Provision Of Emergency Medical Care Research Articles

United center for emergency care and disaster medicine in the Belgorod region: daily work in protracted emergency situations

Introduction. The trend of uniting the ambulance service in the subject of the Russian Federation has already been introduced in more than half of the regions of our country, but despite this, the arguments in favor of such centralization are still being questioned in the professional community.The purpose of the study: to study the impact of the association in the Center of Emergency Medical Care and Disaster Medicine on the specifics of providing emergency medical care to patients in the Belgorod region in working conditions in protracted emergencies.Materials and methods. A comparative analysis of the activities of the emergency medical service was carried out before and after the creation of the Center for Emergency Medical Care and Disaster Medicine. The obtained results were subjected to statistical processing using the Pearson χ2 test.Results. According to the results of the study, it was revealed that despite working in conditions of protracted emergencies of a biological, social and military nature, as a result of the merger, it was possible to significantly (p<0.05) improve the performance of 20-minute delivery of emergency medical services teams to emergency calls. Thanks to the merger, it was possible to ensure timely evacuation of victims with severe combined injuries to level 1 and 2 trauma centers, as well as patients with suspected acute coronary syndrome to the regional vascular center.Conclusion. The creation of the Unified Center for Emergency Medical Care and Disaster Medicine made it possible to organize the effective functioning of the EMS service in the region against the backdrop of a protracted emergency of a biological, social and military nature.

Pharmacological Activities of Warm Alkaline Hydrogen Peroxide Solution and Therapeutic Potential in Medicine: Physical-Chemical Reprofiling as a Promising Lead for Drug Discovery

Abstract: The traditional use of antiseptics, chemotherapeutic, expectorant, mucolytic drugs, and oxygen gas by artificial ventilation does not effectively eliminate hypoxemia in sputum, mucus, pus, and blood asphyxia in COVID-19. The emergency conversion of sputum, mucus, pus, and blood into oxygenated foam inside the airways utilizing the enzyme catalase and warm alkaline hydrogen solutions (WAHPSs) is proposed as a promising area for new therapeutic development.. The possibility of physical-chemical repurposing of hydrogen peroxide from an antiseptic in pyolytics, mucolytics, hemolytics, and oxygen-producing antihypoxants by con-verting a cold, acidic non-carbonated drug into an oxygen-saturated WAHPS and its intrap-ulmonary injection is pointed out as a way to solve this problem. The possibility of medically enriching blood oxygen in hypoxemia by catalase cleavage of hydrogen peroxide when WAHPSs are administered orally as energy drinks or directly into the blood as injections is pointed out. The fact is that virtually all human tissues are rich in catalase, which immediately breaks down hydrogen peroxide into water and oxygen gas. Inhalation and/or intrapulmonary injections of WAHPSs have been shown to provide intra-airway interaction with catalase in sputum, mucus, pus and/or blood and releases oxygen gas, which foams the biological masses, is absorbed into the blood and eliminates hypoxemia. Thus, the physical-chemical repurposing of known drugs can be considered a promising direction for the discovery of new drugs. Value of the data: 1) Why are these data useful? These studies indicate that the enzyme catalase, which is present in many tissues of animals and humans in both normal and disease, can be employed to enrich the tissues with oxygen and eradicate hypoxia when hydrogen peroxide solution is injected into them.. 2) Who can benefit from these data? Mountaineers, divers, submarine sailors, miners, astronauts, traumatologists, resuscitators, car-diologists, transplantologists, pulmonologists, obstetricians and gynecologists, emergency phy-sicians, EMERCOM personnel, and medical workers, providing emergency medical care in cases of smoke in rooms, lack of oxygen in the inhaled air, drowning, bronchial asthma attack, acute respiratory distress syndrome, and asphyxia can use the data presented in this article. 3) How can these data be used/reused for further insights or development of experi-ments? These data can be used to develop new antihypoxants, to improve methods of increasing the organism's endurance to hypoxia, methods of organ and tissue preservation, methods of ische-mia treatment, methods of emergency medical care in urgent conditions, methods of ARDS treatment and standards of medical care.

