List of abbreviations, definitions, terms . 6
Introduction . .7
CHAPTER 1. Organization of provision of urgent and emergency medical aid in Ukraine. Initial action of medical staff in the case of medical emergency of the patient . 8
1.1. The concept of the unified system of the EMC provision in Ukraine . 11
1.2. Duties of medical staff . . 13
1.3. Organization of the EMC service of Ukraine: structure and tasks . 14
1.4. The main tasks, functions, rights and responsibilities of medical staff in the provision of medical care to the patient in medical emergency . . 16
1.5. Ethical, deontological and communicative aspects of EMС . 18
1.6. Features of providing emergency medical care at the pre-hospital, early hospital phase and hospital phases . .. 20
1.7. Equipment of mobile EMC team . 21
1.8. Provision of a family doctor's outpatient clinic for EMC . .. 22
1.9. The check-out card for the EFAMC team, the rules of its execution . . 22
1.10. Ergonomic principles in the work of the EMС team. Team work . 35
1.11. Exploring the EMC station . . 36
1.12. Personal safety of EMC team member when providing emergency medical care . . . 39
1.13. The scene awareness . . 40
1.14. The call and terms of arrival of EMC team . 41
1.15. The order of hospitalization of patients by emergency medical care teams in the health care institutions . . 44
Questions . .47
Case problems .47
Literature .48
CHAPTER 2. Stages of providing emergency medical care to victims and patients in pre-hospital phase . .52
2.1. Initial examination: definition, task, procedure . . 53
2.2. The concept of "golden hour", "platinum half an hour" . 56
2.3. The secondary examination: the definitions and tasks . 57
2.4. The procedure of the secondary examination . 59
2.5. The provision of medical care and preparation for transportation of the patient . . . 66
2.6. The tools of drug administration . 70
Questions . . 73
Case problems . .73
Literature . .74
CHAPTER 3. Technology of provision of emergency medical care during circulatory and pulmonary arrest . . .75
3.1. The concept of terminal states . 76
3.2. Stage I of CPCR: elementary support of life . 79
3.2.1. Phase A: Restoration of airway patency . 79
3.2.2. Phase В: ALV . 88
3.2.3. Phase С: maintenance of blood circulation . 91
3.2.4. Organization of resuscitation complex at the first stage of the CPCR . 93
3.3. Stage ІІ of CPCR: further life support . 93
3.4. Organization of the 1st and 2nd stages of CPCR under certain conditions .95
3.5. Stage ІІІ of CPCR: prolonged life support . .98
Questions . . 99
Case problems . . . 99
Literature . . 100
CHAPTER 4. Diagnostics and treatment of medical emergencies on site . 101
4.1. Acute coronary syndrome . .102
4.2. Cardiogenic shock . 107
4.3. Hypertensive crisis . .108
4.4. Anaphylactic shock . .111
4.5. Hypothermia . .112
4.6. Partial and complete obstruction of the respiratory tract during foreign body intrusion . 115
4.7. Laryngeal edema . 119
4.8. Drowning . 121
4.9. Electric trauma . .124
4.10. Comatose states . 125
4.10.1. General principles of patient management in comatose state . 125
4.10.2. Hypoglycemic coma . 127
4.10.3. Hyperglycemic (diabetic, ketoacidotic) coma . .128
4.10.4. Hyperosmolar coma . 129
4.10.5. Lactacidemic coma . 130
4.11. Acute poisoning . .130
Questions . 136
Case problems .136
Literature . 137
CHAPTER 5. Emergency care for mechanical traumas and mass casualty events . . 139
5.1. Craniocerebral trauma .140
5.2. Traumas of spine . .142
5.3. Mechanical traumas of abdomen . 146
5.4. Pelvic damages . 148
5.5. Damages of pelvic organs . 150
5.6. Mechanical traumas of limbs . .151
5.7. Traumatic injuries of thorax . 153
5.8. Syndrome of long-lasting compression (Crush syndrome) . 156
5.9. Transport immobilization technique . .159
5.11. Polytrauma, hemorrhagic and traumatic shock . 163

5.12. Emergency medical care during mass casualty events . . . . . . . . . . . . . . . . . . . . . . . . 165

5.12.1. EFAMC procedure in mass casualty zone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165

5.12.2. Interaction of teams of ambulance with rescue services . . . . . . . . . . . . . . . . . 167

5.12.3. Organization of sorting zones during victims’ evacuation . . . . . . . . . . . . . . . . 168

5.12.4. Stages of medical sorting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169

5.12.5. Color indication of sorting categories and usage of sorting markers . . . . . . 171

5.12.6. Primary Medical Sorting based on START system . . . . . . . . . . . . . . . . . . . . . . . 172

5.12.7. Evacuation of victims from mass casualty event zone . . . . . . . . . . . . . . . . . . 173

Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 174

Case problems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175

Literature . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175

APPENDICES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 177