Provision Of Emergency Medical Care Research Articles

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.

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.

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.

Creation and Establishment of the State Emergency Medical Services and Disaster Medicine Services in Russia (to the 100th Anniversary of the N.V. Sklifosovsky Research Institute for Emergency Medicine)

After the October Revolution of 1917, the creation of the state healthcare and medical education system in the country played a decisive role in the organization of emergency medical services (EMS) in Moscow on the basis of the former Sheremetev Hospital which later became a large multidisciplinary medical institution — N.V. Sklifosovsky Institute of Emergency Medicine (since 1943 — N.V. Sklifosovsky Research Institute for Emergency Medicine), — and the city EMS station as a part of it.In the pre-war period, the working out of the main principles for the EMS provision was critically important for the development of the services. It became possible to solve scientific and methodological problems related to the training of specialists. The Institute grew into a large institution, research in the field of emergency medicine was carried out at the world level. This contributed to the organization of a network of EMS institutions in the country during 1926–1935.The years of the Great Patriotic War of 1941–1945 enriched the practice of providing emergency medical care, including during mass patient admission.In the post-war years (1946–1970s), the Institute became the leading institution on the problems of EMS in the country. Corresponding divisions were created within the Institute, and on its basis — “Emergency Medicine” scientific and practical association, research and organizational structures of the USSR Ministry of Health, the RSFSR Ministry of Health and the USSR Academy of Medical Sciences. Thanks to this, outstanding results were achieved in the EMS organization: the specialty of “emergency medicine physician” was introduced; emergency hospitals were created in a number of the country’s regions; government programs for EMS provision were successfully implemented; а large number of regulatory documents were prepared to facilitate the further EMS development.N.V. Sklifosovsky Research Institute for Emergency Medicine was among the main initiators of the disaster medicine service, which made it possible to fundamentally solve its organizational and technical problems. Thus, a significant contribution was made to the foundation of this service in Moscow and around the country.At the current stage (from 1992 to the present), EMS improvement has been continued, many developments turned out to be relevant for this services in the Russian Federation. In particular, the created structure of the Institute’s admission and intensive care unit remained the flagship among emergency care institutions in the country for about 20 years. The state program “Improving medical care for road accident victims” was successfully implemented. The Institute’s departments are being actively specialized, making it possible to obtain fundamentally new scientific and practical results for widespread implementation.Since 2011, “Scientific achievements in the field of emergency medical care in the Russian Federation” - collections of research works - have been published annually. The information presented in them can be used throughout the country.The experience in treatment for the novel coronavirus infection COVID-19 allowed the Institute to begin a new page in the history of emergency medical services.The recent opening of an emergency inpatient complex at the Institute contributed to optimizing the work of the hospital’s resuscitation and intensive care units and expanding their treatment and diagnostic capabilities.For more than 10 years, the public and consolidating activities of the scientific and practical society of emergency medicine specialists have been effective. Its work primarily concerns the organization and conduct of scientific and practical events, especially congresses of emergency medicine physicians, as well as the publication of Sklifosovsky Journal Emergency Medical Care, which has unifying significance for a large number of Russian specialists in the field of EMS. The decisions made at the congresses and conferences became the basis for expanding the introduction of advanced medical technologies in the Russian regions, as well as for carrying out important structural reforms in EMS institutions.One of the main achievements of the N.V. Sklifosovsky Research Institute for Emergency Medicine is the creation of the state EMS as a separate branch of healthcare in the country. Over the 100 years of the Institute’s activity, the foundations of its theory and practice have been developed, moreover, a contribution of world significance was made to the EMS development, thereby strengthening the scientific foundation for the activities of the Institute for many years to come.

A Narrative Review of Health Status and Healthcare Delivery in the Oil and Gas Industry: Impacts on Employees, Employers, and Local Communities.

Workers in the oil and gas industry are exposed to numerous health risks, ranging from poor health behaviours to the possibility of life-threatening injuries. Determining the most appropriate models of healthcare for the oil and gas industry is difficult, as strategies must be acceptable to multiple stakeholders, including employees, employers, and local communities. The purpose of this review was to broadly explore the health status and needs of workers in the oil and gas industry and healthcare delivery models relating to primary care and emergency responses. Database searches of PubMed, EMBASE, CINAHL, PsycINFO, and Scopus were conducted, as well as grey literature searches of Google, Google Scholar, and the International Association of Oil and Gas Producers website. Resource-sector workers, particularly those in 'fly-in fly-out' roles, are susceptible to poor health behaviours and a higher prevalence of mental health concerns than the general population. Evidence is generally supportive of organisation-led behaviour change and mental health-related interventions. Deficiencies in primary care received while on-site may lead workers to inappropriately use local health services. For the provision of emergency medical care, telehealth and telemedicine lead to favourable outcomes by improving patient health status and satisfaction and reducing the frequency of medical evacuations.

