Routine Medical Procedures Research Articles

Methodology for Evaluating the Performance of a New Pulse Oximeter Model and Pulse Oximetry Algorithm in Neonates in a Clinical Trial (Exploratory Study)

While evaluating a new domestically produced pulse oximeter model in clinical practice, we discovered a lack of references in Russian-language publications on clinical trial methodologies to assess device reliability and performance.The aim of the study is to create a methodology for conducting a multicenter, prospective, cohort, nonrandomized, controlled clinical trial evaluating a domestic pulse oximeter.Methods. Measurements were performed on 20 preterm infants in the neonatal intensive care unit with a mean birth weight of 2340 [1250; 3125] g and a gestational age of 35 [30; 37] weeks using a new model pulse oximeter simultaneously with the reference monitor. Multiple oxygen saturation measurements of varying duration were taken alternately from the upper and lower limbs, and the number of false desaturation alarms was recorded. Pulse oximeter saturation data were evaluated for correlation with clinical findings.Results. Attachment of sensors to the infant's feet was found to be optimal in terms of ease of use, minimal artifact generation, and minimal interference with routine medical procedures and neonatal care. To reduce motion-induced artifacts and false alarms, the optimal period of SpO₂ monitoring to detect desaturations and bradycardia was determined to be 120 min. Due to the high variability of pulse rate (PR) and saturation in neonates, two-second intervals were determined to be optimal for comparing records from the two monitors. Matching of ECG HR and pulse oximeter PR was required to eliminate artifacts. A mathematical software model required for accelerated analysis of data collected from all sensors during the study was approved.Conclusion. The data analysis supported the proposed methodology for conducting a clinical trial to evaluate the performance and reliability of new pulse oximetry devices.

Medical glove durability during exposure to different solvent agents: an ex-vivo experimental study

BackgroundMedical professionals are constantly exposed to bodily fluids and sanitizing agents during routine medical procedures. Unbeknownst to many healthcare workers, however, the barrier integrity of medical gloves can be altered when exposed to these substances, potentially resulting in exposure to dangerous pathogens.MethodsThis experimental study was designed to test the hypothesis that the durability of both natural and synthetic solvent-exposed medical gloves will be lower than the durability of the gloves in air. The testing consisted of a sample of commercially available medical gloves exposed to 70% ethanol, phosphate buffered saline, and deionized water, aimed at simulating the environments in which medical gloves are commonly worn. Gloves were included in this study based on their performance in previous durability studies in air. Data were collected over a period of three months. The glove assessment device automatically detects pinhole-sized perforations in medical gloves, eliminating the need to visually inspect each glove. Relative durability was measured as the average number of sandpaper touches until glove puncture.ResultsFour out of five glove brands performed better when exposed to all three solvents than in air, which is likely due to slippage in the interface between the wet glove and the sandpaper. Sensicare Micro, a polyisoprene surgical glove, had the most consistent durability in all three solvents tested. A two-way ANOVA revealed that both glove brand (P = 0.0001), solvent (P = 0.0001), and their interaction (P = 0.0040, α = 0.05) significantly affected average glove durability.ConclusionsGlove durability did not remain consistent in 70% ethanol, phosphate buffered saline, deionized water, and air. These results make it clear that additional testing and labeling information would help healthcare workers select gloves for use in specific environments to ensure the best barrier protection against disease or toxins.

Virtual reality vs. tablet for procedural comfort using an identical game in children undergoing venipuncture: a randomized clinical trial.

Recent research has explored the effectiveness of interactive virtual experiences in managing pain and anxiety in children during routine medical procedures, compared to conventional care methods. However, the influence of the specific technology used as an interface, 3-dimensions (D) immersive virtual reality (VR) vs. 2D touch screens, during pediatric venipuncture, remains unexamined. This study aimed to determine if immersive VR is more effective than a tablet in reducing pain and anxiety during short procedures. An interactive game was designed by clinicians and psychologists, expert in pain theory, hypnosis, and procedural pain and anxiety relief, and was tailored for both VR and tablet use. Fifty patients were randomly assigned to either the Tablet or VR group. The primary outcome measures were pain and anxiety levels during the procedure. Secondary outcome measures included the need for physical restraint, duration of the procedure, enjoyment levels, and satisfaction ratings from both parents and nurses. Participants, in both groups, had low levels of pain and anxiety. Physical restraint was infrequently used, procedures were brief, and high satisfaction levels were reported by patients, parents, and nurses. This study suggests that the type of technology used as a support for the game has a minimal effect on the child's experience, with both groups reporting low pain and anxiety levels, minimal physical restraint, and high enjoyment. Despite immersive VR's technological advancements, this study underscores the value of traditional tablets with well-designed interactive games in enhancing children's wellbeing during medical procedures. [ClinicalTrials.gov], identifier [NCT05065307].