PUBLIC ANTI-CRISIS MANAGEMENT AND COMMUNICATIONS WHEN PROVIDING EMERGENCY MEDICAL AID IN THE MEDICAL INDUSTRY OF UKRAINE

In this article, the authors focus on several key problems that arise in the process of management and communication in crisis situations related to the provision of emergency medical care. The article examines approaches to managing crisis situations in the sphere of health care of Ukraine in conditions of increased uncertainty and instability. The authors emphasize the importance of effective communication between medical institutions, government structures and the public to ensure prompt response to emergency situations. The article examines various aspects of public crisis management, including planning, organization of resources, and coordination of actions during the provision of emergency medical care. The article analyzes the tools of public management, which allow to minimize various consequences of incoherence of actions between state institutions and medical institutions. Special attention is paid to the importance of prompt decision-making and establishment of communication links between state bodies, medical workers and the population. The possibilities of applying international experience in the field of anti-crisis management and its adaptation to Ukrainian realities are also discussed. The conclusions of the article emphasize the need to reform the health care system in the direction of strengthening its resilience to crises, improving communication mechanisms, and implementing innovative management solutions to increase the effectiveness of providing emergency medical care in emergency situations. The article emphasizes the need for quick decision-making, building effective communication chains between medical staff, patients and other stakeholders. Special attention is paid to the challenges associated with the lack of resources, the limited capabilities of the health care system in the context of crises and the role of leadership in implementing changes. The article also offers recommendations for improving communication processes and management approaches that will contribute to increasing the effectiveness of medical care during emergency situations, particularly in wartime.

Epidemiology of complications in anesthesiology and possible ways of their prevention

Increase in life expectancy in the world leads to an increase in the number of patients with multimorbidity who will require surgical intervention and anesthesia in the future. The desire of specialists to meet the high standards of clinical guidelines when performing medical interventions is often associated with the risk of complications, especially when providing emergency medical care. Complications during surgical interventions and anesthesia can be observed in institutions of any level and when providing care by any specialists.The aim. To assess the main risk factors that can cause complications when providing anesthesia.Materials and methods. The study was conducted in accordance with international reporting requirements for reviews (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). The search was performed in PubMed and Cochrane Controlled Clinical Trials Register. The method of searching by references was used to select the articles. The search strategy did not include limitations of the language, type and date of the article. Inclusion criteria: full-text publications devoted to the influence of risk factors on the incidence of complications when providing anesthesia care. Exclusion criteria: brief summaries; abstracts without a full-text version; publications without key words.Results. The review assessed the most common risk factors causing complications during anesthesia and ways to reduce them.

Catalase: A Potential Pharmacologic Target for Hydrogen Peroxide in the Treatment of COVID-19.

Acute respiratory distress syndrome in the elderly with COVID-19 complicated by airway obstruction with sputum and mucus, and cases of asphyxia with blood, serous fluid, pus, or meconium in newborns and people of different ages can sometimes cause hypoxemia and death from hypoxic damage to brain cells, because the medical standard does not include intrapulmonary injections of oxygen-producing solutions. The physical-chemical repurposing of hydrogen peroxide from an antiseptic to an oxygen-producing antihypoxant offers hope for the development of new drugs. This manuscript is a meta-analysis performed according to PRISMA guidelines. It is shown that replacement of the traditional acidic activity of hydrogen peroxide solutions by alkaline activity with pH 8.4 and heating the solutions to the temperature of +37 - +42 °C allows to repurpose hydrogen peroxide from antiseptics into inhalation and intrapulmonary mucolytics, pyolytics and antihypoxants releasing oxygen. The fact is that warm alkaline hydrogen peroxide solution (WAHPS) in local interaction with sputum, mucus, pus, blood and meconium provides optimal conditions for the metabolism of hydrogen peroxide to oxygen gas under the action of the enzyme catalase, always present in these tissues. It was established that WAHPS liquefies these biological masses due to alkaline saponification of lipid and protein-lipid complexes and simultaneously transforms dense masses into soft oxygen foam due to active enzymatic metabolism of hydrogen peroxide to oxygen gas, the rapidly appearing bubbles of which are formed by the type of "cold boiling" and literally explode these masses. The results of the first experiments showed that inhalation and intrapulmonary injections of WAHPS can significantly optimize the treatment of suffocation and hypoxemia. The results showed that catalase, which is found in sputum, mucus, pus, and blood, may be a target for localized WAHPS because this enzyme provides an intensive metabolism of hydrogen peroxide to oxygen gas up to the formation of the cold boiling process. These data provide a new perspective way for intrapulmonary drugs and new technologies for the emergency increase of blood oxygenation through the lungs in asphyxia with thick sputum, mucus, pus, meconium and blood.

