Nº 1 (2025)
Safety in Emergency Environment
The Experience of a Multi-Specialty Field Hospital as a Stage of Medical Evacuation in the System of Medical Evacuation Support for an Armed Conflict
Resumo
Summary. The objective of the study is to analyze the experience of the Field Multidisciplinary Hospital (FMG, Hospital) of the Medical Evacuation Support Center (MESC) of the Federal State Budgetary Institution “A.I. Burnazyan Federal Medical Biophysical Center” of the Federal Medical and Biological Agency of Russia (FGBU FMGBC named after A.I. Burnazyan FMBA of Russia) in 2022–2024 in performing the functions of an evacuation receiver in the system of medical evacuation measures during the elimination of medical consequences of a complicated emergency situation (ES) – an armed conflict. Research materials and methods. Research materials – medical and accounting and reporting documents of the FMG on the provision of medical care and medical evacuation of the wounded, sick and injured, etc. Research methods: analytical and statistical methods, content analysis method, case method, methods of direct observation, comparison and description. Results of the study and their analysis. The article presents the results of the study characterizing the work of the PMG in 2022–2024 as a stage of medical evacuation for the provision of medical care and medical evacuation of the wounded, sick and injured in one of the evacuation directions. It is concluded that the analysis of the activities of the Hospital as a stage of medical evacuation allows us to identify and study the problematic issues of the LEO system for the wounded, sick and injured in complicated emergency situations and to substantiate scientific approaches to improving the activities of mobile medical units (MMF) in the specified conditions.
Disaster Medicine. 2025;(1):5-11
5-11
Preliminary Doses Assessment to Victims Due to a Radiation Accident in the Scope of the Activities of a Specialized Radiological Team
Resumo
Summary. The aim of the study is to substantiate the procedure for conducting a preliminary (operational) assessment of emergency doses of radiation exposure to those affected by a radiation accident (EA) to address the priority tasks facing the specialized radiological team (SRT) of the Federal State Budgetary Institution “SRC – Federal Medical Biophysical Center named after A.I. Burnazyan” of the Federal Medical and Biological Agency of Russia (FSBI SRC FMBC named after A.I. Burnazyan FMBA of Russia). Materials and methods of the study. The study materials are the experience of the specialized radiological team in the preliminary assessment of emergency doses of radiation exposure to those affected by EA. The research methods are a modern methodology of instrumental, calculation and clinical-laboratory methods for assessing external and internal radiation doses of those affected. Research results and their analysis. A two-level assessment of dose values is presented – action levels (UD-1 and UD-2) for carrying out medical evacuation measures. It is noted that in some situations associated with high levels of uncontrolled uniform irradiation of personnel, clinical manifestations and hematological parameters allow confidently assessing the dose for the subsequent treatment strategy. Based on the experience of treating patients in the clinic of the Federal State Budgetary Institution of the Russian Federation, the manifestations of the primary reaction and the dynamics of hematological parameters during the first week after irradiation are systematized. Dosimetric measurements and laboratory studies are grouped by the order and timing of their implementation. It is concluded that the results of assessing radiation doses in the volume of activities carried out by the SRB are preliminary and should be used mainly to make decisions on the urgency (order) of sending the affected to a specialized hospital for further examination and treatment.
Disaster Medicine. 2025;(1):12-18
12-18
Mortality from Occupational Coronavirus Infection COVID-19 among Health Workers of Medical Institutions of the Federal Medical and Biological Agency
Resumo
Summary. The objective of the study is to assess mortality from coronavirus infection COVID-19 (ICD-10: U07.1 – Coronavirus infection, COVID-19, the virus has been identified) as confirmed cases of occupational disease of healthcare workers (HR) of medical treatment organizations (MTO) of the Federal Medical and Biological Agency (FMBA of Russia) in 2020-2022. Materials and methods of the study. Research materials – data from the Industry Register of Persons with Occupational Diseases, FMBA of Russia (ORPROFI). Information was entered into the register based on notifications of the final diagnosis of an acute or chronic occupational disease (poisoning), its clarification or cancellation, and acts of investigation of these cases of occupational diseases. Research methods – intensive and extensive indicators were calculated for 10 thousand healthcare workers. Differences between them were considered statistically significant at t≥2 and p≤0.05. Research results and their analysis. The analysis of the study results showed the stability of the dynamics of mortality from occupational coronavirus infection COVID-19 among medical workers of the Federal Medical and Biological Agency of Russia over the observed period: a decrease in mortality among doctors and mid-level medical personnel and an increase in mortality among junior medical personnel. It was noted that the mortality rate among medical workers from COVID-19 increased sharply in 2021 compared to 2020, which may be due, in particular, to the influence on this indicator in 2021 of occupational morbidity among older people and their more severe condition during illness.
