A peripherally inserted central catheter (PICC) line allows permanent vascular access and is widely used in pediatric oncology. In patients, who fully completed antitumor treatment, the PICC line should be removed. In some cases, however, the procedure may be complicated and such a catheter is then called a ‘hard-to-remove’ or a ‘non-removable’. This article describes a clinical case of successful non-surgical removal of a PICC line with a developed fibrin sheath.

Introduction. Over the past decades, permanent venous access devices, in particular port systems and peripherally implanted central catheters, has been increasingly introduced in adult and pediatric oncology. As far as central catheters and permanent access devices are foreign bodies in basic veins, quite naturally that they are one more risk factor for thrombosis.Material and methods. The authors searched literature data ( in Russian and English) for the period up to May 3, 2022 using public databases (Embase, Medline/PubMed, Researchgate, medrxiv.org, RSCI/eLibrary). The following keywords were used for the search: “port-system”, “peripherally implanted central catheter”, “totally implanted vascular access device”, “venous thromboembolism”, “VTE”, “venous thromboembolic complications”, “VTEC”, “catheter dysfunction”, “device malfunction”. Available preprints, articles with “in press” or “online first” status, and clinical cases were also included in the analysis.Conclusion. This review discusses prevention, diagnostics and treatment of venous thromboembolic complications in cancer patients using similar implantable devices. In patients with catheter-associated thromboses, of practical interest are various diagnostic and curative algorithms, recommendations on the choice of vascular access, medicamentous therapy as well as variants of surgical intervention.

Unified approaches to ensuring the chain of survival can improve the patient’s prognosis both in out-of-hospital and in-hospital cardiac arrest.Aim. To discuss practical issues of introducing a program for the availability of automated external defibrillation in a cancer center.Material and methods. For four years, our healthcare facility has been implementing a training program for basic and advanced life support according to the European Resuscitation Council standards, combined with the creation and development of an infrastructure for the availability of automatic defibrillation. A roadmap and infrastructure were developed for the project implementation.Results. In 2018-2022, 229 employees (114 doctors, 85 nurses and 30 nonmedical workers) were trained under the basic life support program. Fifteen defibrillators were placed in various units. During the specified period, first aid in case of sudden cardiac arrest using an automated external defibrillator before the resuscitation team arrival was independently provided by doctors and nurses of departments three times. To implement training in the continuous education system, the curriculum has passed the examination and accreditation in the edu. rosminzdrav system.Conclusion. The development and implementation of such initiatives requires significant organizational and methodological work, including continuous education system. However, in our opinion, this is an extremely useful tool for improving the safety and quality of medical care.

The COVID-19 pandemic affected every sector of society, radically altering the work of health systems throughout the world. In the situation of the mass influx of patients seeking medical care that was hard to control, the issue of the widespread adoption of the medical sorting (triage) principles became urgent within weeks. The review provides analysis of 49 publications dealing with various aspects of arranging pre-hospital triage. The dynamic changes in approaches to triage, its objectives and technologies, as well as in the contribution of various X-ray imaging methods depending on the evolving experience of working with the novel infection, are of great interest. The search for literature in Russian and English published before March 10, 2022 was performed in a number of databases (Embase, Medline/PubMed, Researchgate, medrxiv.org, RISC). The search was performed using the following keywords: COVID-19, coronavirus, коронавирус, SARS-COV-2, 2019nCOV, lung ultrasound, computed tomography, computerized tomography, компьютерная томография, СT, triage, сортировка. The strategy of establishing pre-hospital triage centers or stations in case of pandemic makes it possible to reduce both the burden on the emergency departments and the occupancy rate for inpatient services. Quick access to various imaging methods (X-ray imaging, lung ultrasound or computed tomography) greatly facilitates taking clinical decisions, and could be considered beneficial in the current extraordinary situation.

INTRODUCTION: In the conditions of primary triage of patients with the new coronavirus infection, various medical imaging methods, including «point of care ultrasound», have become key.OBJECTIVE: The aim of this paper is to review data published during the pandemic on the assessment of the role of various ultrasound diagnostic methods in medical triage of patients with COVID-19.MATERIALS AND METHODS: The authors performed a systematic literature search in Russian and English for the period up to March 10, 2022 using various databases and repositories (Embase, Medline/PubMed, Researchgate, medrxiv.org, RSCI/elibrary). The search was carried out on the keywords «COVID-19», «coronavirus», «коронавирус», «SARS-CoV-2», «2019nCOV», «lung ultrasound», «POCUS», «point of care ultrasound», «прикроватный ультразвук», «ультразвуковое сканирование легких», «triage», «сортировка».RESULTS: The final analysis included 42 publications on different aspects of the use of point of care ultrasound during the pandemic. Of considerable interest are the technical features of the research, classifications and triage algorithms used in different countries.CONCLUSION: The widespread introduction of «point of care ultrasound» technology in the prehospital, emergency department and intensive care units greatly facilitates clinical decision making, including in the initial assessment of the severity of the condition of patients with pneumonia caused by SARS-CoV-2.