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The article reveals the problem of diagnosing urgent pathology in childhood at the prehospital stage of emergency and emergency medical care. The revealed diagnostic errors make it possible to focus the attention of doctors on the most common discrepancies in the diagnoses of the prehospital and inpatient stages. The purpose of the work: to identify the structure of the discrepancy of diagnoses in the provision of SMP to children with the data of the reception department of a children’s hospital. Materials and methods:13957 case histories of children aged 0 to 17 years hospitalized by ambulance and emergency medical teams were analyzed. The frequency of discrepancies between the diagnoses of the prehospital stage and the reception department of the hospital, depending on the nosological variant of pathology and the age of children, was determined. The results of the study: The most frequent discrepancies in diagnoses were found in children of the first 7 years of life with acute respiratory pathology and infectious diseases. In children from 12 to 17 years of age, the differences in diagnoses were mainly due to cases of acute surgical pathology and were associated with over diagnosis and the complexity of assessing the child’s condition. Conclusion: Based on the results obtained, it is shown that there is a need for a more in-depth study of the features of the diagnosis of acute infectious diseases and respiratory pathology in children, as well as a differential approach in cases of urgent surgical pathology during advanced training and professional retraining of emergency and emergency physicians.
The article reveals the problem of diagnosing urgent pathology in childhood at the prehospital stage of emergency and emergency medical care. The revealed diagnostic errors make it possible to focus the attention of doctors on the most common discrepancies in the diagnoses of the prehospital and inpatient stages. The purpose of the work: to identify the structure of the discrepancy of diagnoses in the provision of SMP to children with the data of the reception department of a children’s hospital. Materials and methods:13957 case histories of children aged 0 to 17 years hospitalized by ambulance and emergency medical teams were analyzed. The frequency of discrepancies between the diagnoses of the prehospital stage and the reception department of the hospital, depending on the nosological variant of pathology and the age of children, was determined. The results of the study: The most frequent discrepancies in diagnoses were found in children of the first 7 years of life with acute respiratory pathology and infectious diseases. In children from 12 to 17 years of age, the differences in diagnoses were mainly due to cases of acute surgical pathology and were associated with over diagnosis and the complexity of assessing the child’s condition. Conclusion: Based on the results obtained, it is shown that there is a need for a more in-depth study of the features of the diagnosis of acute infectious diseases and respiratory pathology in children, as well as a differential approach in cases of urgent surgical pathology during advanced training and professional retraining of emergency and emergency physicians.
Studying and improving the theory of errors of doctors has always been important, and today it has become especially relevant.The article lists the main provisions of the advanced version of the theory of errors of doctors. The main content of the articleis devoted to four important aspects of the problem of physician errors. The article states the main contradiction of the problemof errors in medicine. The structure of general objective and subjective causes of medical errors is shown. The main optionsfor doctors to experience errors that complicate doctors’ mutual understanding in this problem are formulated. For the fi rsttime, the reasons for the denial of errors by doctors are summarized. These aspects and conclusions on them are the result ofan analysis of publications on the problem of errors in medicine, repeated discussions of the problem on professional medicalsites. The content of these aspects was based on its own material on error analysis and observation from practice. The aboveaspects and their conclusions need not so much to be confi rmed by special studies, but rather to refl ect on their role and placein the problem of errors. The general objective and subjective reasons for the occurrence of medical errors are shown inconnection with their possible "guilt". Lack of experience is presented as the most common cause of medical errors. Variousoption for doctors to experience errors are presented as a reason that makes it diffi cult for doctors to understand this problem.
Introduction. The performance of professional duties in stressful conditions leads to the emergence of low-adaptive forms of guilt in medical workers. Purpose of the study is to identify the features of low-adaptive forms and guilt types in medical workers in the post-COVID period. Material and methods. Eight hundred sixteen selected medical workers with pronounced maladaptive forms and guilt types participated in the study using questionnaires for measuring maladaptive forms and guilt types. Results. Above average levels of guilt of comprehensive responsibility, survivor’s guilt, low-adaptive forms of guilt in general, moral norms were revealed. The average level of guilt in general, the guilt of self-hated, the guilt of separation, the guilt of the state, the guilt of the trait. There was established a high correlation between moral norms and the guilt of the survivor, the guilt of comprehensive responsibility and the general indicator of low-adaptive forms of guilt; noticeable connection: guilt of comprehensive responsibility and guilt-state, guilt-feature and general indicator of guilt; survivor’s guilt, guilt-feature and overall guilt score. Limitations. The results of the study cannot be extrapolated to the professional profiles of all medical workers, since forms and types of guilt may be associated with other symptoms of post-traumatic stress. Conclusion. The results of the study will allow healthcare managersorganizers to systematically monitor stressful working conditions in order to prevent and level them, as well as to implement the prevention of low-adaptive forms and types of guilt in medical workers to maintain and strengthen their professional health.
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