Disaster Medicine. 2025;(1):19-23
19-23
Public Health and Healthcare
Problems of Treatment (Medical Examination) of Victims during an Armed (Military) Conflict
Resumo
Summary. The objectives of the study are to theoretically study the main organizational problems of treatment (medical examination) of military personnel and persons equivalent to them in combat conditions in the Special Military Operation (SMO) zone; to empirically confirm the theoretical premises put forward during the study of the examination and treatment results identified over two years of the hospital’s operation. Research materials and methods. The research materials are scientific papers devoted to: the organization and legal regulation of medical care for military personnel (employees); problematic issues of conducting military medical (MME) and medical examination; the nature and specifics of medical examination and certification in military medical organizations. Research methods: systemic and comprehensive approaches; epistemological means of functional and comparative legal analysis, etc. Research results and their analysis. The article considers the issues of taking into account the results of internal quality control when conducting a military medical examination of the wounded (sick) during an armed (military) conflict. The issues of recording the results of primary health care provided to victims during military operations and monitoring the quality and safety of such care when making expert decisions by military medical commissions (MMC) are disclosed in detail. It is noted that the accuracy and validity of MMC conclusions, which directly affect the provision of guarantees and compensation to military personnel, depend on the correct recording of the volume, quality and circumstances of medical care in primary medical documents. The system of providing medical care in armed conflict and the regulatory framework for this activity are assessed. Directions for further improvement of quality control and safety of medical activities and recording its results when conducting military medical examination in armed conflict are proposed.
Disaster Medicine. 2025;(1):24-29
24-29
Clinical Aspects of Disaster Medicine
Providing Specialized Surgical Care to Children Injured in Earthquakes: a Review of Scientific Publications
Resumo
Summary. The aim of the study is to substantiate the need to form specialized pediatric surgical teams to improve the effectiveness of treating children in emergency situations (ES) based on the analysis of special systematic reviews and original publications on the provision of staged surgical care to children injured in earthquakes. Research methods: analytical method and generalization method. Research results and their analysis. The article presents the state of the art of organizing surgical care for adults and children in earthquake-affected regions. The structure of earthquake injuries in children and adults is considered. The anatomical and physiological features of the child’s body that must be taken into account when providing medical care to children in the context of their mass admission during earthquakes are indicated. The main errors in the strategy and tactics of surgical treatment of open injuries of the musculoskeletal system in children are presented. A conclusion is made about the medical and social significance of the formation of mobile pediatric teams in providing staged medical care to children during their mass admission after destructive earthquakes.
Disaster Medicine. 2025;(1):30-36
30-36
Emergencies in Endocrinology in the Pre-Hospital Period: from the Experience of Emergency Medical Teams in Ryazan in 2018-2023
Resumo
Summary. The objectives of the study based on the experience of emergency medical care (EMC) teams in Ryazan: to study the prevalence and dynamics of emergency conditions in endocrinology in the prehospital period in 2018-2023; to determine the most common endocrine disorders requiring emergency medical care; to determine the frequency of fatal outcomes at the stage of medical evacuation and the frequency of hospitalizations. Materials and methods of the study. The study materials are the maps of EMC team calls in Ryazan in 2018-2023. The research methods are the analytical method and the method of generalization. Results of the study and their analysis. The analysis of statistical data for Ryazan for 2018-2023 showed that emergency conditions in endocrinology remain relevant, make up on average 0.5% of all calls to EMC teams and only in the last few years have they shown a slight downward trend. The leading place among calls to emergency medical teams is occupied by newly diagnosed diabetes mellitus (DM) and hypoglycemia. Women suffering from diabetes mellitus more often seek emergency medical care – mainly due to hypo- and hyperglycemia in type 2 DM. The proportion of fatal outcomes among patients with diabetes mellitus in the pre-hospital period was 0.1%; 42% of patients with DM were hospitalized in medical treatment organizations (MTO).
Disaster Medicine. 2025;(1):37-40
37-40
Complications in Smoking Patients in the Immediate Surgical Period: Measures to Reduce their Incidence
Resumo
Summary. The aim of the study was to determine the frequency of complications associated with residual myoplegia in the early postoperative period in smoking and non-smoking patients and to develop a scheme to reduce their frequency. Materials and methods of the study. The study included 173 smoking and non-smoking male patients who were divided into groups depending on the use of different doses of neostigmine as a decurarizing agent for inhalation or intravenous anesthesia of the type of total intravenous anesthesia. The degree of recovery of patients was assessed by the Aldrete and PARS scales. Complications in patients on the first day of the early postoperative period were assessed using a scale developed by the authors. Statistical analysis was performed using the STATISTICA 10.0 program – developer StatScoft.Inc. The data are presented as a median with an interquartile range (IQR). To test the difference between two compared paired samples, the Wilcoxon W-test was used. Results of the study and their analysis. When using neostigmine for decurarization in the generally accepted dosage of 50 mcg/kg on the first day of the postoperative period in smoking patients, compared to non-smokers, clinically significant complications from the bronchopulmonary and cardiovascular systems, difficult-to-relieve pain in the area of the surgical wound and delirium are more often recorded, requiring constant monitoring by medical personnel. The use of neostigmine in the maximum permissible dose of 70 mcg/kg leads to a several-fold decrease in postoperative complications in smokers and non-smokers, which is especially important when a large number of patients are admitted to the clinic at the same time.