Nurses′ knowledge and practice about neonatal pain management in public hospitals in West Oromia, Ethiopia, 2022: multi-centered cross-sectional study

BackgroundIn low-and middle-income countries inadequate neonatal pain management persists as a significant public health issue despite the availability of guidelines. Newborns often experience pain from routine medical and surgical procedures, with limited nurses’ knowledge and suboptimal practices posing common obstacles to effective neonatal pain management in hospital settings. Hence, this study aimed to evaluate nurses’ knowledge and practices related to neonatal pain management and the factors influencing them in public hospitals in West Oromia, Ethiopia, in 2022.MethodsA multicenter cross-sectional study was conducted among 203 nurses working in public hospitals in West Oromia from 8th May-6th June 2022. Data was gathered using structured, self-administered questionnaire and sampled through simple random sampling. The collected data were coded and entered into a computer using Epi-Data version 4.6 Statistical Software. They were analyzed using the Statistical Package for Social Science (SPSS; IBM Corporation) version 26. Binary logistic regression was used to identify significant independent variables at p < 0.05.FindingsIn this study, 127 (62.6%) exhibited adequate knowledge, while 33 (16.3%) nurses demonstrated good practice in neonatal pain management. Attending lectures or receiving training about neonatal pain management was found to be significantly associated with nurses’ knowledge of neonatal pain management [AOR, 2.31, 95%CI; 1.29–4.27]. On the other, having adequate knowledge of neonatal pain management [AOR, 3.3, 95%CI; 1.14–9.32]; the presence of a pain management policy in place [AOR, 5.44, 95% CI; 1.92–15.37] and attending lectures on neonatal pain management [AOR, 2.55, 95% CI; 1.09–5.97] were found to be significantly associated to nurses’ practices.ConclusionGiven the substandard level of nurses’ practice in neonatal pain management. It is suggested to enhance the nurses’ knowledge and practice about neonatal pain management by providing refreshment courses, training sessions, or facilitating nurses’ opportunity access to reading resources about neonatal pain management.

Antimicrobial resistance: Impacts, challenges, and future prospects

Antimicrobial resistance (AMR) is a critical global health issue driven by antibiotic misuse and overuse in various sectors, leading to the emergence of resistant microorganisms. The history of AMR dates back to the discovery of penicillin, with the rise of multidrug-resistant pathogens posing significant challenges to healthcare systems worldwide. The misuse of antibiotics in human and animal health, as well as in agriculture, contributes to the spread of resistance genes, creating a "Silent Pandemic" that could surpass other causes of mortality by 2050. AMR affects both humans and animals, with resistant pathogens posing challenges in treating infections. Various mechanisms, such as enzymatic modification and biofilm formation, enable microbes to withstand the effects of antibiotics. The lack of effective antibiotics threatens routine medical procedures and could lead to millions of deaths annually if left unchecked. The economic impact of AMR is substantial, with projected losses in the trillions of dollars and significant financial burdens on healthcare systems and agriculture. Artificial intelligence is being explored as a tool to combat AMR by improving diagnostics and treatment strategies, although challenges such as data quality and algorithmic biases exist. To address AMR effectively, a One Health approach that considers human, animal, and environmental factors is crucial. This includes enhancing surveillance systems, promoting stewardship programs, and investing in research and development for new antimicrobial options. Public awareness, education, and international collaboration are essential for combating AMR and preserving the efficacy of antibiotics for future generations.

