State of Comorbidity in Patients with Hypertension under Conditions of Industrial Production

Comorbid conditions in patients with hypertension on the background of occupational hazards create additional problems in the treatment of hypertension. An analysis of working conditions in 76 workers of the Ivano-Frankivsk armature factory who underwent regular medical check-ups regarding first-/second-degree hypertension (the main group) showed that they were exposed to occupational hazards of chemical (acrolein carbon, iron oxide, chromium, fluorine compounds, sulfuric acid) and physical (high temperature, noise, vibration, electromagnetic radiation, dust) nature for a long period of time (from 4 to 11 years). Comorbid conditions were most often observed among the patients of the main group as compared to the patients of the control group (n = 17), who were not exposed to occupational hazards - 82.06% and 73.34% of cases, respectively. In the patients of the main group, chronic bronchitis was detected in 26.56% of cases and coronary artery disease was diagnosed in 25.09% of cases as compared to 8.33% and 18.34% of cases in the control group. At the same time, 38.89% of hypertensive patients of the main group were diagnosed with chronic bronchitis and concomitant coronary artery disease, which were not observed in the patients of the control group. The patients of the main group were more likely to have dyslipidemia, left ventricular hypertrophy, aortic fibrosis, hypertensive retinopathy as compared to the patients of the control group. In the control group, patients with overweight and type 2 diabetes mellitus prevailed. Quality of life assessment using the 36-Item Short Form Health Survey among the patients of the main group revealed a significant decrease in the indicators of physical and vital activity, fulfillment of daily professional duties. In the control group, a worsening emotional state prevailed

Therapeutic Doctors` Competency during the Providing Emergency Medical Care at the Scene

During the last years it has been observed the worldwide trend in regular creation, upgrading and implementation of emergency care protocols at the prehospital stage in the medical practice. The huge role is given to the methods of doctors` simulation preparedness in case of the emergency care at the scene. Modern doctors` preparedness requires practicing of the resuscitation in the simulation centers on the specific dummies or devices without the risk of making any harm to the patient, developing the ability to make quick and correct decision and conduct all necessary manipulations and interferences without any mistake. According to the professional literature, it is usually observed the lack of practical skills concerning the emergency care at the scene of an accident among therapeutic doctors`. Nowadays, one of the most important task undergraduate and postgraduate medical educations is the creation of simulation centers for quality training of highly qualified specialists, including emergency medical care. The aim of given investigation is the evaluation of the professional therapeutic doctors` competency in providing emergency medical care at the scene in accordance to the latest recommendations of the European Resuscitation Council (2021) and American Heart Association (2020). According to tests conducted in the 2017-2018s among therapeutic doctors about their abilities of the resuscitation conducting, it was revealed that only 52% were able to diagnose the state of clinical death; 63% - were able to perform chest compression; 15% were able to provide opening of airways; extremely low was the numbers of those who were able to use AED and ventilation – 5% and 9% correspondently. Therefore, one of the key tasks of the modern medical simulative education is to prepare therapeutic doctors to be able to perform emergency resuscitation at the scene. Key words. Simulative medicine, emergency medical care, the scene of an accident, therapeutic doctors