Weaknesses of the existing organization of emergency medical care in European countries

The importance of an emergency medical care system for ensuring affordable and quality healthcare in any country is indisputable. Studying and analyzing existing problems in organizing this system is the first step to solving them. The present study aimed to investigate and outline the possible scope of the problems of emergency medical care, their recurrence, and similarity in 17 European countries. Content analysis of documents was used. The most characteristic organizational problems in providing emergency medical care for each of the countries are identified and grouped into five categories: Direct patient access to hospital emergency departments; Overloading of emergency departments by non-urgent, self-referral patients; Telephone triage by dispatchers - nurses or assistants; Existing and/or impending shortage of doctors in Emergency Medical Services (EMS); Regional and social inequalities in access to emergency medical care. A quantitative measurement of the categories and their relative weight were reported. Based on the analysis, the conclusions of the study were drawn. The identified problems, grouped into categories of weaknesses of the existing emergency medical care organization in European countries, may serve as a basis for undertaking health care reforms.

스마트 글래스 기반 응급원격의료지도 시스템 설계 및 구현

This paper proposes a smart glass-based emergency tele-medical direction system. This system is designed for hospital specialists to provide remote medical guidance to on-site coast guards or emergency responders. To identify the requirements necessary for system development, relevant technological trends and case studies were analyzed. Based on this analysis, three system requirements were defined: 1) The system must be able to determine the necessity of patient transport, 2) It should assist in providing emergency medical care during transport to the hospital, and 3) It must be capable of transmitting patient information to medical facilities. A prototype that meets these requirements was developed and its usability was evaluated.

THE START SORTING SYSTEM AND THE NURSE’S PARTICIPATION IN ITS IMPLEMENTATION

Introduction. This article highlights the problem of organizing the sorting of patients during mass admission to medical institutions and providing emergency medical care. The role of the nurse in conducting triage and providing emergency care at the early hospital stage is within the framework of limited resources. The urgency of working out the response protocol in the event of an emergency. The aim of the study – to determine the role of the nurse in the triage and provision of emergency care at the early hospital stage within the framework of a limited resource. To establish the relevance of the use of the START medical triage system in the practical activities of a nurse. The relevance of working out the response protocol in the event of an emergency among nurses. The main part. The medical triage system START (Simple Triage and Rapid Treatment) is an effective tool for organizing and accelerating the process of correct routing of patients in mass cases and crises when resources are limited and medical needs are high. Medical triage criteria also include signs of primary medical examination. As their professional responsibilities expand, nurses can use the ABCD algorithm to assess the patient’s condition. Knowledge of the principles of this medical triage system, the ability to provide emergency medical care, evenly and effectively distribute resources, follow the instructions of the coordinating physician, describe medical documentation, and label the patient’s category have become the duties of nurses due to the increasing frequency of emergencies. Conclusions. The START (Simple Triage and Rapid Treatment) triage system is used for prompt and efficient selection of victims during emergencies. The role of the nurse in this process is extremely important. First of all, the nurse must have skills in the application of the START triage technique and an understanding of its basics. During triage, the nurse can quickly assess the condition of each victim, determine the category, and assign the appropriate color tag. Provision of emergency medical care in conditions of limited resources, coordination, and reporting for further organization of medical care are key elements in the formation of nursing competence during triage. Using the principles of medical triage can help optimize treatment and save more lives in emergencies.