Perception of post-MBBS interns toward their internship and skill developed during internship: A cross-sectional observational study in a tertiary care hospital

Background: In India, MBBS programs span 5½ years, with 1-year mandatory internship during which interns acquire essential medical skills. However, recent literature has highlighted that interns lack the knowledge and confidence to perform routine and emergency medical procedures. Aim and Objectives: This study aimed to investigate the perceptions of post-MBBS interns regarding their internship experience and the skills they developed during this period. Materials and Methods: An observational, cross-sectional, questionnaire-based study was conducted with 100 participants. The study utilized a pre-validated questionnaire consisting of 13 questions related to attitudes and 30 questions related to skills acquired during internship. Descriptive statistics were applied to analyze the data using SPSS version 24.0. Results: Among participants, 57 were male and 43 were female. The majority perceived the internship as a challenging phase, which significantly improved their skills and contributed to their development as independent practitioners. Internship experiences strongly influenced postgraduate specialization choices. The workload during the internship was considered high by most participants, with some postings deemed unnecessary. 94 participants reported performing menial tasks. While certain skills, such as blood pressure measurement, blood collection, intramuscular, intravenous, subcutaneous injections, and respiratory therapy insertion, were performed by over 80% of interns, other skills such as arterial blood gas interpretation, episiotomy, pleural tapping, and endotracheal intubation were only performed independently by very few participants. Conclusion: This study sheds light on the perceptions and skill development of post-MBBS interns during their internships, underscoring the importance of practical experiences for professional growth.

Identifying Thyroid Dysfunction Using Standard Laboratory Testings – A Systematic Review

Thyroid dysfunction includes various thyroid-related illnesses, with subclinical hypothyroidism or hyperthyroidism at the initial stage. Blood TSH and T4 levels indicate a neutral ground between clinical conditions. Following guidelines for levothyroxine administration based on thyroid hormonal levels is beneficial for hypothyroid patients. TSH, a measurable signal, is crucial for assessing thyroid activity, with reference ranges determined by testing facilities. However, elevated TSH levels require consideration of the patient's history and lifestyle before intervention. A Machine Learning-based Thyroid Dysfunction Identification (ML-TDI) model was developed to screen individuals for medicinal intervention. Despite its prevalence and health consequences, thyroid dysfunction often goes undiagnosed. The study used standard laboratory data and machine learning algorithms to identify thyroid dysfunction, suggesting the potential for technology-driven screenings during routine medical procedures. However, assessing the benefits and risks of widespread thyroid illness evaluation requires well-conducted randomized trials.

Implementation of a Minimal Sedation Protocol for Patients With Developmental Disabilities and Needle Phobia.

Objective Patients with intellectual and developmental disabilities (IDD) experience needle phobia at greater rates than individuals in the general population. Needle phobia deters patients with IDD from receiving routine medical procedures, which impacts their physical health outcomes. The aim of this quality improvement study was to assess the feasibility of a minimal sedation protocol in an outpatient care setting for patients with IDD and needle phobia. Methods The sample included 18 patients characterized as having a diagnosis of IDD only or IDD and needle phobia compared to patients with only a diagnosis of needle phobia. Reasons for referral to intervention included routine lab work, therapeutic drug monitoring, and routine vaccination. The minimal sedation intervention involved intranasal administration of a benzodiazepine (midazolam) by a registered nurse. Outcomes of interest were administration of the sedation and administration of medical orders. Results Nearly a third of patients were children (33.3%, n=6), and 39% of patients were female (n=7). Individuals with IDD (including those both with and without needle phobias) comprised 72.2% of patients (n=13). Half of intervention encounters were successful in both administering the sedation and performing the medical orders (n=9). Among individuals with IDD, 38.4% successfully completed the intervention (n=5). Conclusion This pilot study assessed the feasibility of implementing a minimal sedation protocol in primary care outpatient care settings. The preliminary results suggest that the minimal sedation protocol may improve the uptake of needle-related medical procedures for patients with IDD and/or needle phobia. The minimal sedation protocol should be studied in a larger sample and among multiple outpatient settings to establish effectiveness of the intervention.

Iatrogenic Flexion-Related Classic Metaphyseal Lesion of the Distal Tibia: Three Cases

BackgroundClassic metaphyseal lesions (CMLs) should raise concern for nonaccidental trauma. However, iatrogenic causes for CMLs have increasingly been described and warrant close consideration. Increasing the clinical understanding of CML mechanics and their relation to often routine medical procedures will enhance provider awareness and expand the differential diagnosis when these otherwise highly concerning injuries are identified. Case ReportsWe describe three clinical cases where suspected iatrogenic dorsiflexion or plantar flexion resulted in an isolated distal tibia CML. Respectively, we present heel-stick testing and i.v. line placement as clinical correlates of these two mechanisms. Although prior reports have aimed to describe iatrogenic CML etiologies, they have not focused on dorsiflexion or plantar flexion as predominant mechanisms of injury. Why Should an Emergency Physician Be Aware of This?Emergency physicians are critical to the surveillance and identification of nonaccidental trauma. Given that children oftentimes present to the emergency department with subtle yet concerning signs of maltreatment, an emergency physician must be aware of the potential causes of injury as well as the recommended response. Although avoiding missed cases of abuse and improving the detection of injuries is crucial for child health and well-being, failing to consider or recognize alternative explanations could also have serious implications for a child and their caregivers.

