S. Sedova ◽  
Leonid M. Protsenko

Introduction. High-quality medical support is an essential component of effective and safe recreation of children in the camp. Aim is a scientific substantiation of improving the system of medical care in the camps. Material and methods. A survey of 353 directors of day and stationary camps was conducted in the fall of 2020. Results. The most pressing medical problems of the system of medical care of children in the camp were identified: lack of medical personnel (in 46.3% of camps); difficulties with licensing medical activities in the camp (in 15.8% of camps); low qualifications of medical personnel and medical literacy of pedagogical personnel in matters of medical support for camps (in 7.1% and 10.7% of camps, respectively); the inaccuracy of information available in the camp about the state of health of children in the medical certificates of children (in 22.6% of camps). 74.6% of directors pointed to the problems of interaction with the parents of children (unwillingness to provide children with medical certificates or necessary additional information about the state of health of children, refusal to receive treatment prescribed in the camp, etc.). Conclusion. It is necessary to improve the legal regulation in the field of children’s recreation; provision of camps with qualified medical personnel; educational programs on medical care for children in the camp for teachers; increasing the responsibility for the health of children during their rest period of medical organizations that draw up medical documents for children in front of the camp, as well as parents of children.


2020 ◽  
Vol 11 ◽  
pp. 31-34
Author(s):  
Polina G. Gabay ◽  

Purpose. To study the indices of carelessness in the provision of medical care from a criminological standpoint. Methodology: it includes the following methods: historical and legal, comparative legal, analysis and forecasting. Conclusions. 1. Elements of everyday carelessness in health care can be distinguished only conditionally and only in the sphere of relations that are within the framework of personal relations between medical personnel and patients. 2. The structure of health crime includes three groups of crimes: professional crimes of health workers; malfeasance of employees of the studied area; crimes, the responsibility for which arises for these subjects along with other persons. Scientific and practical significance. The conclusions presented in the article are aimed at increasing the effectiveness of counteracting careless criminality in the healthcare sector in the provision of medical care.


2021 ◽  
Vol 38 (2) ◽  
pp. 73-80
Author(s):  
Yu.N. Slepenok ◽  
◽  
G.V. Stankevich ◽  
L.P. Stepanova ◽  
◽  
...  

The article discusses the particular conditions of holding medical organizations accountable for causing harm to the health of patients. The conditions of civil liability, as well as the degree of responsibility of a medical organization in the provision of medical services, are analyzed. The authors are of the opinion that medical care should be organized in accordance with the procedures, conditions and standards for the provision of such care, however, the standards cannot cover all the options that may arise during the provision of medical care, therefore they are aimed at creating an average “sample”, to determine the approximate order of possible actions carried out by medical personnel. Attention is also paid to the consideration of the features of causing harm to the patient’s health, depending on whether the harm was caused in the provision of medical care or medical services. In conclusion, it was concluded that the conditions for bringing medical organizations to justice should include: unlawful action (inaction), harm, a causal relationship between unlawful action and harm, as well as the fault of the injurer.


2003 ◽  
Vol 50 (4) ◽  
pp. 129-133
Author(s):  
Srdjan Dikic ◽  
Dragoljub Bilanovic ◽  
Tomislav Randjelovic ◽  
D. Radovanovic ◽  
Miroslav Granic ◽  
...  

Diagnosis of intraabdominal bleeding caused by spleen injury must be performed in the shortest possible period of time, with little risk for the patient, and with high preciseness. By its simple performance, high preciseness and little risk for the patient, DPL imposes as the predominant method in initial diagnostic of intraabdominal bleeding. Control and monitoring of lavage may duly signalize degree of bleeding. Preciseness of this diagnostic in our series ranges up to 93.3%. DPL method is especially important in a combined neurotrauma. Ultrasonography is a sovereign method in diagnostic of bleeding source as well as in monitoring of bleeding that from the very beginning does not require urgent surgical intervention. Its importance is in monitoring both intrasplenic and subcapsulary hematomas. It is not appliable in disturbed and haemodynamically unstable patients. It is in particular important in children where a maximum conservative attitude with respect to operative treatment has been assumed. CT takes the leading place with respect to preciseness of bleeding area, and the combined thoracoabdominal trauma. Preciseness of CT in our series comes up to 96.6%, but can be applied only in haemodynamically stable patients. Same as US of abdomen so the CT of abdomen represents a prominent method in monitoring of both intrasplenic and subcapsular hematomas, which do not require urgent surgical intervention.


Author(s):  
Sergey A. Suslin ◽  
Maiia L. Sirotko ◽  
Marina N. Bochkareva ◽  
Sergey A. Babanov

Currently, work in any medical organization carries a risk of coronavirus infection, and, first of all, this applies to medical organizations dealing with the treatment of patients infected with coronavirus. Medical workers are a group at increased risk of infection with the SARS-CoV-2 virus in the provision of medical care in modern conditions, which determines their incidence of COVID-19 [1-3]. The aim of the study is to explore the prevalence of cases of COVID-19 infection in medical workers providing medical care on an outpatient basis. Materials and methods. The analysis of the incidence of COVID-19 medical workers in one of the large medical organizations of the Samara region during the period of the pandemic was carried out. The medical staff of the medical organization includes 207 doctors. There are 11 subdivisions in the structure of the medical and prophylactic institution. Research methods: content analysis of the modern regulatory framework (2020-2021), statistical, expert. For the period from May 2020 to March 2021 71 cases of infection of medical workers on an outpatient basis with SARS-CoV-2 were identified, of which 32 doctors (45%) and 39 people (55%) nurses. Based on the results of the expert assessment, the insurance nature of the infection case was established in 50 people (70%). Among the medical and nursing categories of medical workers, the largest number of cases was made by doctors and nurses of primary contact - specialists of the district service: general practitioners (40%), pediatricians (32%), doctors - obstetricians-gynecologists (12%), nurses adults (76%) and children (20%) polyclinic departments. A third of health workers received inpatient treatment for severe COVID-19, an average of 60 days. Conclusion. Medical workers are a risk group of COVID-19 who need support measures, since the possibility of occupational infection has been sufficiently proven, and the risk probably depends on the work performed and the conditions of direct contact of medical personnel, which requires further study in the current persisting epidemic conditions.


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