MANAGEMENT OF MEDICAL CARE FOR THE VICTIMS OF ROAD ACCIDENTS IN TRAUMATOLOGY CENTERS OF SAINT-PETERSBURG

The number of road accidents, fatal outcomes and victims exceeded in 1.5 times in Saint-Petersburg in comparison with Moscow. At the average, 600 victims were treated in each of 6 first-level traumatology centers every year. The quantity of patients, who were admitted to 3 second-level traumatology centers, numbered 10 times less. About 300 people entered to others hospitals. The lethality consisted of 15%, 20% and 37%, respectively. There are a lot of matters, that should be discussed, such as an importance of better treatment financing of multitrauma by using compulsory medical insurance system, an optimization of pre-admission treatment and a necessity of patient delivery by mobile medical team using the anaesthesiology and resuscitation

EARLY ENTERAL INFUSSIONS IN COMPLEX TREATMENT OF SEVERE COMBINED CHEST TRAUMA

On the basis of study and treatment of 98 victims it was stated that the absorption of isotonic glucose electrolytes solutions in the small intestine was saved even increased in case of large hemorrhage in severe polytrauma with chest, abdominal injury and other regions trauma. An application of early enteral infusions allowed reducing of the volume of parenteral introduction solutions and facilitated to a reliable decrease of development frequency of nosocomial pneumonia of attributive lethality

FEATURES OF DIAGNOSTICS AND TREATMENT OF EXTREMELY SEVERE COMBINED INJURY

The data of examination and treatment of 356 victims with extremely severe combined injury and shock of III degree were analyzed. All the patients had a medical unfavorable life prognosis. On the basis of the research, it was proved, that the modern approach of treatment of such trauma should include an adequate anti-shock treatment in conditions of the first-level trauma center. The operative activity should be increased in cases of combined trauma of bones by their early external fixation. The authors re commend an application of up-to-date prevention sepsis treatment, late reconstructive - restorative operation performance after its full relief and nutritive metabolic therapy. This approach allowed reducing of the rate of life-threaten infectious complications on 32,4% and noninfectious - on 31,7%, the lethality - on 24%