Medical Care For Injuries Research Articles

Application of new approaches in the organization and conduct of classes on combat and special training of military medical personnel

Abstract. Considers an example of organizing and conducting practice-oriented classes on providing emergency medical care for injuries with medical personnel of the military level, garrison and base military hospitals in the Western military district. In large garrisons of the military district in 2019, we conducted four rounds of field training on the organization of emergency medical care for major life-threatening conditions. The format of classes included master classes and blitz lectures on various topics: cardiopulmonary resuscitation, stopping ongoing external bleeding, eliminating asphyxia and pneumothorax, transport immobilization, and features of the use of modern means of emergency medical care. An important practical part of the training was training with surgeons of military and hospital units on living biological objects. At the beginning and end of the course, primary and control tests of the level of knowledge were conducted. During the initial testing, the percentage of correct answers in the groups averaged: surgeons (n=20) 53,9%, doctors of other specialties (n=25) 56,5%, average medical staff (n=34) 52,8%, health instructors (n=52) 52,6%. During the control testing, the following results were obtained: 71,5; 83,5; 84,3 and 83,9% respectively. The format of classes reliably (p˂0,05) showed their high efficiency in all groups. Thus, the need to actively introduce a practice-oriented form of training in the form of demonstration classes, including the use of biological models and simulators, into the combat and special training of military medical personnel is obvious and beyond doubt.

The problem of continuity in the provision of medical care as an element of a violation of the rights of the patient with trauma pathology

This article is devoted to the disclosure of the key legislative problems in the implementation of the legal rights of certain categories of citizens – patients with traumatic pathology in obtaining qualified medical care. The choice of the category of patients in this work is not accidental and is due to the fact that today traumatism is one of the main causes of mortality. Disability associated with the consequences of traumatic injuries ranks third in the overall structure of the causes of persistent disability in the Russian Federation and is one of the most important indicators characterizing the quality of medical care to this population. The quality of medical care provided to the population, guaranteed by the Constitution of the Russian Federation, is affected by the observance and implementation of the rights of patients enshrined in the Federal law «on the basis of public health protection», first of all, the right to access to the required medical care. As a result of the study of this problem, a number of shortcomings of the current legal regulation of certain areas of domestic health care have been identified, which in our opinion significantly reduces the effectiveness of the state policy in the field of health protection of the population of Russia, including in ensuring the implementation of effective medical care for injuries, especially in terms of medical rehabilitation at the post-hospital stage of medical care. The methodological basis of this work was a set of methods of scientific knowledge, social processes and facts, dialectical method of knowledge, involving the study of legal and social phenomena, the method of system analysis, the method of analysis of literary, including st atistical data.

A national survey of facilities for complainants of sexual assault.

In 2006, a national survey demonstrated wide disparities in services offered to sexual assault complainants in the UK, most marked between sexual assault referral centres and non-sexual assault referral centres (police victim examination suites). With national standards introduced in 2009 and the expansion of sexual assault referral centres, we aimed to evaluate the current situation. A questionnaire based on the original 2006 survey, collecting data on population covered, access, funding, personnel, medical care and clinical governance was sent to all 44 UK sexual assault referral centres open in 2012. No non-sexual assault referral centres were identified. Data were collected over six months from December 2012. Twenty-three sexual assault referral centres from England and Scotland responded (response rate 52%), but not all answered every question. All (20/20) had 24 h access for acute referrals, although one sexual assault referral centre reported 24 h opening was not always possible due to recruitment issues. Thirteen of 20 (65%) had a separate rota for under 16 s, but this was often not 24 h/day. All services (20/20) offered facilities for non-police referrals and for provision of anonymous intelligence. All sexual assault referral centres employed female examiners, 11/17 (65%) male examiners and half (10/20) forensic nurse practitioners. All (21/21) offered pregnancy testing and emergency contraception, 19/21 (90%) HIV post-exposure prophylaxis , 12/21 (57%) hepatitis B virus vaccine and 11/21 (52%) medical care for injuries on site. For follow-up care, 12/21 (57%) provided in house counselling, 10/21 (48%) sexually transmitted infection screening, 12/21 (57%) hepatitis B virus vaccination and 14/21 (67%) HIV post-exposure prophylaxis . Our survey shows improvement in services for complainants of sexual assault since 2006 with better access to forensic examinations, medical and psychological care. However, as the response rate was low and without data from non-sexual assault referral centre services, we cannot give a comprehensive national picture. Our results also show that there has been little improvement in providing sexual health screening on site or by referral and this should be addressed by sexual assault referral centres.

Hecamede: Homeric nurse of the battle-wounded in the Trojan War

The Homeric epics present the 10-year lasting Trojan War, offering the description of battle wounds and medical care of injuries. Hecamede is referred by the Homer as a battlefield nurse who had knowledge of the treatment of bleeding battle wounds.

