Том 332, № 8 (2011)

Since December 1, 2009 was reorganized the structure and significantly extended the composition of hospitals and outpatient clinics (subsidiaries) subordinated to the Main Military Clinical Hospital n.a N.N. Burdenko, hospital bed capacity increased to 3770 beds available against 1320. In fact GVKG in new structure has become a major hospital health-care union. The need for sustainability of the union demanded revision of the available and create a modern management system. The aim of performed study was to examine lessons learned, building a new system and strengthening the chain of command. Achieving this goal required the development and introduction of modern, more precise and well-functioning system of interaction between units, and the collection of primary medical and health-economic information for assessing the performance of departments, centers, divisions and associations in general, making more informed decisions the organization of therapeutic and prophylactic and therapeutic and diagnostic work.

The article is based on personal experience of the authors with assistance in the aftermath of the tsunami in the Republic of Indonesia, which killed about 120 thousand (December 26, 2004 at 255 km to the west coast of Sumatra). In the disaster area were sent to 183 medical detachments for special purposes of the Volga-Urals Military District, reinforced brigade of specialized medical care of military medical institutions under the central government and the Moscow Military District. As the authors noted, in the aftermath of a disaster like the tsunami, at first put forward preventive measures among displaced persons. The experience gained by the Medical Service of the Armed Forces of the Russian Federation in the aftermath of natural disaster in the Republic of Indonesia, is used to plan future humanitarian operations abroad with the assistance of military medical specialists from Russia.

Article is devoted to the clinical description of fighting posttraumatic stress disorder, and also questions of their early diagnostics in the conditions of military unit. The characteristics of the basic clinical variants ofposttraumatic stress disorder and postfighting personal changes at combatants are resulted. Concept substantive provisions ««combatant accentuation» is stated the person. It is underlined necessity of the earliest rendering of the mediko-psychological (psychotherapeutic) help to the military men who have transferred fighting stress.

Research objective - to raise safety of conduction anesthesia of a humeral plexus by depression of cases of intraneural introduction of anesthetic on the basis of application of ultrasonic scanning during performance of blockade. Materials and methods. 137 blockade of a humeral plexus by axillary access are executed. Depending on a method of identification of nerves patients have been distributed on two groups: 1) identification of nerves by means of ultrasonic scanning (n=68); 2) a combination нейростимуляции and ultrasonic scanning for identification of nerves (n=69). Results. At a finding of a section of a needle in immediate proximity from a nerve (according to ultrasonic scanning) peripheral motor reaction was absent in 63,8% of cases. Intraneural introduction of a solution of local anesthetic was observed more often (p<0,05) at identification нейростимулятором (69,6%), than at ultrasonic identification of nerves (17,6%). The conclusion. Diffusion of local anesthetic observed by means of ultrasonic scanning confirms an exact site of an end of a needle that allows to avoid its intraneural introduction.

The authors analyzed the use of two different survey methods (PPO and «Vidicor») of entrants of the St. Petersburg Suvorov Military School. It is shown that the methods of the final results do not contradict each other. The discrepancy between the results is 4,4%, but the method of «Vidicor» has several advantages: lower labor costs and psycho trauma of surveyed, most dynamic and effective, the possibility of creating an electronic database. This allows us to recommend it for use.

For the new medical kits and bags original covers were developed, which are adapted to the modern combat gear set of individual soldiers, provide convenience and ease of use in providing a self-interacting, and medical care, can begin to provide assistance «to go».