编号 1 (2024)

Summary.
Purpose of the study. Formulation of the concept of creating a system for monitoring the health status and risk management of personnel of enterprises supervised by the Federal Medical and Biological Agency of Russia, and the population of adjacent territories.

Results. The proposed concept provides for the formation of a Register – a distributed database of personnel of enterprises supervised by the FMBA of Russia and the population of adjacent territories. In the structure of the Register (code name “FMBA-health”) the main link is the PERSON section. Each person included in the Register (employee of supervised enterprises or residing in territories supervised by FMBA of Russia) has his own strictly unique code. Identification data about the person is linked to this code (subject to the requirements of the Personal Data Law). The register provides the following main data sections: “Health” (with possible subsections “Oncology”, “Occupational diseases”, “Disability”, etc.), “Enterprise” contains information about the employee of the enterprise (or part of it in the pilot project) and working conditions, associated with the analyzed hazard factors, “Place of residence” (with data on natural or technogenically modified characteristics of the natural environment). The mathematical theory of assessing the total production risk is presented on the basis of published works with the participation of the authors. The most developed and actually functioning is the ESCID system of the FMBA of Russia – collecting information about the radiation factor.

The theoretical provisions of the concept of man-made risk management are given within the framework of a three-tier system of social protection and medical assistance to personnel of production facilities with hazardous and especially hazardous working conditions: the first link is related to working conditions, the second – with the provision of specialized medical care, including in-depth early diagnosis for medical reasons, and the third – associated with the possibility of compensation payments to sick employees based on establishing a cause-and-effect relationship between working conditions and a diagnosed disease (insured event).

Summary. The purpose of the study is to analyze the effectiveness of the Dagestan Center for Disaster Medicine (DCMC, TCMC) in 2019–2022.

Materials and methods of research. Research materials – reporting documentation on the work of the DCMK in the indicated years. Research methods – analytical and statistical.

Research results and their analysis. The characteristics of the Dagestan Center for Disaster Medicine are presented. The main areas of activity of TCMC are considered and the effectiveness of its work in 2019–2022 is analyzed. It is noted that the specifics of the reporting period are associated with the spread of the new coronavirus infection COVID-19 and the implementation of organizational changes in the All-Russian Disaster Medicine Service and the Disaster Medicine Service of the Russian Ministry of Health.

Summary. The purpose of the study is to develop organizational and methodological approaches to the training of teachers for teaching first aid and participants in its provision in the Russian Federation.

Materials and methods of research. Research materials – domestic and foreign experience in training and retraining of first aid participants; regulations governing the training of teachers to teach first aid. Research methods – literary-analytical, formal-legal and content analysis methods.

Research results and their analysis. The stages of creating an Educational and Methodological Complex (EMC) on first aid and other educational materials formed on its basis that contribute to the unification of teaching first aid for various categories of the population are presented. Attention is paid to the components of teaching methods, teaching features and principles of first aid training. A summary table is presented – an organizational diagram of the fundamentals of personnel policy in the first aid system in the Russian Federation.

Summary. The purpose of the study is to analyze the organization and results of providing medical care to children (affected, patients) who received thermal injury in emergency situations (ES) in the metropolis.
Materials and methods of research. Research materials – data contained in the automated information and analytical system “Disaster Medicine of the City of Moscow” of the Moscow Territorial Scientific and Practical Center for Disaster Medicine of the Moscow Department of Health (CEMP).
Statistical data processing was performed using the StatTech program (Stattech LLC, Russia). During the research, the computing and graphic capabilities of Microsoft Office programs were used.
When carrying out the study, historical, statistical and analytical methods were used.
Research results and their analysis. Of the 285 children with thermal burns received in emergencies, 124 (43.5%) were pronounced dead at the scene of the event before the arrival of emergency medical services (EMS) and specialized emergency response teams.
Of the 161 patients who received emergency medical care, 133 (82.6%) were referred to hospital; 28 (17.4%) – for outpatient follow-up treatment. 24.2% of the total number of patients who received medical care were in extremely serious and serious condition, including 3.1% who required invasive respiratory support. It was noted that in the prehospital period, in 20% of cases, the severity of the condition of patients subsequently hospitalized in the hospital was assessed incorrectly.

Summary. The purpose of our study was to study the influence of professional activity on the functional state of the body of medical workers of emergency medical teams (SMP).
Materials and methods of research. The study involved 65 medical workers from mobile ambulance teams. The distribution of those examined by gender was 19 men and 46 women; by position – 16 doctors and 49 paramedics. The study was carried out from May to October 2021. The work schedule of the subjects was: work shift – 24 hours, rest period – 72 hours. The indicators recorded before and after work (n=46), between adjacent shifts after rest (n=23) were assessed, as well as at different periods of the year (n=16).
HRV monitoring was used as a method for objective analysis of fatigue. The choice of methodology was determined by the specifics of the work of mobile ambulance teams during the COVID-19 pandemic, which was characterized by a large number of people in need of emergency medical care with a shortage of time and personnel.
Research results and their analysis. The predominance of the activity of the parasympathetic department before work, the increased activity of sympathetic influences and the predominance of central regulatory mechanisms over autonomous ones after work were established; the greater severity of negative changes at the end of work in doctors compared with paramedics; negative dynamics of off-season indicators, confirming the persistence of negative changes in the functional state of employees.