Experiences of emergency care by the women exposed to acute physical intimate partner violence from the Finnish perspective

In the acute trauma caused by intimate partner violence (IPV), the emergency department (ED) and its staff are often the first contact for women. The failure to intervene in IPV situations may contribute to further injury and health problems for women, as well as to frequent visits to the ED. The aims of this study is to describe the history of IPV with its health consequences for women when seeking care for their acute injuries and what kinds of care experiences had the women had when visiting EDs. Data were collected via questionnaires from 35 women and after that seven semi-structured interviews were conducted. The data were analyzed using quantitative and qualitative methods. Among the women the lifetime prevalence of physical IPV was 94%. Ninety-seven percent of past and 56% of acute cases of physical violence were accompanied by psychological violence. The surveyed women highlighted individual needs for care, including appropriate medical care of injuries, and psychological and tangible support. The women worried about their children and partners and regarded supporting the whole family as important. There is a need for ED professionals to develop family-oriented services, and a need for further training and research on how to deal with women exposed to IPV.

Alcohol Use, Injuries, and Prenatal Visits During Three Successive Pregnancies Among American Indian Women on the Northern Plains Who have Children with Fetal Alcohol Syndrome or Incomplete Fetal Alcohol Syndrome

The purpose of the study was to compare three sequential pregnancies of American Indian women who have children with FAS or children with incomplete FAS with women who did not have children with FAS. Two retrospective case-control studies were conducted of Northern Plains American Indian children with fetal alcohol syndrome (FAS) (Study 1) or incomplete FAS (Study 2) in 1981-1993. Three successive pregnancies ending in live births of 43 case mothers who had children with FAS, and 35 case mothers who had children with incomplete FAS were compared to the pregnancies of 86 and 70 control mothers who did not have children with FAS, respectively, in the two studies. Prenatal records were abstracted for the index child (child with FAS or incomplete FAS) and siblings born just before and just after the index child, and comparable prenatal records for the controls. Compared to the controls, significantly more case mothers used alcohol before and after all three pregnancies and during pregnancy with the before sibling and the index child. Mothers who had children with FAS reduced their alcohol use during the pregnancy following the birth of the index child. All Study 1 case mothers (100%) and 60% of Study 2 case mothers used alcohol during the pregnancy with the index child compared to 20 and 9% of respective control mothers. More study 1 case mothers experienced unintentional injuries (OR 9.50) and intentional injuries during the index pregnancy (OR 9.33) than the control mothers. Most case mothers began prenatal care in the second trimester. Alcohol use was documented before, during and after each of the three pregnancies. Women of child-bearing age should be screened for alcohol use whenever they present for medical services. Mothers who had a child with FAS decreased their alcohol consumption with the next pregnancy, a finding that supports the importance of prenatal screening throughout pregnancy. Women who receive medical care for injuries should be screened for alcohol use and referred for appropriate treatment. Protective custody, case management and treatment services need to be readily available for women who use alcohol.

Injuries and Health Care Use in Women with Partners in Batterer Intervention Programs

Objective:To characterize injury frequency, injury patterns, and health care seeking behavior in women with intimate partners enrolled in batterer intervention programs. Methods: A standardized telephone interview was conducted on a sample of women with male partners enrolled in batterer intervention programs in four U.S. cities. Information on prior injuries and the utilization of health care services was sought. Results: Four hundred and eighty eight of the 648 women (75.3%) reported a history of prior injury as a result of abuse. Contusions were the most common injury. Of the women reporting contusions, 233 (51.4%) reported contusions as their only injuries. Another 220 women (48.6%) reported other injuries in addition to contusions. In the majority of cases (63.2%) the contusions were to multiple body parts. When the contusion involved only one anatomical region, it was mostly to the face. A total of 192 of the 488 injured women (39.3%) reported ever seeking medical care for injuries caused by their intimate partner. Twenty-three women (4.7% of the injured cohort or 3.5% of the total cohort) reported having ever been hospitalized for injuries sustained from abuse.

Trauma in the Elderly: The Impact on the Health Care System

The impact of injuries in the elderly on the acute health care system was assessed in terms of the cost of injuries. The cost of injuries in the elderly (greater than or equal to 60 years) was compared with that in the younger group (less than 60 years) in a health district in northern Sweden. Even though the elderly made up only one sixth of the total injured during a one year period, they accounted for 42% of the total cost of the medical care of injuries. The mean medical care cost increased significantly from the age of 60 years; the cost was four times higher in the older group than in the younger group. Severe injuries in the elderly cost almost 2.5 times more than those in the younger group. In conclusion, since the elderly place a heavy burden on the health care system, they urgently need to be given priority in injury research and injury intervention programmes.