Prospects for the use of modern domestic medical devices to eliminate the life - threatening consequences of injuries and treat traumatic shock on the battlefield and advanced stages of medical evacuation

2021 ◽  
Vol 342 (9) ◽  
pp. 78-88
Author(s):  
I.M. Samokhvalov ◽  
Yu.V. Miroshnichenko ◽  
K.P. Golovko ◽  
V.V. Boyarintsev ◽  
E.O. Rodionov
Keyword(s):  
Medical Devices ◽  
Traumatic Shock ◽  
Medical Evacuation ◽  
Life Threatening ◽  
Advanced Stages ◽  
Domestic Medical

scholarly journals The first domestic devices for intraosseous infusion - is the great advance of military medicine in pre-hospital stage enhancement

2018 ◽  
Vol 20 (4) ◽  
pp. 106-112
Author(s):  
I M Samokhvalov ◽  
K P Golovko ◽  
A V Denisov ◽  
S Yu Telitsky ◽  
N A Zhirnova ◽  
...  
Keyword(s):  
Blood Volume ◽  
Medical Devices ◽  
Limited Liability ◽  
Traumatic Shock ◽  
Infusion Therapy ◽  
Volume Resuscitation ◽  
Limited Liability Company ◽  
Circulating Blood Volume ◽  
Medical Evacuation ◽  
Intraosseous Infusion

Traumatic shock is considered to be the most common clinical form of a severe patient’s condition (63%). Timely and adequate blood volume resuscitation is one of the most important procedures in providing medical care to critically injured casualties and patients at the forward medical evacuation stage. The key to this problem, especially when the infusion therapy is needed at the pre-hospital stage, is the development of alternative (extravascular) techniques of plasma volume expander administration. The article presents the results of testing of the first domestic medical devices for intraosseous infusion in critically injured casualties and patients. At present, on commission of the Russian Ministry of Defense and with the scientific support of Kirov Military Medical Academy, domestic enterprises developed test samples of medical devices to provide intraosseous infusions: a «Disposable device for intraosseous infusion of solutions if there is no intravenous access, which was designed on the basis of a spring drive» - the index «VKI-P», developed by limited liability company «Novoplast-М» and a set for intraosseous infusion using an electric drive - the index « VKI-E», developed by limited liability company «Research engineering company «Spetsproekt». Assessment of performance of test samples of the medical devices for intraosseous infusions «VKI-P» and «VKI-E» was carried out using pathophysiologic model of traumatic shock in 14 experimental animals (pigs) by creating artificial blood loss of medium severity, 25% of circulating blood volume (in average 440 ml), followed by its resuscitation with intraosseous infusion of 0,9% solution of NaCl. As a result of the performed tests it was found that the device «VKI-P» and the set «VKI-E» provide for NaCl infusion in major vessels (with an intraosseous infusion), 750 ml of volume during 45-50 min, and can be used as an alternative access to provide infusion as a part of anti-shock therapy, which solves the problem of volume resuscitation when giving care to severely injured casualties and patients at the forward medical evacuation stages. These samples may be recommended for inclusion into the medical service list of complete supplies and the Medical Corps supply support, the Armed Forces of the Russian Federation.

Prospects for improving pre-hospital care for wounded with gunshot penetrating wounds to the chest

2020 ◽  
Vol 22 (3) ◽  
pp. 140-147
Author(s):  
K. P. Golovko ◽  
V. Yu. Markevich ◽  
T. Yu. Suprun ◽  
A. B. Vertiy ◽  
S. E. Komyagin ◽  
...  
Keyword(s):  
Medical Devices ◽  
Armed Forces ◽  
Pleural Drainage ◽  
Treatment Results ◽  
Medical Evacuation ◽  
Chest Injuries ◽  
Negative Factor ◽  
Life Threatening ◽  
The Russian Federation ◽  
State Defense

