TOPICAL ISSUES OF LEGAL QUALIFICATION OF INAPPROPRIATE PROVISION OF MEDICAL CARE TO PATIENTS WITH A NEW CORONAVIRUS INFECTION

Author(s):  
Антон Викторович КОЛОКОЛОВ

Автором поднимается проблема квалификации действий ненадлежащего характера по оказанию медицинской помощи, которые повлекли за собой наступление уголовно наказуемых последствий. Дается уголовно-правовая характеристика преступлений, совершаемых в сфере медицинской деятельности, примеры анализа специфических признаков при ненадлежащем оказании медицинской помощи больным COVID-19. The author raises the problem of qualifying inappropriate actions to provide medical care, which entailed criminal consequences. The article provides a criminal legal description of crimes committed in the field of medical activity, and examples of the analysis of specific signs in case of improper provision of medical care to patients with COVID-19.

Author(s):  
Olga Shinkareva

Article is devoted to the analysis of the Order of the Russian Ministry of Health of 19.03.2020 № 198n (an edition of 29.04.2020) “About a temporary order of the organization of work of the medical organizations for implementation of measures for prevention and reduction of risk of spread of a new koronavirusny infection of COVID19” regarding formation of the temporary staff list of the division of the medical organization providing medical care to citizens with a koronavirusny infection of COVID-19 and also the requirement with the staff of this division. The criteria recommended by the Ministry of Health of the Russian Federation for determining the number of rates of medical workers in these divisions, requirements for medical workers of the division have been considered, a practical example of calculation of rates has been given.


2020 ◽  
Vol 1 (1) ◽  
pp. 14-17
Author(s):  
Evgenia Dvoryankova ◽  

COVID-19 pandemic posed a number of new formidable challenges to medical community. Dermatologists have not only to detect, define and reverse the new coronavirus infection cutaneus manifestations, but also to provide medical assistance to colleagues with occupational dermatitis due to personal protective equipment use. Moreover, it is necessary to provide quality medical care to patients with acute and chronic dermatosis given the limitations of present pandemic situation.


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.


Author(s):  
Л.А. Балыкова ◽  
Л.Ф. Сабиров ◽  
Е.В. Семелева

Возникновение нового варианта вируса и эпидемический потенциал, проявленный возбудителем COVID-19, поставили перед специалистами здравоохранения задачи, связанные с быстрой разработкой диагностики и профилактики новой инфекции, а также тактики оказания медицинской помощи больным. Активное распространение коронавирусной инфекции заставило активно вносить изменения в систему медицинского образования. Целью данной работы был анализ эпидемиологической ситуации по COVID-19 в Республике Мордовия для понимания особенностей развития эпидемического процесса и составления его прогноза, а также рассмотрения перестройки образовательного процесса в условиях пандемии. Проведен ретроспективный анализ эпидемиологической ситуации по заболеваемости COVID-19 в Республике Мордовия, проанализирована эффективность реализации профилактических и противоэпидемических мероприятий, приведены данные по динамике заболеваемости, выздоровлению и летальности пациентов. Изучены элементы перестройки образовательного процесса. Проанализирована эпидемиологическая ситуация в сравнении с некоторыми регионами РФ, изучены данные по проведению вакцинации, по динамике коечного фонда за период пандемии. Вероятность смерти от коронавируса COVID-19 в Республике Мордовия аналогична мировым показателям. Можно предположить, что дистанционное обучение займет одну из лидирующих позиций в высшей школе. Благополучная ситуация в Республике Мордовия с заболеваемостью и летальностью от новой коронавирусной инфекции складывалась благодаря реализации научно обоснованной стратегии опережающего реагирования – на основе постоянной оценки масштабов распространения новой коронавирусной инфекции, анализа тенденций эпидемического процесса, моделирования развития эпидемической ситуации и проводимых превентивных мероприятий. Непосредственное участие преподавателей университета в лечебной работе, использование их опыта и знаний в решении практических задач будут способствовать повышению качества медицинской помощи и развитию системы здравоохранения Республики Мордовия не только в условиях пандемии COVID-19, но и в дальнейшем. The emergence of a new variant of the virus and the epidemic potential manifested by the causative agent of COVID-19 have set health professionals tasks related to the rapid development of diagnostics and prevention of a new infection, as well as tactics for providing medical care to patients. The active spread of coronavirus infection has forced active changes to the system of medical education. The goal is to analyze the epidemiological situation of COVID-19 in the Republic of Mordovia in order to understand the development of the epidemic process and make a forecast, consideration of the restructuring of the educational process in the context of a pandemic. In this article, a retrospective analysis of the epidemiological situation on the incidence of COVID-19 in the Republic of Mordovia is carried out, the effectiveness of the implementation of preventive and anti-epidemic measures is analyzed, data on the dynamics of morbidity, recovery and mortality of patients are presented. The elements of the restructuring of the educational process are studied. The epidemiological situation was analyzed in comparison with some regions of the Russian Federation, data on vaccination, on the dynamics of the bed fund during the pandemic period were studied. The probability of death from the COVID-19 coronavirus in the Republic of Mordovia is similar to the indicators around the world. It can be assumed that distance learning will take one of the leading positions in the process of studying in higher education. A favorable situation in the Republic of Mordovia with morbidity and mortality from a new coronavirus infection was formed positive to the implementation of a scientifically grounded strategy of proactive response – based on a constant assessment of the scale of the spread of a new coronavirus infection, analysis of trends in the epidemic process, modeling the development of the epidemic situation and ongoing preventive measures. The direct participation of university teachers in medical work, the use of their experience and knowledge in solving practical problems will contribute to improving the quality of medical care and the development of the healthcare system of the Republic of Mordovia not only in the conditions of the COVID-19 pandemic, but also in the future.