Perceived Effect of the COVID-19 Pandemic Among People With Spinal Cord Injury: A Descriptive Study

ObjectiveTo describe the self-reported effect of the COVID-19 pandemic on the lives of persons with spinal cord injury. DesignCross-sectional study. ParticipantsThere were a total of 382 adult participants with traumatic spinal cord injury of at least 1-year duration, all of whom were identified through a state-based surveillance registry in the Southeastern United States (N=382). The majority of participants were male (68.4%) and 72% were ambulatory. The average age at the time of the study was 57.7. Main Outcome MeasuresParticipants completed a self-report assessment online or by mail on the effect of COVID-19 on quality of life, ability to get daily necessities, and access to health care. ResultsOver half of the participants reported a negative effect of the pandemic in at least 1 of 5 life areas (58.9%), with community participation being the primary area affected (51.4%). A small number of individuals had trouble obtaining necessities, with approximately 12% reporting difficulties getting enough or quality food and 8.2% reporting difficulty getting prescription medications. In addition, 25% reported delaying health care procedures because of fear of catching COVID-19. Among those requiring personal assistance, 32% reported a decrease in quality of care and 51.9% relied more on family to assist with their care. Conclusion(s)The COVID-19 pandemic had multiple negative effects. Of particular importance were reduced access to health care and declines in quality and stability of attendant care, with greater reliance on family. Fear of contracting COVID-19 when accessing routine medical procedures needs to be addressed in future outbreaks.

Virtual Training of Medical Students to Promote the Comfort and Cooperation of Patients with Neurodevelopmental Disabilities

Patients with neurodevelopmental disabilities generally have less access to necessary medical care compared to those without disabilities. Barriers to adequate care include patient fear and uncooperative behavior during routine medical procedures and inadequate preparation of medical professionals to treat this population. Researchers have identified multiple behavior-analytic procedures for promoting comfort and cooperation during medical treatments. Efficient, cost-effective training programs are needed to widely disseminate behavior-analytic procedures to medical students and professionals. The purpose of this study was to assess the efficacy of a virtual training to prepare medical students to implement behavioral procedures that could be easily incorporated into typical wellness examinations. Seven medical students received behavioral skills training (BST) delivered remotely via the Internet. Results showed that the training successfully increased students’ correct implementation of the procedures in roleplay with the experimenter and with patients with neurodevelopmental disabilities. Responding also maintained at high levels 2 weeks after the training. These findings suggest that virtual BST is an efficient, practical approach for training health care professionals to implement general behavior management strategies to increase the comfort and cooperation of patients with NDD.

Correlations between ultrasound, tomographic, and intraoperative measurements of the great saphenous vein used as an arterial graft.

The great saphenous vein is the major superficial vein of the lower limb, and also the most often used as arterial graft material for lower limb revascularization. Prior knowledge of the quality of the vein can guide choice of therapeutic strategy, avoiding surgery that is doomed to failure. Discrepancies between intraoperative findings of the quality of the great saphenous vein and imaging tests are also frequently observed. To evaluate the diameter of the great saphenous vein using two imaging methods (Duplex Ultrasound and Computed Tomography) and the gold-standard (intraoperative direct measurement of the vein), comparing the results. Prospective, observational study of data obtained during routine medical procedures performed by the Vascular Surgery team. 41 patients were evaluated, with a 12-month follow-up. 27 (65.85%) were male and mean age was 65.37 years. 19 (46.34%) patients had femoropopliteal grafts and 22 (53.66%) had distal grafts. Preoperative saphenous vein internal diameters measured with the patient supine were on average 16.4% smaller on CT and 33.8% smaller on US than the external diameters measured after intraoperative hydrostatic dilatation. There were no statistical differences in measurements when sex, weight, and height were considered. Saphenous vein diameters were underestimated by preoperative US and CT scans when compared to intraoperative measurements. Thus, in patients undergoing graft planning for revascularization, the choice of conduit should take this data into consideration, so that use of the saphenous vein is not ruled out unnecessarily during planning.