Abstract. The analysis of injuries, life-threatening consequences and outcomes of treatment of wounded with penetrating chest wounds and the results of approbation of a prototype (medical) disposable set UD-02v for the elimination of strained and open pneumothorax, hemothorax, pleural drainage and collection of spilled blood with the possibility of subsequent reinfusion at the pre-hospital stage is presented. The prototype of the UD-02v set was created as part of the implementation of the state defense order in 2018. Its creation is due to the fact that despite the improvement of medical care at the stages of medical evacuation and the widespread use of individual armor protection, chest injuries currently remain a frequent type of combat surgical injury, accounting for 6 to 12% of all injuries. The main cause of death of injured and injured with chest injuries remains blood loss caused by continuing intrapleural bleeding and concomitant damage to other anatomical areas. Stressful pneumothorax, together with intrapleural bleeding, account for 93% of preventable causes of fatal chest injuries at the pre-hospital stage. Untimely elimination of the consequences of severe breast injuries should be considered as a negative factor affecting the outcome of treatment, and significant improvement in treatment results should be expected only in the case of early elimination of the most severe consequences of breast injuries. The developed set of UD-02v exceeds foreign medical devices in its medical and technical characteristics, and is the most promising for acceptance for the supply of the Armed forces of the Russian Federation as part of the samples of complete and service equipment.

scholarly journals Neuromorphic on-chip recognition of saliva samples of COPD and healthy controls using memristive devices

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Pouya Soltani Zarrin ◽  
Finn Zahari ◽  
Mamathamba K. Mahadevaiah ◽  
Eduardo Perez ◽  
Hermann Kohlstedt ◽  
...  
Keyword(s):  
Medical Devices ◽  
Energy Efficient ◽  
Performance Evaluations ◽  
Chronic Obstructive ◽  
Healthy Controls ◽  
Effective Management ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Life Threatening ◽  
On Chip

AbstractChronic Obstructive Pulmonary Disease (COPD) is a life-threatening lung disease, affecting millions of people worldwide. Implementation of Machine Learning (ML) techniques is crucial for the effective management of COPD in home-care environments. However, shortcomings of cloud-based ML tools in terms of data safety and energy efficiency limit their integration with low-power medical devices. To address this, energy efficient neuromorphic platforms can be used for the hardware-based implementation of ML methods. Therefore, a memristive neuromorphic platform is presented in this paper for the on-chip recognition of saliva samples of COPD patients and healthy controls. Results of its performance evaluations showed that the digital neuromorphic chip is capable of recognizing unseen COPD samples with accuracy and sensitivity values of 89% and 86%, respectively. Integration of this technology into personalized healthcare devices will enable the better management of chronic diseases such as COPD.

scholarly journals What Features and Functions Are Desired in Telemedical Services Targeted at Polish Older Adults Delivered by Wearable Medical Devices?—Pre-COVID-19 Flashback

Sensors ◽  
2020 ◽  
Vol 20 (18) ◽  
pp. 5181
Author(s):  
Eliasz Kańtoch ◽  
Anna Kańtoch
Keyword(s):  
Older Adults ◽  
Medical Devices ◽  
Demographic Data ◽  
Telemedicine Service ◽  
Desirable Feature ◽  
Chi Squared ◽  
Life Threatening ◽  
Wearable Medical ◽  
Study Participants ◽  
Adult Volunteers

The emerging wearable medical devices open up new opportunities for the provision of health services and promise to accelerate the development of novel telemedical services. The main objective of this study was to investigate the desirable features and applications of telemedical services for the Polish older adults delivered by wearable medical devices. The questionnaire study was conducted among 146 adult volunteers in two cohorts (C.1: <65 years vs. C.2: ≥65 years). The analysis was based on qualitative research and descriptive statistics. Comparisons were performed by Pearson’s chi-squared test. The questionnaire, which was divided into three parts (1-socio-demographic data, needs, and behaviors; 2-health status; 3-telemedicine service awareness and device concept study), consisted of 37 open, semi-open, or closed questions. Two cohorts were analyzed (C.1: n = 77; mean age = 32 vs. C.2: n = 69; mean age = 74). The performed survey showed that the majority of respondents were unaware of the telemedical services (56.8%). A total of 62.3% of C.1 and 34.8% of C.2 declared their understanding of telemedical services. The 10.3% of correct explanations regarding telemedical service were found among all study participants. The most desirable feature was the detection of life-threatening and health-threatening situations (65.2% vs. 66.2%). The findings suggest a lack of awareness of telemedical services and the opportunities offered by wearable telemedical devices.

