Medical-Evacuation Characteristics of Persons Affected During Earthquakes

Goncharov, S.F.; Chadov, V.I.

doi:10.1017/s1049023x00042527

Cited by 1 publication

(4 citation statements)

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“…Распределение пострадавших с сочетанной травмой таза в зависимости от варианта повреждения тазового кольца в 2009-2018 гг., n (%) (4,6) 485 (8,4) 182 (3,2) 932 (16,3) 160 (2,8) MedicoBiological and SocioPsychological Problems of Safety in Emergency Situations. 2019.…”

Section: таблицаunclassified

“…При землетрясении интенсивностью в 5 баллов травмы таза составляли 4 % ко всем санитарным потерям, имея тенденцию к возрастанию до 6,0-6,2 % параллельно уве личению мощности землетрясения. При этом, до 50-70 % возрастает число лиц с риском ле тального исхода, требующих проведения про тивошоковых мероприятий [3].…”

Section: таблицаunclassified

“…Сочетанная травма таза встречается в 61,7-70,5 % случаев, а у 21-28 % пострадав ших в клинической картине отмечаются по вреждения головы, груди -10-17 %, органов живота -от 6,3 до 24,5 % и конечностей -до 92,4 % [3,6].…”

Section: таблицаunclassified

“…чело век населения России в год [22]. В результате высокоэнергетических воздействий -дорож нотранспортных происшествий (ДТП), паде ний с высоты, сдавлений массивными предме тами при различных техногенных и природных чрезвычайных ситуациях травмы таза стали более тяжелыми [3,15,24,26,30]. Увеличи лось число открытых нестабильных переломов с обширными повреждениями мягких тканей и нейрососудистых структур, массивной вну тренней кровопотерей, являющейся одной из основных причин смерти пострадавших [2,16,20,22,25,28,29].…”

Section: Introductionunclassified

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The structure, features and nature of combined pelvic injuries in victims in the level I trauma center of a St. Petersburg agglomeration

Кажанов

Mikityuk

Kolchanov

et al. 2019

Med.-biol. soc.-psihol. probl. bezop. črezvyčajnyh situac.

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Relevance. Mortality and unsatisfactory results of treatment of combined injuries of the pelvis, especially with pelvic ring fractures, are still high. This is due to the lack of an effective system of specialized medical care for this category of victims.Intention: To study the frequency, characteristics and structure of combined injuries of the pelvis with damage to the pelvic ring based on the experience of specialized medical care in the level I trauma center (St. Petersburg I.I. Dzhanelidze Research Institute of Emergency Medicine).Methodology. We analyzed the 10-year (2009–2018) treatment results for 932 victims with a combined pelvic injury at the level I trauma center: St. Petersburg I.I. Dzhanelidze Research Institute of Emergency Medicine. In the study group, 667 victims had unstable pelvic ring injuries.Results and Discussion. Combined injuries of the pelvis, accompanied by damage to the pelvic ring in a large urban agglomeration as a result of high-kinetic injuries (road traffic injury, catatrauma, etc.) were observed in 16.3% of the structure of polytrauma. 75.8% of the victims were of working age. In the structure of injuries, pelvic ring injuries among polytrauma mainly resulted from traffic accidents (57.9 %). The initial fractures were classified as stable type A (265; 28.5 %), partially stable type B (485; 52 %), and vertically unstable type C (182; 19,5 %) according classification М. Tile и М.Е. Muller (AO/ASIF). Four or more areas of the body were affected int 60.8 %, and pelvic injuries dominated in 62.8 % of observations. Half of the patients with pelvic ring injury were diagnosed with more than 25 points by the ISS. Among them, life-threatening complications were identified in 77.7 %. Of these, 33.6 % had pelvic bleeding, the second largest source of acute blood loss was intra-abdominal – 12 % of observations. The mechanism of damage to the pelvic ring was lateral compression (LCI) – 54 % and vertical shift – 57.7 %. In the structure of morphological damage to the posterior pelvic ring, unilateral and bilateral fractures of the sacrum were more common: 51.7 and 13.2 %, respectively. Multiple pelvic injuries was diagnosed in 7.3 % of victims, most had ruptures of the bladder and posterior urethra; open pelvic injuries, including extensive traumatic skin detachment were observed in a small percentage of observations (3.4 %).Conclusion. Unstable pelvic ring injuries differ from other types of pelvic injuries due to more common (33.1 %) traumatic shock (grade III traumatic shock) and greater acute blood loss (> 20 % blood volume; 35.9 %), especially in victims with vertically unstable pelvic injuries. This requires rapid transportation of the victim to the trauma center, proper organization of pre-hospital care, including temporary fixation of the pelvis and early specialized medical care.

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Section: таблицаunclassified