Issues of improving the legal regulation of the first aid and determining its expanded scope

Introduction. First aid is a special type of assistance, is the primary measure in the chain of survival of the victim in emergency situations. The scope of the first aid in this edition of regulatory legal acts is not sufficient in situations where the victim is in a remote, inaccessible area and without the possibility of providing emergency medical care, which significantly reduces the chance of survival. The purpose of the work is to determine the list of measures for the provision of the extended first aid and develop proposals for improving the regulation of relations in the field of the first aid in an expanded volume between the participants of these relations to protect their legitimate rights and interests. Materials and methods. Research material: regulatory legal acts regulating relations in the field of the first aid and determining its scope. Research methods: analytical, logical, and information modelling. Results. The analysis of the studied normative legal acts showed the presence of a legal gap in the field of regulation of first aid including the uncertainty of the volume of the extended first aid. To improve the regulatory and legal regulation of first aid activities and contribute to the current legislation, the author has developed and proposed a draft volume of the extended first aid for discussion. Research limitations. In the study of issues related to the provision of the extended first aid, 18 regulatory legal acts were selected and analyzed: the Constitution of the Russian Federation, 7 federal laws, 10 orders of relevant ministries; as well as 2 technical acts (GOST). Conclusion. The developed project of the expanded first aid is proposed for consultations and discussions with state structures and officials defining health policy, as well as representatives of scientific institutions of the medical community to develop management decisions aimed at achieving a high level of preservation of human and citizen life and health in emergency situations.

Features of organizing the provision of emergency medical care on-site in the city of Saint Petersburg

Special attention is paid to the development of primary health care and emergency medical care in our country, since timely prevention of the development of diseases and early provision of medical care to citizens is a priority task facing the domestic healthcare system. National projects and programs in healthcare are aimed at improving the provision of medical care, preventing diseases and promoting a healthy lifestyle. Providing emergency medical care is undoubtedly associated with all types of medical care and is an effective factor. Timely provision of emergency medical care contributes to a favorable outcome for each patient. That is why the need to analyze the experience of organizing the provision of emergency medical care on-site in a medical organization providing primary health care is of utmost importance. The purpose of the study is to analyze the organization of emergency medical care on-site in the city of St. Petersburg and identify its features. The research materials included analyzed orders of the Russian Ministry of Health, orders of the Health Committee of the city of St. Petersburg, open literary sources, medical documentation of the emergency department of a medical organization providing primary health care. As a result of the analysis and based on the data obtained, proposals were developed to improve the organization of emergency medical care on-site in the city of St. Petersburg, taking into account the existing shortcomings.

Emergency care and treatment of cerebral stroke at the stages of hospitalisation

According to the World Health Organization experts, about 7 million deaths due to cerebrovascular disease are recorded annually worldwide, and the number of stroke deaths is projected to reach 7.8 million by 2030. The main causes of stroke and its growth are population ageing, urbanisation, unhealthy lifestyles, insufficient control of risk factors (hypertension, atherosclerosis, diabetes, stressful situations, etc.). It is also associated with untimely provision of emergency medical care at the pre-hospital stage and ineffective treatment of strokes at the hospital stage, as well as a low efficiency of preventive treatment for recurrent stroke and rehabilitation measures. The lecture presents modern methods and techniques for treating patients with acute cerebrovascular accident at different stages: pre-hospital, hospital, and rehabilitation.