scholarly journals Digital light 3D printing of customized bioresorbable airway stents with elastomeric properties

2021 ◽  
Vol 7 (6) ◽  
pp. eabe9499
Author(s):  
Nevena Paunović ◽  
Yinyin Bao ◽  
Fergal Brian Coulter ◽  
Kunal Masania ◽  
Anna Karoline Geks ◽  
...  
Keyword(s):  
3D Printing ◽  
Medical Devices ◽  
Standard Of Care ◽  
Rapid Manufacturing ◽  
Medical Implants ◽  
Psychological Burden ◽  
Life Threatening ◽  
Airway Stents ◽  
Central Airway

Central airway obstruction is a life-threatening disorder causing a high physical and psychological burden to patients. Standard-of-care airway stents are silicone tubes, which provide immediate relief but are prone to migration. Thus, they require additional surgeries to be removed, which may cause tissue damage. Customized bioresorbable airway stents produced by 3D printing would be highly needed in the management of this disorder. However, biocompatible and biodegradable materials for 3D printing of elastic medical implants are still lacking. Here, we report dual-polymer photoinks for digital light 3D printing of customized and bioresorbable airway stents. These stents exhibit tunable elastomeric properties with suitable biodegradability. In vivo study in healthy rabbits confirmed biocompatibility and showed that the stents stayed in place for 7 weeks after which they became radiographically invisible. This work opens promising perspectives for the rapid manufacturing of the customized medical devices for which high precision, elasticity, and degradability are sought.

scholarly journals Forensic medical examinattion of living persons in cases of injury of the organs of external respiration

2021 ◽  
Vol 8 (2) ◽  
pp. 95-99
Author(s):  
Vasil Olkhovsky ◽  
Mykola Gubin ◽  
Edgar Grygorian
Keyword(s):  
Methodological Approach ◽  
Objective Assessment ◽  
Traumatic Shock ◽  
Medical Examination ◽  
Expert Assessment ◽  
External Respiration ◽  
Medical Assessment ◽  
Solid Objects ◽  
Life Threatening ◽  
Post Traumatic

Backrgound. Trauma of external respiratory organs in victims is often a reason for the referral to forensic medical examination by law enforcement. Purpose of this work was to analyze the peculiarities of formation forensic medical expert conclusion, based on the results of determining the gravity of bodily injuries in victims with closed trauma of the organs external respiration, depending on their morphological and clinical characteristics and gravity, to find the ways to unify expert assessment. Subjects and Methods. 183 conclusions of forensic medical examination in the Kharkiv regional expert institution, on the cases of a closed blunt trauma of the organs of external respiration, were analyzed. Results. According to the mechanism of bodily injuries, in 171,1 (93,4 %) cases there was an impact of blunt solid objects on the neck and chest, in 11 (6 %) cases there was a compression of the neck by hands or other blunt solid objects, in 1 (0,5 %) case – a compression of the neck by hands and a loop. At the given trauma, modern experts’ approaches to an assessment of bodily injuries were defined. Grievous bodily injuries were defined in 17 (9,3 %) cases of trauma, with the emergence of life-threatening events such as acute respiratory failure, traumatic shock, mechanical asphyxia. Moderate bodily injuries were determined by experts in the 151 (82,5 %) cases, mostly injuries from fractures of ribs and cartilage of the larynx, at absence danger to life. Light bodily injuries were determined by experts in 15 (8,2 %) cases of mostly laryngeal injuries, complicated by its post-traumatic inflammation. The absence of unified scientific and methodological approach for the objective assessment of injuries of the external respiratory system organs has been defined. Conclusions. When conducting a forensic medical assessment of such injuries, there are cases of both underestimation and overestimation of the gravity of bodily injuries. According to the results of the performed investigation, further ways to unify morphological and clinical approaches at forensic-medical assessment of these bodily injuries were defined.