Disaster Medicine. 2025;(1):41-45
41-45
Readiness of Nurses to Collect Venous Blood from Victims in Emergency Situations upon Their Mass Admission to Medical Organizations
Resumo
Summary. The purpose of the study is to analyze the readiness of nurses to collect venous blood from victims in emergency situations (ES) upon their mass admission to health care organizations (HCOs). Research materials and methods. The research materials are data from a sociological survey of procedural nurses in order to identify their level of knowledge, skills, and abilities in performing the medical procedure of collecting venous blood for laboratory testing. The survey was conducted anonymously on the Telegram platform. Additionally, to clarify the level of skills in performing blood collection and sample preparation, an expert audit was conducted among procedural nurses in 25 departments of a large city multidisciplinary LMO. Research methods – analytical method and generalization method. Research results and their analysis. Analysis of the research results showed that most procedural nurses do not experience difficulties in collecting venous blood. However, every third nurse with 5-10 years of experience experiences difficulties in carrying out this procedure, and more than half of the nurses faced the need to re-collect venous blood. In addition, every third nurse does not follow the recommendations for performing procedures related to the use of a tourniquet and patient identification. The most typical errors made by nurses when collecting venous blood for laboratory tests are: lack of primary mixing of the sample; lack of mixing of test tubes; horizontal arrangement of test tubes with collected venous blood and violation of sample collection to the required filling mark. It was concluded that the results of the study showed the need to improve the readiness of nurses in procedure rooms to collect venous blood for laboratory tests in the event of a mass admission of victims in emergency situations to medical institutions.
Disaster Medicine. 2025;(1):46-51
46-51
Reactions of the Central and Autonomic Nervous System as a Component of the Psychophysiological Response when Using Functional Tests
Resumo
Summary. The aim of the study was to examine the dynamics of the body’s psychophysiological response to an aversive stimulus and the level of orienting reaction while waiting for it. Materials and methods of the study. The pilot study involved 30 military personnel (all men), whose professional activity was special military training (respondents). The respondents were divided into two groups, the selection criterion was length of service in the troops. The study used the psychophysiological telemetry device “Reakor-T” (software “Encephalan-SA”). The spectral indices of heart rate variability (HRV) – the predominance of the sympathetic or parasympathetic divisions of the autonomic nervous system (ANS) and electroencephalography (EEG) – the functional activity of the central nervous system (CNS) were analyzed. Results of the study and their analysis. In the waiting situation, the psychophysiological reactivity relative to the background values in the respondents of the two groups was not identical. In respondents with less military service experience, psychophysiological reactivity was more intense at the stimulus expectation stage than when an active stimulus was presented. Conclusions: Analysis of background values during psychophysiological examination of special contingents has low prognostic potential. The use of functional tests during psychophysiological examination allows us to assess the level of reactivity to presented stimuli relative to background values, as well as the recovery potential upon completion of external stimulation.
Disaster Medicine. 2025;(1):52-59
52-59
Application of the Direct Discrete Fourier Transform Method to Improve the Assessment of Simple Sensorimotor Response in Nuclear Industry Workers during Their Psychophysiological Examination
Resumo
Summary. Currently, to assess the functional state of the central nervous system (FS CNS), standards are used that have not been revised for 25 years and include 6 indicators: average reaction speed, standard deviation, minimum average reaction time, variation range, mode and its amplitude. The aim of the study is to justify the need to use a new method – the direct discrete Fourier transform method for assessing the results of a simple sensorimotor reaction (SSMR) in nuclear industry workers during their psychophysiological examination (PPE). Research materials and methods. Research materials – the results of a psychophysiological examination of 3488 employees of the State Scientific Center – Federal Medical Biophysical Center named after A.I. Burnazyan of the Federal Medical and Biological Agency of Russia, conducted in the laboratory of psychophysiological studies in the period from 01/19/2021 to 03/07/2024. Research method – applying the direct discrete Fourier transform method to the SSMR data and, based on the obtained frequency spectrum (harmonics), calculating the “Frequency signal power density” indicator as an integral characteristic of the psychophysiological state of the subject at the time of the SSMR test. Research results and their analysis. The new integral indicator Lg(Pωnorm) for assessing the level of CNS FS significantly differed between the groups of subjects with normal and elevated standard indicators of CNS FS assessment based on the results of PSMR. Lg(Pωnorm) most accurately characterizes the time indicators of PSMR, taking into account both their average values and their variability. It was concluded that the use of Lg(Pωnorm) will facilitate a wide range of specialists in assessing the CNS FS and predicting the reliability of professional activity of workers in the nuclear industry.