Caring for Adults With Significant Levels of Intellectual Disability in Outpatient Settings: Results of a National Survey of Physicians.

Between 1% and 2% of the U.S. population has an intellectual disability (ID) and often experience disparities in health care. Communication patterns and sedation use for routine medical procedures are important aspects of care for this population. We explored physicians' communication patterns and sedation use in caring for patients with significant levels of ID through a mailed survey of 1,400 physicians among seven specialties in outpatient settings (response rate = 61.0%). Among physicians who saw at least one patient with significant levels of ID in an average month, 74.8% reported usually/always communicating primarily with someone other than the patient. Among specialists, 85.5% (95% CI: 80.5%-90.5%) reported doing so, compared to 69.9% (95% CI: 64.4%-75.4%) for primary care physicians (p < 0.001). Also, 11.4% reported sedating at least one patient with significant levels of ID for a routine procedure. Three quarters of physicians reported communicating primarily with persons other than the patient usually or always-an approach that, in some instances, may not align with best medical practice. The percentage of physicians who report sedating at least one individual is associated with significant ID and the physician's volume of patients with significant ID.

Small Molecules Originated from Tryptophan and their Clinical Significance as Potential Biomarkers.

L-tryptophan is an essential amino acid necessary for the human body to function. Its degradation occurs through two metabolic pathways. Approximately 95 % of the Ltryptophan available in the body is converted via the kynurenine pathway, while the remainder is degraded via the serotonin pathway. Properly maintained balance between the concentrations of individual small molecular metabolites is extremely important to maintain homeostasis in the human body, and its disruption could lead to the development of numerous neurological, neurodegenerative, neoplastic, as well as cardiovascular diseases. Recent reports have suggested that by controlling the levels of selected L-tryptophan metabolites (potential biomarkers), it is possible to diagnose numerous diseases, monitor their course, and assess patient prognosis. The aim of this paper is to review the currently important clinical applications of selected biomarkers from the L-tryptophan metabolism pathways that would be helpful in early diagnosis, monitoring the course and treatment of serious diseases of affluence, which ultimately could improve the patients' quality of life, as well as support targeted therapy of the aforementioned diseases. Since the biochemical biomarkers determination in body fluids presents the ideal minimally invasive tool in the patents' diagnosis and prognostication, this study emphasizes the current trends and perspectives of application of analysis of selected L-tryptophan metabolites named kynurenine and serotonin-derived small compounds in the routine medical procedures.

Effect of an Enhanced Recovery After Surgery Protocol on Opioid Consumption in Post-Cesarean Patients

This research study evaluated the effects of an enhanced recovery after surgery (ERAS) protocol on opioid consumption during hospitalization and the number of opioids prescribed at discharge for postcesarean women. Opioid addiction and overdose are epidemic in the United States. Drug addiction can begin with consumption of opioid medication after a routine medical procedure. The most common surgical procedure in the United States is cesarean birth.

ГОСТРА НИРКОВА НЕДОСТАТНІСТЬ УНАСЛІДОК ВИКОРИСТАННЯМ ВНУТРІШНЬОВЕННИХ КОНТРАСТНИХ РЕЧОВИН ДЛЯ МЕДИЧНИХ РАДІОЛОГІЧНИХ ВТРУЧАНЬ: ПОШИРЕНІСТЬ ТА ВИЗНАЧЕННЯ ФАКТОРІВ ВПЛИВУ

Medical radiological diagnostic or therapeutic interventions are widely used as routine medical procedures in patients of all ages. At the same time, radiographic contrast agent exposure has been increasingly blamed for acute kidney injury (AKI) which reduces patients’ quality of life. This study aimed to explore the diff erences in incidence and infl uencing factors for AKI and its subtypes among patients after radiological diagnostic or therapeutic interventions with intravenous contrast agents, including computed tomography (CT), angiography, and magnetic resonance imaging (MRI). This observational study included 8060 patients (from the large nephrological clinic in Berlin, Germany) and AKI was diagnosed according to AKIN criteria ranging. The pooled prevalence of AKI was 9 %. Patients with AKI aged 60–79 years (51%) and 80–100 years (37%), respectively, were predominant. AKI was signifi cantly associated with using iodinated radiographic contrast agents (94 %) after CT and angiography and 92 % of patients had AKIN 1. The prevalence of AKIN 2 and AKIN 3 was higher among patients after MRI with non-iodinated radiographic contrast agents. To sum up obtained results, the incidence of AKI among patients after intravenous contrast agents for medical radiological interventions is low. Diff erences in the prevalence of AKI were found to be related to age and the type of contrast agents used

Health Care Logistics Network Design and Analysis on Pandemic Outbreaks: Insights From COVID-19.