2021 ◽  
Vol 25 (1) ◽  
pp. 25-28
Author(s):  
V. G. Svarich ◽  
I. M. Kagantsov ◽  
V. A. Svarich ◽  
E. G. Perevozchikov

Introduction. The first publications about acute appendicitis in the conditions of the new COVID-19 coronavirus infection have appeared. Most authors point to the increased time of seeking medical help in such patients and an increase in the level of postoperative complications.Material and methods. A retrospective study of 192 case histories of patients aged 3 to 17 years with various forms of acute appendicitis who were treated in the surgical Department of the Republican children’s clinical hospital in the period from 2019 to November 2020 was conducted. Children operated on during 2019 before the start of the new coronavirus pandemic were included in the first group (n = 114). Children operated on in 2020 after the development of a new coronavirus pandemic were included in the second group (n = 78).Results. The age of patients in both groups compared did not differ significantly. The course of the disease was within the average accumulated indicators and the terms of hospitalization did not change significantly. According to our observations, the time of admission to the surgical hospital from the time of the disease in the pre-coronavirus period and during it also did not differ significantly, which indicates that the same availability of medical care remains even during the epidemic. Our study also showed that the number of requests for complicated appendicitis in children during the COVID-19 epidemic even decreased, which ultimately led to a decrease in the level of postoperative complications. The study did not establish a significant difference between the main results of treatment of children with acute appendicitis before and during the new COVID-19 coronavirus infection. Only the level of postoperative complications significantly decreased in patients operated during the COVID-19 epidemic, which is associated with a lower admission of children with complicated appendicitis.Conclusion. With the onset of the pandemic, the organization of medical care for the child population with acute pathology in the Komi Republic did not change and did not have any restrictions, which made it possible to maintain the timely provision of surgical care to children with acute appendicitis at the proper level.


2021 ◽  
Vol 22 (1) ◽  
pp. 26-31
Author(s):  
S. N. Alekseenko ◽  
A. S. Bagdasaryan ◽  
A. A. Sirunyants ◽  
D. V. Pukhnyak ◽  
Z. A. Kamalyan ◽  
...  

The pandemic of a new coronavirus infection caused the need to reorganize the work of emergency medical services (EMS) due to the high contagiousness and mortality, multiple organ lesions, difficulties in diagnosis and the lack of protocols for providing medical care to patients at the prehospital stage.The purpose and objectives of the study is to assess the activities of the ambulance service in the context of a new coronavirus infection in Krasnodar.Materials and methods: data of the information base of the integrated automated system for managing the activities of the ambulance station SBIHC KEH of the Ministry of Health Care of the Krasnodar Region in Krasnodar.Results. А differentiated approach and algorithm was developed for assessing the severity of the condition in patients with COVID-infection and ARVI, their routing and organization of treatment in Krasnodar.Conclusion: an assessment of the work of the ambulance service in combination with the measures taken during the observation period will ultimately allow organizing high-quality medical care to the population. 