Correlates of Cardiology Nurses' Clinical First Aid Competence in a Selected Hospital in Shandong, China

As a cardiology department is an important place to receive critically ill patients, the improvement of nurses' own quality can significantly improve the first aid competence and resuscitation success rate, thus saving patients' lives. The clinical emergency care competencies of cardiac nurses include the ability to recognize changes in a patient's status in a timely manner during the course of treatment, as well as the ability to carefully assess the situation and make timely judgments. This ability to provide emergency medical care under stress is critical to the overall competence of the nurse. Cardiology nurses should improve their ability to learn on their own, continue to learn new knowledge and techniques, enhance their level of professional benefit, and actively participate in cardiovascular specialty nurse training in order to improve their critical care and emergency care abilities.

Road accidents on Indian National highways, ambulance reachability and transportation of injured to trauma facility: Survey-based introspection of golden hour.

The transportation system plays a crucial role in the context of socioeconomic development, whereas the highway infrastructure acts as a base for the transportation system. In recent years, a rich impetus has been given to the development of road infrastructure by Indian governance. There is a need to introspect how well the prevailing highway infrastructure is equipped with emergency rescue management during road accidents. Lack of ambulance service and trauma facilities along the highways results in a steady loss of lives and injuries and increases people's exposure to risks. This study aims to determine the response time of ambulance reachability to the accident spot on Indian national highways associated with heavy commercial transportation. Also, determining the time to transport the injured to the nearest trauma facility is another factor included as an objective in this investigation. The study adopted survey-based research, whereby the variables in the questionnaire were designed to record and assess the time for an ambulance to reach the accident spot and, from there, to transport the injured to the trauma management facility on Indian highways. Two hundred twenty-five participants who were either victims/relatives of victims or those involved in the rescue of the injured have participated in the survey. The dates of the accident events were 2017 and 2022. The survey resulted in the identification of two categories of highway accidents. The first category of accidents happened on the highways near city limits/dense settlements, and the second category occurred on the core highways. The percentage of accidents caused on the highways either adjacent to or passing through the city limits/dense settlements was reported to be higher than the accidents on the core highways. Ninety percent of the participants reported successful contact with the ambulance call/service centre, but only ~75% success rate exists for ambulances to reach the accident scene. On the core highways, the time taken for the ambulance to arrive at the accident scene is 25-35 minutes. The results from the survey ascertained that the patients were prioritised for treatment in the nearest hospitals (irrespective of having a trauma facility) at a distance of ~12-20 km, for which the time taken is ~15-25 minutes. Importantly, from the interviews, it is understood that in many cases, these hospitals have further referred to specialty hospitals located in nearby cities or trauma centres with greater facilities. Occasions exist where the injured were taken directly to hospitals 30-40 km from the accident spot, for which the time was more than 40 minutes. The results provide evidence that in either of the accident cases on the highways that are adjacent to/passing through the city limits or on the core highways, the total time for emergency care accessibility is nearly 60 minutes or greater; this implies that in the majority of cases, there is very meagre time left to provide emergency medical care to the needy and injured on the Indian highways to abide by the concept of golden hour. Plausible reforms backed by technology for enabling highways into 'emergency rescuable highways' are highly needed to guarantee a safer and more sustainable transportation system in India.

Medical Response to the February 6, 2023, Earthquakes in Hatay: Challenges Faced in the Deadliest Disaster in the History of Türkiye.

The Kahramanmaraş earthquakes struck the north-eastern part of Türkiye and Syria on February 6, 2023. It is well known that timely coordination and provision of emergency medical care in the field is particularly important to save lives after earthquakes. This study aimed to identify the challenges faced by medical responders on the ground. This exploratory-descriptive qualitative study was conducted in Hatay, the province most affected by the earthquakes. Data were collected through in-depth semi-structured interviews and field observations, and then analyzed using thematic analysis approach. The study was carried out with 15 first responders from the medical profession. The study revealed 9 themes of challenges faced by medical responders: providing safety and security, human resources management, meeting personal needs, recording data, communication, patient transport, burial procedures, psychological acumen, and logistical problems. Some problems were resolved after 72 h and some continued until day 7. Inadequate organization of volunteer health workers, communication breakdowns, and logistical problems are some of the main challenges. To address these issues, satellite phones and radio systems can be promoted, as well as disaster-resilient logistical planning and better coordination of volunteers.