scholarly journals Conceptual principles of the wounded combatants’ evacuation, suffering military surgical trauma on the medical support levels

2020 ◽  
Vol 87 (5-6) ◽  
pp. 60-64
Author(s):  
I. P. Khomenko ◽  
I. A. Lurin ◽  
S. O. Korol ◽  
V. Yu. Shapovalov ◽  
B. V. Matviichuk
Keyword(s):  
Traumatic Shock ◽  
Statistical Investigation ◽  
Unstable State ◽  
Surgical Trauma ◽  
Medical Support ◽  
Shock State ◽  
Trauma Severity ◽  
Medical Evacuation ◽  
Joint Forces ◽  
Severity Degree

Objective. To improve the results of treatment of the wounded persons, suffering a combat surgical trauma, elaborating and introducing of objective scales of the trauma severity estimation into the medical evacuation system while conduction of Antiterroristic operation / Operation of Joint Forces. Materials and metods. Complex medical-statistical investigation was performed, in which 684 wounded persons, suffering a combat surgical trauma were included. Dynamical medical control and determination of the trauma severity degree in accordance to AdTS (Admission trauma Scale) were applied on all levels of medical support. Results. In the beginning of conduction of Antiterroristic operation / Operation of Joint Forces a mortallty have had occurred during transportation of wounded persons in unstable state (more than 9 points) to military-medical clinical centers. The wounded persons in a traumatic shock state were transported on forth level of medical support, what have been considered an organization defect in the help deliver process, which leaded to death of military persons. At the same time an unjustified delay of transportation of servicemen, suffering wounds of the wrist and foot (up to 5 points), on the first and second levels of medical support, leading to development of severe complications, have occurred. Taking into account the above mentioned, the authors have provided a differentiated approach for medical evacuation of wounded persons, suffering a combat surgical trauma, depending on its severity degree. Conclusion. Evacuation of wounded persons, suffering a combat surgical trauma, constitutes an integral part of the medical support system of Antiterroristic operation/Operation of Joint Forces, closely connected with a medical support process during transportation. Medical evacuation of wounded persons with injuries of the vision organ, the wrist and foot must be accomplished urgently to specialized clinic of the fourth level of medical support.

scholarly journals Some prehistory of New Zealand intensive care medicine

2009 ◽  
Vol 37 (1_suppl) ◽  
pp. 16-29
Author(s):  
R. V. Trubuhovich
Keyword(s):  
Intensive Care ◽  
New Zealand ◽  
Intensive Care Medicine ◽  
Traumatic Shock ◽  
Cardiac Massage ◽  
Paper Briefly ◽  
Early 19Th Century ◽  
Beliefs And Practices ◽  
Life Threatening ◽  
Ventilatory Failure

In taking 1960 as the foundation year for the practice of intensive care medicine in New Zealand, this paper briefly looks into the previous two centuries for some interventions in life-threatening conditions. With the help of descriptions in early 19th century journals and books by perceptive observers, the author focuses on some beliefs and practices of the Maori people during pre-European and later times, as well as aspects of medical treatment in New Zealand for early settlers and their descendants. Dr Laurie Gluckman's book Tangiwai has proved a valuable resource for New Zealand's medical history prior to 1860, while the recent publication of his findings from the examination of coroners’ records for Auckland, 1841 to 1864, has been helpful. Drowning is highlighted as a common cause of accidental death, and consideration is given to alcohol as a factor. Following the 1893 foundation of the New Zealand Medical Journal, a limited number of its papers which are historically relevant to today's intensive care are explored: topics include tetanus, laryngeal diphtheria, direct cardiac massage, traumatic shock, thiopentone management for fitting and the ventilatory failure due to poliomyelitis.

