Prospects for improving pre-hospital care for wounded with gunshot penetrating wounds to the chest
- Authors: Golovko K.P.1, Markevich V.Y.1, Suprun T.Y.1, Vertiy A.B.1, Komyagin S.E.2, Zhirnova N.A.1, Samokhvalov I.M.1
-
Affiliations:
- Military medical academy of S.M. Kirov
- Limited Liability Company "Novoplast-M"
- Issue: Vol 22, No 3 (2020)
- Pages: 140-147
- Section: Experimental trials
- URL: https://journals.rcsi.science/1682-7392/article/view/50550
- DOI: https://doi.org/10.17816/brmma50550
- ID: 50550
Cite item
Abstract
Abstract. The analysis of injuries, life-threatening consequences and outcomes of treatment of wounded with penetrating chest wounds and the results of approbation of a prototype (medical) disposable set «UD-02v» for the elimination of strained and open pneumothorax, hemothorax, pleural drainage and collection of spilled blood with the possibility of subsequent reinfusion at the pre-hospital stage is presented. The prototype of the «UD-02v» set was created as part of the implementation of the state defense order in 2018. Its creation is due to the fact that despite the improvement of medical care at the stages of medical evacuation and the widespread use of individual armor protection, chest injuries currently remain a frequent type of combat surgical injury, accounting for 6 to 12% of all injuries. The main cause of death of injured and injured with chest injuries remains blood loss caused by continuing intrapleural bleeding and concomitant damage to other anatomical areas. Stressful pneumothorax, together with intrapleural bleeding, account for 93% of preventable causes of fatal chest injuries at the pre-hospital stage. Untimely elimination of the consequences of severe breast injuries should be considered as a negative factor affecting the outcome of treatment, and significant improvement in treatment results should be expected only in the case of early elimination of the most severe consequences of breast injuries. The developed set of «UD-02v» exceeds foreign medical devices in its medical and technical characteristics, and is the most promising for acceptance for the supply of the Armed forces of the Russian Federation as part of the samples of complete and service equipment.
Full Text
##article.viewOnOriginalSite##About the authors
K. P. Golovko
Military medical academy of S.M. Kirov
Author for correspondence.
Email: vmeda-nio@mail.ru
Russian Federation, Saint Petersburg
V. Yu. Markevich
Military medical academy of S.M. Kirov
Email: vmeda-nio@mail.ru
Russian Federation, Saint Petersburg
T. Yu. Suprun
Military medical academy of S.M. Kirov
Email: vmeda-nio@mail.ru
Russian Federation, Saint Petersburg
A. B. Vertiy
Military medical academy of S.M. Kirov
Email: vmeda-nio@mail.ru
Russian Federation, Saint Petersburg
S. E. Komyagin
Limited Liability Company "Novoplast-M"
Email: vmeda-nio@mail.ru
Russian Federation, Saint Petersburg
N. A. Zhirnova
Military medical academy of S.M. Kirov
Email: vmeda-nio@mail.ru
Russian Federation, Saint Petersburg
I. M. Samokhvalov
Military medical academy of S.M. Kirov
Email: vmeda-nio@mail.ru
Russian Federation, Saint Petersburg
References
- Брюсов, П.Г. Новые технологии при хирургическом лечении огнестрельных проникающих ранений груди / П.Г. Брюсов, Н.Ю. Уразовский // Хирургия. – 2001. – № 3. – С. 46–51.
- Военно-полевая хирургия локальных войн и вооруженных конфликтов: руководство для врачей / Под ред. Е.К. Гуманенко, И.М. Самохвалова. – М.: ГЭОТАР-Медиа, 2011. – 672 с.
- Мирошниченко, Ю.В. Использование комплектов медицинского имущества, наборов и укладок медицинских при ликвидации медико-санитарных последствий чрезвычайных ситуаций / Ю.В. Мирошниченко [и др.] // Мед.-биол. и соц.-психол. пробл. безопасности в чрезвыч. ситуациях. – 2014. – № 3. – С. 39–47.
- Самохвалов, И.М. «Потенциально спасаемые» раненые – резерв снижения догоспитальной летальности при ранениях и травмах: перспективы / И.М. Самохвалов [и др.] // Скорая медицинская помощь. – 2019. – № 3. – С.10–16.
- Самохвалов, И.М. Проблема устранения открытого и напряженного пневмоторакса на передовых этапах медицинской эвакуации и пути её решения / И.М. Самохвалов [и др.] // Воен.-мед. журн. – 2020. – Т. 341, № 2. – С. 23–32.
- Указания по военно-полевой хирургии. – М.: ЭЛБИ-СПб, 2000. – 416 с.
- Beckett, A. Needle Decompression for Tension Pneumothorax in Tactical Combat Casualty Care: Do Catheters Placed in the Midaxillary Line Kink More Often Than Those in the Midclavicular Line? / A. Beckett [et al.] // The Journal of Trauma: Injury, Infection, and Critical Care. – 2011. – Vol.71. – P. 408–412.
- Belmont, P. Combat wounds in Iraq and Afganistan from 2005 to 2009 / P. Belmont [et al.] // J. Trauma Acute Care Surgery. – 2012. – Vol. 73, №. 1. – P. 3–12.
- Butler, Fr. Management of Suspected Tension Pneumothorax. TCCC Guidelines Change / Fr. Butler [et al.]. – 2017. – №. 2. – P. 36.
- Milisavljevic, S Thoracic trauma. In: Cagini L, ed. Current Concepts in General Thoracic Surgery. In Tech. / S. Milisavljevic, M. Spasic, M. Arsenijevic – 2012. – P. 214–256.
- Rossaint, R. The European guideline on management of major bleeding and coagulopathy following trauma: fourth edition / R. Rossaint [et al.] // Critical Care. – 2016. – P. 1–55.