2018 ◽  
Vol 13 (3) ◽  
pp. 107-119
Author(s):  
Patimat A. Bekshokova ◽  
Gayirbeg M. Abdurakhmanov ◽  
Kerim S. Bekshokov ◽  
Patimat I. Gabibova ◽  
Kazbek K. Bekshokov ◽  
...  

Aim.To carry out a comparative analysis of self-rated health, medical activity, and satisfaction with the quality of medical care in public health institutions by residents of rural settlements of the Untsukul district, Republic of Dagestan.Methods.The study was conducted by the method of questioning 2643 respondents, among them 1453 women and 1181 men.Results.According to the results of the survey, the majority of the interviewed residents of Untsukul district (68.2%) are satisfied with their health. Medical activity of the population at the time of the study was 60.6%. As to respondents who applied to the medical institutions of the Untsukul district during this period, 13.5% are not satisfied with the quality of medical care in public health institutions, 23.5% are fully satisfied, 30% are not fully satisfied.Conclusion.A social survey in the form of a questionnaire is one of the most effective methods of obtaining information about the self-rated health of the population. Timely analysis of medical activity of the population, its satisfaction with the quality of medical care will improve the efficiency of the health system.


2020 ◽  
Vol 21 (3) ◽  
pp. 44-47
Author(s):  
V. M. Shaytor ◽  
D. A. Zemlyanoy ◽  
M. V. Ponyatishina ◽  
A. N. Galustyan

The paper presents the basic ideas about quarantine infections, especially coronavirus infection, and proposes an algorithm for routing patients with COVID‑2019 at the prehospital stage of emergency and emergency care.


Bioethics ◽  
2021 ◽  
Vol 27 (1) ◽  
pp. 59-62
Author(s):  
I.A. Serova ◽  
◽  
A.U. Yagodina ◽  
O.A. Kostenko ◽  
◽  
...  

The article presents a reflexive technology for conducting a survey among residents on the problem of health of medical workers during pandemic. Content analysis of reminiscences about the peculiarities of providing medical care during pandemic of coronavirus showed the need for the early implementation of rapid testing for SARS-cov-2 before personnel in order to stop the spread of infection by medical workers. There is a clear need to analyze the effectiveness of ways of dividing contagious patient groups from other patients in primary medical care. The return to the workplace of doctors after a coronavirus infection is connected with their preliminary examination and rehabilitation – it is a thesis for current human rights issues.


Author(s):  
N. V. Izmozherova ◽  
A. A. Popov ◽  
A. I. Tsvetkov ◽  
M. A. Shambatov ◽  
I. P. Antropova ◽  
...  

Introduction. Acute respiratory distress syndrome (ARDS) and cardiovascular events, acute myocardial injury being the most frequent of the latter, are among the leading causes of death in COVID-19 patients. The lack of consensus on acute myocardial injury pathogenesis mechanisms, the patients management, treatment an rehabilitation logistics, the anticoagulant treatment in identified SARS-CoV-2 or suspected COVID-19 patients setting indicates the need to assess, analyze and summarize the available data on the issue.Materials and methods. Scientific publications search was carried out in PubMed, Google Scholar databases for the period from December 2019 to September 2021.Results and Discussion. Cardiospecific troponin I increase beyond reference limits is reported to occur in at least every tenth patient with identified SARS-CoV-2, the elevated troponin detection rate increasing among persons with moderate to severe course of the infection. The mechanisms of acute myocardial injury in patients with COVID-19 are poorly understood. By September 2021, there are several pathogenesis theories. A high frequency viral myocarditis direct cardiomyocytes damage is explained by the high SARS-CoV-2 affinity to ACE2 expressed in the myocardium. The cytokine storm related myocardial damage is reported a multiple organ failure consequence. Coagulopathy may also trigger myocardial microvessels damage. Up to every third death of SARS-CoV-2 infected persons is related to the acute myocardial injury. At the same time, due to the high incidence of the acute myocardial injury, it is rather difficult to assess the true incidence of acute myocardial infarction in patients with COVID-19. In the pandemic setting, the waiting time for medical care increases, the population, trying to reduce social contacts, is less likely to seek medical help. In this regard, in order to provide effective medical care to patients with acute myocardial infarction, it is necessary to develop algorithms for providing care adapted to the current epidemiological situation.Conclusion. The treatment of patients with probable development of acute myocardial damage against the background of new coronavirus infection should be performed in accordance with the current clinical guidelines. Anticoagulant therapy should be administered in a prophylactic dose under control of hemostasis parameters and a wide range of biochemical parameters.


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