Summary. The purpose of the study is to compare different types of pain relief for wounded patients with traumatic shock in the prehospital period of medical care.
Materials and methods of research. The study included 168 patients, 101 of them with mine-fragmentation injuries of the lower extremities; 67 – with multiple fractures of the lower extremities received in road traffic accidents (RTA). The majority of those examined (131 patients – 78%) were men. The study included people of working age – from 19 to 59 years. All patients were diagnosed with stage II–III shock. gravity. The study did not include patients with traumatic brain injury (TBI) or patients whose level of consciousness was below 12 points on the Glasgow Coma Scale. Primary health care for the subjects was provided by medical and paramedic teams of emergency medical services (EMS) or the Disaster Medicine Service (EMS). Comparative studies were conducted in two groups of patients.
Statistical processing of the obtained data was performed using the standard software package for applied statistical analysis StatPlus 2009 Professional using Student’s t test.
Research results and their analysis. In the prehospital period of medical care as part of intensive care, 98 wounded (group 1) were injected intramuscularly with 1 ml of a 2% solution of promedol for pain relief; 70 wounded (group 2) were administered intranasally 100 mg of ketamine and 4 mg of dexamethasone. The results of the study showed that in patients of the 2nd group the analgesic effect was recorded after 5–7 minutes, in patients of the 1st group – 30–45 minutes after administration. The intensity of pain according to the visual analogue scale in patients of group 2 was two times lower than in patients of group 1.

Summary. The purpose of the study is to develop a model for express diagnostics of the professional psychological suitability of conscript military personnel.
Materials and methods of research. The object of the study was randomly selected conscript military personnel (n=60), whose average age was (23.78±1.27) years. Criteria for inclusion in the study were conscription age and written consent of the subject to participate in the study; exclusion criteria from the study – lack of written consent to participate in the study, incorrect testing, severe illness – high fever, chills, etc.
When processing the research results, descriptive statistics methods and cluster analysis using the K-means method were used. The significance of differences between groups was assessed using Student’s t-test; to develop decision rules, the multiple regression method and forward discriminant analysis stepwise with inclusion were used (F-enter = 2.0); (F-remove=1.9) and p<0.05. The critical value of the significance level was considered to be 0.05. Mathematical data processing was carried out using the STATISTICA v.10.0 software package.
Research results and their analysis. Using the example of conscripted military personnel, the possibility of predicting professional psychological suitability using express testing based on vibraimage technology is shown. The results of testing aimed at assessing personality accentuations, abilities (types of multiple intelligences according to G. Gardner), as well as the moral qualities of military personnel were analyzed. Decisive rules have been constructed that make it possible to predict the professional psychological suitability of a serviceman with an accuracy of more than 91%.

Summary. The purpose of the study is based on the analysis of medical documentation and the work experience of medical specialists of the Center for Air Ambulance and Emergency Medical Care (CAS and EMS) of the Federal State Budgetary Institution “State Research Center – Federal Medical Biophysical Center named after A.I.Burnazyan” FMBA of Russia for medical evacuation by rail (MEZHT) of the wounded to determine the main features of medical evacuation measures (MEM) and the structure of the contingent evacuated during armed conflicts.
Materials and methods of research. Research materials – primary medical documentation of 8 flights of a temporary military medical train (VVSP) of the Russian Ministry of Defense. Study period: July–August 2023. The study used methods of mathematical analysis and direct observation.
Research results and their analysis. Currently, temporary military ambulance trains evacuate mainly walking and low-mobility lightly wounded patients, which is due both to the lack of operational need for long-distance MET for this category of patients due to the stable operation of air ambulances, and to the not entirely satisfactory conditions for placing seriously wounded bedridden patients in the air ambulance. 
Currently, the Air Forces operate in accordance with the scheme of routing the wounded from the zone of armed conflict to medical treatment organizations (HMO) in the rear of the country. At the same time, the existing difficulties in MEVT of bedridden, seriously wounded patients, including those in intensive care, require improvement of railway ambulance transport. In the author’s opinion, the most rational option for such an improvement in modern conditions is the further development of schemes for modifying passenger cars to meet the needs of the MEZhT of the seriously wounded and sick.

Summary. The objectives of the study are to analyze and give a general assessment of the organization of scientific research on the problems of disaster medicine, including within the framework of dissertation works carried out mainly by specialists of the Disaster Medicine Service (QMS) of the Russian Ministry of Health; outline the main directions for its further improvement.
Materials and methods of research. Research materials – regulatory, program and methodological documents regulating the procedure for organizing scientific research on the problems of disaster medicine in 1994–2020: all (116) dissertation works defended in the dissertation council in the specialty 05.26.02 “Safety in emergency situations (medicine) disasters)”, which operated in 1996–2020. at the All-Russian Center for Disaster Medicine “Zashchita” (VTsMK “Zashchita”); data from expert assessment cards on the research topic, filled out by the teaching staff of the departments: disaster medicine, mobilization training of health care and disaster medicine, disaster medicine and life safety of educational organizations of higher medical and additional professional education of the Ministry of Health of Russia; scientific works and publications devoted to the study of problematic issues in disaster medicine.
When carrying out the study, the following methods were used: methods of content analysis and expert assessment; statistical, analytical, bibliographic methods and field observation method.
Research results and their analysis. The results of the study are presented, characterizing the state of the organization of scientific research on problematic issues of disaster medicine, including within the framework of dissertations carried out by specialists from medical organizations subordinate to the Ministry of Health of Russia. Reasonable proposals were made to improve the organization of scientific research in disaster medicine.