scholarly journals In memory of academician A.A. Vishnevsky – the chief surgeon of the Ministry of defense of the USSR (for the 45th anniversary of his death)

2021 ◽  
Vol 15 (1) ◽  
pp. 85-91
Author(s):  
Temury S. Morgoshiia ◽  
Nikolai A. Syroezhin ◽  
Alexander V. Inkin
Keyword(s):  
Local Anesthesia ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Burn Injuries ◽  
Medical Sciences ◽  
Surgical Interventions ◽  
Medical Evacuation ◽  
Pathogenetic Therapy ◽  
Advanced Stages

The life and work of academician Alexander Alexandrovich Vishnevsky are presented. During the Great Patriotic War, Alexander Alexandrovich served as an army surgeon and chief surgeon for a number of fronts. He became the director of the A.V. Vishnevsky of the USSR Academy of Medical Sciences in 1948 and later served as the chief surgeon of the USSR Ministry of Defense starting in 1956. As a student and the closest associate of his father A.V. Vishnevsky, Alexander Alexandrovich participated in the creation of a domestic surgical school and then became its leader after his fathers death. Analysis of the early works of Alexander Alexandrovich reveals his devotion to the anatomical substantiation of local anesthesia based on the method of creeping infiltrate. The well-known monograph Novocaine blockade and oil-balsamic antiseptics as a special type of pathogenetic therapy (1952), written by Alexander Alexandrovich and his father, is the result of many years of research on the role of nervous trophism in the pathogenesis of a number of surgical diseases. Alexander Alexandrovich also found that in the advanced stages of medical evacuation, surgical interventions on the wounded can be performed under local anesthesia by using the creeping infiltrate method. In peacetime, A.A. Vishnevsky continued to investigate the issues related to anesthesia and nervous trophism and collaborated with his colleagues to address a number of other pressing problems, including the surgery of the heart and blood vessels, mechanisms for compensating for impaired functions of organs and systems, the use of cybernetics and electronics in surgery, burn injuries, and the use of polymers in surgery. Moreover, A.A. Vishnevsky was the first surgeon in Russia to perform a successful open-heart surgery under the conditions of artificial circulation (1957). He was awarded the highest Ren Leriche International Prize for his work on local anesthesia during heart surgery (1955).

The study of respiration function under trimeperidine treatment in composition of combined formulation in a model of experimental blast injury

2017 ◽  
pp. 103-109
Author(s):  
Н.Г. Венгерович ◽  
М.А. Юдин ◽  
С.В. Чепур ◽  
И.М. Иванов ◽  
Е.И. Строкина ◽  
...  
Keyword(s):  
Respiratory Function ◽  
Soft Tissues ◽  
Traumatic Shock ◽  
Male Rats ◽  
Laboratory Animals ◽  
Control Group ◽  
Medical Evacuation ◽  
Data Registration ◽  
Blast Trauma ◽  
Respiration Function