Legal aspects, responsibilities and possibilities of providing emergency medical care by a district pediatrician at the patient’s home

The authors raise an issue of job responsibilities of a district paediatrician in case of a home visit, as well as of the standards for packing first-aid kits and emergency medical care kits. The provisions of the applicable legal acts are provided. The proceedings of international conventions on primary medical care for children, current federal clinical guidelines, paediatric medical care standards and procedures, orders of the Ministry of Health of the Russian Federation were analysed. We paid attention to the experience of foreign countries, as well as the regions of the Russian Federation in providing emergency medical care to the paediatric population. A survey among local paediatricians was conducted: 30 district paediatricians (10 persons from each of three children’s outpatient departments in different districts of St. Petersburg) answered questions on the algorithm for activities during home visit if emergency care was required. The results of the survey and analysis of the applicable legal acts showed that the district paediatrician is responsible for the life and health of his/her patients. However, there is no single standard regulating the responsibilities to provide emergency care to the child by the district pediatrician during home visit, and the volume of this care has not been established. Urgent conditions require immediate medical care right when they are detected by a paediatrician on call, until an ambulance team arrives. In conclusion, the authors determined that the creation of unified algorithms for emergency medical care to be provided by a paediatrician on call encompasses a number of medical, ethical and legal aspects. The development of this document is certainly a necessity and requires a balanced, judicious approach.

ANAPHYLAXIS, EMERGENCY MEDICAL CARE AT THE PRE-HOSPITAL AND EARLY HOSPITAL STAGES

Abstract. The article deals with issues related to anaphylaxis, namely: definition, diagnostic criteria, differential diagnosis, equipment for providing and algorithm for providing emergency medical care to patients who are in critical condition at the prehospital and early hospital stages.

PROBLEMATIC ASPECTS AND CHALLENGES AHEAD OF THE MEDICAL PROFESSIONALS WORKING IN EMERGENCY MEDICAL CARE IN BULGARIA

PURPOSE: The article aims to determine the most common problematic aspects and challenges ahead of the medical professionals working in emergency medical care in the Republic of Bulgaria. For that reason, scientific developments, reports and publications of researchers and experts have been studied and analyzed. MATERIALS AND METHODS: A survey was conducted via an interview and direct anonymous questionnaire throughout the first quarter of 2019 amongst 325 respondents. RESULTS: The medical professionals providing emergency medical care face numerous challenges that require instant and adequate measures. Options for overcoming the difficulties that medical professionals face daily are sought at all levels of the hierarchy. A lot of work is done in the direction of a real interaction between all the subjects. CONCLUSIONS: The issues of the EMC require complex, radical measures.

Highly Realistic Simulation Training of Doctors in Providing Emergency Medical Care in Critical Conditions for the Patient's Life

Educational programs for the provision of emergency medical care expand the knowledge of the cadet in the field of intensive care and resuscitation, bring them closer to real life situations, provide an opportunity to hone the skills of diagnostic techniques and manipulations without risk to the patient, correct mistakes, increase the level of stress resistance in further independent work, and clinical experience in a virtual environment gives confidence in the correctness, efficiency and quality of medical care in practical healthcare.

Application of Combined Teaching Methods Using Virtual Clinic "Dimedus" and Robot-Simulator "Apollo" in the Process of Training in the Provision of Emergency Medical Care

An important task of training students in simulation centers is to teach algorithms of actions in extreme situations, to make the right decision as quickly as possible and to perform manipulations flawlessly. The article discusses the main advantages of using a combined teaching method using the virtual clinic "Dimedus" and the robot simulator "Apollo", which allows you to maximize the benefits of virtual learning, effectively use the emergency class, and objectively evaluate the formation of individual educational and practical skills.