Disaster Medicine. 2025;(1):60-64
60-64
Actual Problems of Medical Evacuation
Interregional Medical Evacuation of Patients and Victims in Emergency Situations: Problem Status
Resumo
Summary. The purpose of the study is to examine and analyze scientific publications devoted to the main problems of organizing and conducting interregional medical evacuation of patients and victims in emergency situations (ES). Research materials and methods. Research materials – articles and scientific works of a number of domestic and foreign authors in the field of organizing and conducting interregional medical evacuation of patients and victims in ES. Research methods – systemic and comprehensive approaches, methods of theoretical generalization and comparative analysis. Research results and their analysis. Analysis of the research results showed that there are a number of problems in the field of organizing and conducting interregional medical evacuation of patients and victims in ES that require further study. These problems include: the need to develop uniform organizational and methodological approaches to conducting interregional medical evacuation of patients and victims, including the creation of algorithms for its organization and implementation; scientific substantiation of the mechanisms for using various types of ambulance transport – air, rail, etc.; implementation of unified electronic databases and document flow; involvement of specialized medical consultants; training of medical personnel, etc.
Disaster Medicine. 2025;(1):65-70
65-70
In Order of Discussion
Efficiency of Humic Substances in Patients with Inflammation and Pain Syndrome of the Knee Joint during Postoperative Medical Rehabilitation
Resumo
Summary. The aim of the study is to evaluate the effectiveness of using a drug based on an extract of humic substances to reduce the inflammatory response and the severity of pain syndrome, as well as to accelerate functional recovery in patients in the postoperative period after surgery on the knee joint. Materials and methods of the study. The study involved 60 patients divided into study group and control groups. Patients in the study group received a drug based on humic substances in addition to standard therapy. The effect of humic substance extract on the inflammatory response, severity of pain syndrome and functional recovery of the joint in the postoperative period was studied. Research results and their analysis. The analysis of the study results showed a significant decrease in the levels of pro-inflammatory biomarkers (CRP, IL-6 and TNF-α), a decrease in swelling and pain, and an increase in the range of motion in the knee joint in patients receiving humic substances. In addition, subjective assessment showed high patient satisfaction with this treatment and a decrease in the need for additional analgesics. The anti-inflammatory and analgesic activity of humic substances allows us to recommend them as an effective means of improving postoperative recovery and improving the quality of life of patients after knee surgery.
Disaster Medicine. 2025;(1):71-77
71-77
The Relevance of Expanding the Scope of First Aid for Persons with Medical Education
Resumo
Summary. The objectives of the study are to assess the state of regulatory legal regulation (RLR) of first aid provision by persons with medical education, in some specific conditions of its provision, in a volume exceeding the volume stipulated by the Procedure for the provision of first aid, approved by the order of the Ministry of Health of Russia dated May 3, 2024 No. 220n; to make practice-oriented proposals for improving the regulatory legal regulation of this area. Research materials and methods. Research materials are federal laws and by-laws of the Russian Federation on this issue. Research methods are general scientific and specific methods of scientific knowledge. Research results and their analysis. The study revealed a number of problems in the area of legal regulation of first aid with the participation of persons with medical education, in some specific conditions of its provision. In particular, it was established that legal acts provide for the need for a medical worker and the provision of assistance to them outside a medical organization, including during organized transportation of a group of children by bus; in children’s health camps; when moving convicted pregnant women and women with children under four years of age; when organizing physical education and sports events. The authors established that these requirements are illegitimate due to their inconsistency with the provisions of the Federal Law “On the Fundamentals of Health Protection of Citizens in the Russian Federation” dated November 21, 2011 No. 323-FZ. In order to eliminate the legal conflict, the authors propose to develop and approve by orders of the Ministry of Health of Russia procedures for providing first aid for some specific conditions of its provision, requiring the participation of persons with medical education, in a larger volume, compared to the volume established by the Procedure for providing first aid, approved by order of the Ministry of Health of Russia dated May 3, 2024 No. 220n.
Disaster Medicine. 2025;(1):78-82
78-82
Jubilees
80 лет Казанфару Магомедовичу Курбанову
Disaster Medicine. 2025;(1):83-83
83-83