Цель исследования - изучение функции внешнего дыхания при изолированном применении тримеперидина и в составе комбинированной рецептуры в различных дозах на модели экспериментальной взрывной травмы. Методика. Эксперименты выполнены на белых нелинейных крысах-самцах массой 200-240 г. В качестве анальгетиков использовали субстанцию тримеперидина (опиатный наркотический анальгетик) и дексмедетомидина (селективный a-2-адреномиметик). Для изучения влияния анальгетической комбинации на показатели дыхания в условиях травматического шока препараты вводили внутримышечно через 15 мин после моделирования травмы. Дозы тримеперидина при монотерапии составили 1,7 (1 ED) и 13,6 мг/кг (8 ED), а в комбинации - 0,574 (1 ED) и 4,592 (8 ED) мг/кг при совместном введении с дексмедетомидином в дозах 2,8 и 22,4 мкг/кг соответственно. В группе контроля осуществлялось введение физиологического раствора. В динамике у животных регистрировали функцию внешнего дыхания, определяли частоту дыхания (ЧД) и дыхательный объём (ДО), которые фиксировали до травмы (фон) и сразу после повреждения, а также спустя 15, 30 мин, 1, 2 и 24 ч после введения анальгетиков. Также исследовали динамику показателей сатурации кислорода крови (SpO) и частоты сердечных сокращений (ЧСС). Регистрацию данных производили в сроки, аналогичные изучению функции дыхания, через 10-15 с после стабилизации пульсовой волны. В работе использовали оригинальную модель взрывной травмы, позволяющую получить у лабораторных животных помимо обширных разрушений мягких тканей развитие общего контузионно-комоционного синдрома. Результаты. Показано, что взрывная травма приводит к росту минутного объёма дыхания за счет резкого повышения частоты с одновременным сохранением значений дыхательного объёма. Назначение тримеперидина в максимально суточной дозе сокращает минутный объём дыхания в 5 раз в сравнении с группой контроля. Введение препарата сопровождалось развитием острой дыхательной недостаточности III степени тяжести у большинства животных и гибелью половины особей в группе. Применение комбинированных обезболивающих рецептур позволяет существенно снизить дозу наркотического анальгетика, повышает безопасность проведения лечебно-эвакуационных мероприятий. Заключение. Применение экспериментальной комбинированной анальгетической комбинации тримеперидина и дексмедетомидина способствовало сохранению параметров минутного объёма дыхания, в основном за счет сохранения частоты дыхательных движений, препятствовало прогрессированию артериальной гипоксемии и предупреждало гибель животных. The purpose is to study respiratory function in isolated use of trimeperidine and as a part of a combined formulation in various doses in a model of experimental blast trauma. Methods. Experiments were carried out in a model of white non-linear male rats weighing 200-240 g. The substance of trimeperidine and dexmedetomidine was used as analgetics. To study the influence of analgesic combination on respiration characteristics following traumatic shock the drugs were injected intramuscularly 15 min following trauma modelling. Doses if trimeperidine in monotherapy were 1,7 (1 ED) and 13,6 mg/kg (8 ED) and in combination - 0,574 (1 ED) and 4,592 (8 ED) with 2,8 и 22,4 mg/kg of dexmedetomidine respectively. The control group got saline. In dynamics the respiratory function of animals was registered as well as respiratory rate and volume which were also recorded before trauma (background), immediately following injury and 15, 30 min, 1, 2 and 24 hour following analgetics administration. The dynamics of oxygen saturation in blood (SpO) and heart rate were also studied. Data registration was carried out in time-limits similar to study of respiration function 10-15 sec following pulse wave stabilization. The original model of blast trauma was used in this research. It allows having both extensive injuries of soft tissues in laboratory animals as well as general commotiocontusionale syndrome. Results. It was shown that blast trauma leads to an increase of volume of breath per minute due to rapid rate decrease with simultaneous retention of level of respiratory volume. The administration of trimeperidine in maximum daily dose induces 5-fold reduction of volume of breath per minute in comparison with controls. The injection of the drug was accompanied by the development of an acute respiratory failure (III degree) in majority of animals and death of the half of the group. The application of combined analgesic formulations allows decreasing a dose of narcotic analgetics and enhancing safety of analgesic aid in a system of medical-evacuation measures. Conclusion. The application of experimental combined analgesic combination of trimeperidine and dexmedetomidine enables to preserve minute lung volume parameters mainly due to retention of respiratory movement rate; it also inhibits the progression of arterial hypoxemia and prevents from death of the animals.

Sign in / Sign up

Export Citation Format

Share Document