КЛИНИЧЕСКИЙ СЛУЧАЙ ОКАЗАНИЯ ЭКСТРЕННОЙ МЕДИЦИНСКОЙ ПОМОЩИ ПАЦИЕНТУ С КАТАТРАВМОЙ

We present a clinical case of providing emergency medical care to a patient with a combined injury resulting from a fall from a height (catatrauma). We consider clinical aspects, features of diagnosis and treatment tactics of a patient with multiple injuries, including concussion, various bruises and abrasions of soft tissues, open fracture of the radius of the left upper limb, closed fracture of the femur neck and open comminuted fracture of the middle third of the right thigh, as well as traumatic shock. The patient was taken to a medical institution in serious condition with pronounced clinical signs. The initial examination revealed a concussion, which neurological status and computed tomography results confirmed. The focus of emergency care was on an open fracture of the radius of the left upper limb requiring immediate surgery, as well as an open comminuted fracture of the middle third of the right thigh. Based on the results of radiography, the presence of fragments was established, which required stabilization of the fracture and further surgical treatment. In addition, the patient was in a state of traumatic shock, which required emergency infusion therapy and vital signs monitoring. Both blood loss and pain syndrome caused the shock. The measures taken to quickly restore hemodynamic stability, including infusion therapy, which improved the patient's condition. During the treatment, the necessary surgical interventions were performed. Anesthesiologist and resuscitator supervised the postoperative period with an emphasis on pain therapy and prevention of complications. The results of the diagnosis and treatment of this clinical case emphasize the importance of a comprehensive and multidisciplinary approach to patients with combined injuries after falling from a height. The description of this case provides a better understanding of the specific aspects of medical care for such complex injuries, helps to optimize treatment tactics and improve the quality of emergency medical care for this category of patients.

Пример клинического случая оказания экстренной медицинской помощи больному с тяжелой сочетанной травмой

Abstract. We consider a case of providing emergency medical care to a patient with a concomitant injury as a result of a traffic accident. Purpose of the research: to consider a clinical case report of effective emergency medical care to a victim with severe concomitant injury. We describe main aspects of diagnosing this kind of patients, the difficulties of providing care to patients with concomitant injury and the treatment results. Materials and methods. This research uses materials from the medical documentation of the trauma department of Archbishop Luke Tambov City Clinical Hospital. Results. Effective treatment of such injuries and a favorable outcome, as a rule, is possible only in a multidisciplinary medical institution, since it is in this type of medical organizations it is possible to obtain all the necessary instrumental and laboratory diagnostics of the injuries, there are also many specialists in various fields, which allows to competently organize the correct surgical tactics, develop a treatment plan, prescribe all the necessary infusion therapy to eliminate the resulting hypovolemia, and in the event of shock – anti-shock therapy to eliminate the patient’s unstable hemodynamics as quickly as possible, in case of development or progression of respiratory failure – establish respiratory support with the possibility of transferring the patient to artificial lung ventilation, in the case of prolonged artificial lung ventilation – a tracheostomy, and of course, adequate pain relief for the pain syndrome that accompanies absolutely every case of concomitant injury. All this together is aimed at stabilizing the patient’s condition, preventing possible complications, and if they occur, their timely identification and elimination, carrying out further rehabilitation to return the patient to a full life. Conclusions: the annual increase in the number of road accidents and the development of severe injuries in connection with this requires the further development of various types of diagnostics, indicates the need to ensure the availability of CT examinations, MRI machines, the development of traumatology, surgery and neurosurgery, which ultimately will favorably contribute to timely diagnosis and effective treatment of life-threatening conditions that occur in victims of road traffic accidents.