Health care systems throughout the world are under pressure as a result of COVID-19. It is over two years since the first case was announced in China and health care providers are continuing to struggle with this fatal infectious disease in intensive care units and inpatient wards. Meanwhile, the burden of postponed routine medical procedures has become greater as the pandemic has progressed. We believe that establishing separate health care institutions for infected and non-infected patients would provide safer and better quality health care services. The aim of this study is to find the appropriate number and location of dedicated health care institutions which would only treat individuals infected by a pandemic during an outbreak. For this purpose, a decision-making framework including two multi-objective mixed-integer programming models is developed. At the strategic level, the locations of designated pandemic hospitals are optimized. At the tactical level, we determine the locations and operation durations of temporary isolation centers which treat mildly and moderately symptomatic patients. The developed framework provides assessments of the distance that infected patients travel, the routine medical services expected to be disrupted, two-way distances between new facilities (designated pandemic hospitals and isolation centers), and the infection risk in the population. To demonstrate the applicability of the suggested models, we perform a case study for the European side of Istanbul. In the base case, seven designated pandemic hospitals and four isolation centers are established. In sensitivity analyses, 23 cases are analyzed and compared to provide support to decision makers.

АНАЛИЗ РЕЗУЛЬТАТОВ МЕДИЦИНСКОГО ОТБОРА КАНДИДАТОВ В КОСМОНАВТЫ 2019–2020 гг.

The paper is devoted to analysis of candidates selection that started with review of submitted medical information and continued on applicants' arrival for examinations for the selection campaign of 2019–2020, discussion of routine medical tests and procedures, primary causes for selecting-out, and view on how to optimize the process in future.

IMPACT OF COVID-19 PANDEMIC ON GASTROINTESTINAL ENDOSCOPY PROCEDURES

Background- COVID-19, an emerging coronavirus disease is a major health problem. It has markedly affected the routine medical procedures including Gastrointestinal(GI) endoscopies. Inspite of guidelines suggested by various GI societies,for safe GI endoscopy procedures in period of COVID pandemic, most of the endoscopists as well as the patients were hesitant for the endoscopy procedures.We sought to measure the impact of the same on GI endoscopy activity in Pune. Method- A pre-validated questionnaire containing 28 questions was sent across to the GI endoscopy surgeons. Responses were collected to assess the perception of GI endoscopists regarding the practice of endoscopy and the risk of self-contamination during COVID-19 Pandemic. This data was analysed using appropriate statistical applications. Result-51 GI endoscopists from Pune participated in our study out of which 80.3% (41/51) were involved in the management of COVID-19 patients outside the endoscopy department. During the study period, 86.28% (44/51) of endoscopists had to cancel procedures on grounds of COVID19 pandemic.Symptoms compatible with COVID-19 infection were reported by 29.41% (15/51) of the endoscopists out of which 13 (86%) responders had a positive RTPCR test for COVID-19 Conclusion- COVID-19 pandemic has seriously affected GI endoscopy practice. COVID 19 infection rate was also remarkable in endoscopists and endoscopy staff. As the screening of patients with GI problems was hampered, there was definitive delay in diagnosis and treatment. Nevertheless, endoscopy centers should adapt and make changes in their practice to face future pandemic, emphasizing safety of staff without delaying patient care.

Standard operating procedures in work of nursing staff as way to prevent infections associated with provision of medical care

In the conditions of modern realities of domestic healthcare, more and more attention is paid to the quality of medical care provided by both doctors and paramedical personnel. In order to minimize risks when performing routine medical procedures, it is necessary to create standard operating procedures that should help medical staff to provide high-quality and timely medical care in real practice. The article offers an answer to frequently asked questions regarding the development of standard operating procedures and an example of a standard operating procedure for the rehabilitation of the tracheobronchial tree and tracheostomy care.