Assessment of Readiness of Students to Pass the Practical Skills Exam of the Second Stage of Primary Accreditation of Specialists with Higher Medical Education in the Specialty "Pediatrics" (Station "Emergency Medical Care")

One of the key stages in the primary accreditation of students of medical universities in the specialty "Pediatrics" is the stage of passing practical skills at accreditation stations, which is aimed at assessing the development of competencies corresponding to labor functions, determined by the professional standard of a district pediatrician. One of these stations is the station "Emergency Medical Care", during the development of which the accredited person must develop the skills for providing emergency medical care in an outpatient setting

Caring for older patients with reduced decision-making capacity: a deductive exploratory study of ambulance clinicians’ ethical competence

BackgroundAs more people are living longer, they become frail and are affected by multi-morbidity, resulting in increased demands from the ambulance service. Being vulnerable, older patients may have reduced decision-making capacity, despite still wanting to be involved in decision-making about their care. Their needs may be complex and difficult to assess, and do not always correspond with ambulance assessment protocols. When needing an ambulance, older patients encounter ambulance clinicians who are under high workloads and primarily consider themselves as emergency medical care providers. This situates them in the struggle between differing expectations, and ethical conflicts may arise. To resolve these, providing ethical care, focussing on interpersonal relationships and using ethical competence is needed. However, it is not known whether ambulance clinicians possess the ethical competence required to provide ethical care. Thus, the aim of this study was to deductively explore their ethical competence when caring for older patients with reduced decision-making ability.MethodsA qualitative deductive and exploratory design was used to analyse dyadic interviews with ambulance clinicians. A literature review, defining ethical competence as comprising ethical sensitivity, ethical knowledge, ethical reflection, ethical decision-making, ethical action and ethical behaviour, was used as a structured categorization matrix for the analysis.ResultsAmbulance clinicians possess ethical competence in terms of their ethical knowledge, highlighting the need for establishing an interpersonal relationship with the older patients. To establish this, they use ethical sensitivity to interpret the patients’ needs. Doing this, they are aware of their ethical behaviour, signifying how they must act respectfully and provide the necessary time for listening and interacting.ConclusionsAmbulance clinicians fail to see their gut feeling as a professional ethical competence, which might hinder them from reacting to unethical ways of working. Further, they lack ethical reflection regarding the benefits and disadvantages of paternalism, which reduces their ability to perform ethical decision-making. Moreover, their ethical knowledge is hampered by an ageist approach to older patients, which also has consequences for their ethical action. Finally, ambulance clinicians show deficiencies regarding their ethical reflections, as they reflect merely on their own actions, rather than on their values.

X-ray diagnostics of gunshot wounds of main vessels of the limbs: theoretical analysis

The analysis of damage to the main vessels of the limbs was considered for the formation of further organizational and tactical instructions for the provision of emergency medical care at the stages of evacuation of the injured to specialized wartime departments. It was determined that with the help of MSCT-angiography, signs of damage to main vessels can be accurately diagnosed, and additional information about damage to bone structures, neighbouring organs and tissues can be obtained. It is emphasized that MSCT is an effective and accurate method in the assessment of clinically significant arterial injuries of the lower extremities in case of gunshot injury. It was noted that timely diagnosis of vessels gunshot wounds can contribute to the preservation of the functionality of the limbs and the life of patients, reducing the risk of bleeding, infections and other complications. It was noted that the correct medical decisions, in particular, the correct diagnosis of gunshot injuries to blood vessels will help doctors make informed decisions regarding emergency surgical care, the choice of treatment methods and preoperative preparation.
 The aim. The aim of the work is the theoretical substantiation of gunshot injuries of the main vessels of the limbs and the definition of practical diagnostic methods.
 Materials and methods: analysis of theoretical sources, comparison, induction of isolated analytical data. The study was conducted based on the database of the State institution "National Institute of Cardiovascular Surgery named after M. M. Amosov of the National Academy of Medical Sciences of Ukraine".
 Results. It was determined that with the help of MSCT-angiography, signs of damage to main vessels can be accurately diagnosed, and additional information about damage to bone structures, neighboring organs and tissues can be obtained.
 Conclusions. Radiological diagnosis of gunshot injuries of the main vessels of the limbs demonstrates the importance of using radiological diagnostics in the detection and analysis of vascular injuries in gunshot injuries of the extremities. The study confirms the high efficiency of this method, its accuracy and reliability in determining the nature of damage. In addition, radiological diagnostics allows timely and accurate determination of the extent and nature of injuries, which is important for making informed clinical decisions and providing adequate medical care to the injured