Managing gender-based violence patients: implications for the practices and attitudes of emergency medical care providers

Managing gender-based violence patients: implications for the practices and attitudes of emergency medical care providers

Assessing Patient Demographics and Emergency Response Adaptation in a Primary-Level State Hospital Following the 6 February Türkiye Earthquakes

Aim: On 6 February 2023, a series of earthquakes with magnitudes of 7.8, 6.6, and 7.6 struck the south-eastern region of Türkiye within a span of 10 hours, starting from 04:00 am. These earthquakes resulted in a devastating loss of life, with casualties exceeding 50,000 across 10 provinces. The destruction caused by these earthquakes was widespread with the collapse of many buildings, including hospitals. This study aimed to assess the patient demographics and emergency response adaptation in a primary-level state hospital following the 6 February Türkiye earthquakes. Materials and Methods: The study was conducted at the Reyhanlı State Hospital, which remained largely unaffected by the earthquakes. The hospital faced challenges in providing medical care due to the loss of staff, damaged infrastructure, and limited resources. A volunteer orthopaedic surgery team, along with other medical professionals, provided treatment to the earthquake victims. The patient data was collected from the conventional record book of the operating room. Results: From 6 to 12 February 2023, a total of 111 surgeries were performed at the hospital, with 92 (%83) being earthquake-related. Orthopaedic surgeons operated on most of the patients. The most common surgeries included fasciotomies, amputations, and fracture fixations. The surgeries were performed in a time-sensitive manner, with immediate life- and extremity-saving procedures prioritized. The hospital's infrastructure challenges and the lack of digital recording systems hampered the data collection process. Conclusion: The study highlights challenges faced by a primary-level Hospital during the earthquakes. Our indings stress the importance of preparedness, infrastructure, and efficient patient records for effective emergency healthcare during natural disasters. Lessons learned can aid future plans for better emergency medical care in earthquake-prone regions.

Priapism: what every non-urologist should know about?

Priapism is an emergency that requires immediate treatment and should be managed by every doctor who works in an emergency room. emergency medicine clinicians may be the first-line providers and should be capable of applying the initial management of priapism. Those providing emergency medical care in low-resource areas should know how to utilize interdisciplinary collaboration with urologists and be familiar with techniques of aspiration, irrigation, phenylephrine injections, and T shunts.

Training of Emergency Medical Specialists in Contemporary Realities

Relevance. In accordance with Federal Law No. 323-FZ [17], emergency medical assistance, including emergency specialized medical care, is provided in emergency form outside a medical organization, as well as on outpatient and inpatient basis. An ambulance is an emergency medical service that travels to those whose lives and health are in danger. Emergency medical assistance, including emergency specialized medical care, is provided in case of diseases, accidents, injuries, poisonings and other conditions requiring urgent medical intervention. The reasons for calling an ambulance in an emergency form are sudden acute diseases (conditions) and (or) sudden exacerbations of chronic diseases without obvious signs of a threat to life, requiring urgent medical intervention. In the training of doctors, including in postgraduate education, these factors are taken into account.Aim of the study. Improvement of the quality of theoretical and practical training of emergency medical specialists, as well as clinical residents and practical doctors of various specialties, taking into account issues of emergency and military medicine.Material and methods. A review of official documents of the Ministry of Healthcare of the Russian Federation and the literature on postgraduate education of doctors with subsequent primary specialized accreditation for 2018-2022 was carried out. The literature on modern approaches to the provision of emergency medical care to victims was studied, taking into account the specifics of military (tactical) medicine for 2020–2022.Conclusion. The training of emergency medical professionals, taking into account the realities of the present, should include issues of tactical medicine and be practice-oriented using simulation equipment. It is necessary to know and be able to work with modern means of protection and medical care available in the troops; be prepared to work in medical institutions of various levels with the mass flow of injured and wounded.