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Mrs Hanna Statyvka, psychologist, UASOPTE
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Airway: Patency Position of artificial airway (if present)
Breathing: Quantity and quality of respirations (rate, depth, pattern, symmetry, effort, use of accessory muscles) Breath sounds Presence of spontaneous breathing.
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2. Interventions include securing the airway with bag-valve-mask ventilation or intubation, assessing breathing with pulse oximetry and chest x-rays, supporting circulation with IV access and fluid boluses, evaluating neurologic status via GCS, and conducting a full secondary survey and spinal precautions.
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Critically ill patients : critically ill patients are those who are at risk for actual (or) potential life threatening health problems.
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1.3.2. Dr. Svetlin Nikolov - BLG Hissar
1. MILITARY MEDICAL ACADEMY
SOFIA
Col. Dr. Svetlin Nikolov, MD
Nikolay Petrov MD, PHD, DSC
Brigadier General MC;
Col. Ass. Prof.L. Aleksiev, MD;
Col. Ass. Prof.R. Popov, MD;
Col. Ass. Prof.V. Mutafchiyski, MD;
2. “MMA possibilities to provide
further treatment and
rehabilitation of Ukrainian troops
in Hospital for post treatment and
rehabilitation (BDPLR) –Hissar”
3. INTRODUCTION
By Decision №874 from 27 November 2014, the Council of
Ministers approved the takeover of the Republic of Bulgaria the
function of a leading nation in the NATO Trust Fund for further
treatment and rehabilitation of Ukrainian military personnel.
The Decision was a result of practically stated intention of our
country for contribution in kind to the Trust Fund during the
summit in Wales in September 2014. It will consist of activities
of further treatment and rehabilitation of injured Ukrainian
military personnel in facilities of MMA and the results will be
reported as a contribution to the fund. To implement
commitments under contribution in kind of the Republic of
Bulgaria to the Fund is allocated the sum of 250 000 Euro,
which should be provided by the Ministry of Defence.
4. Hissar is a famous SPA resort located at the foot of Sredna Gora mountain with a
history dating back 2500 years, marked by the Thracian, Greek, Roman and Slavic
cultures.
6. MMA - BDPLR hospital Hissar
MMA - BDPLR - Hissar is located amidst a spacious park of 57 acres at the
eastern end of Hisar with built up area of 4636 square meters.
7. The subject of activity of BDPLR-
Hissar
The subject of activity of BDPLR-Hissar is defined in Art. 21-22 LHI /RB
under which, in the hospital for post treatment and rehabilitation to
accommodate persons in need of long-term recovery of health, persons with
chronic diseases requiring care and maintaining a satisfactory condition.
8. Hisar hospital - main mission
BDPLR Hisar hospital is almost century history and undisputed authority
among the society. Its main mission is to enhance the quality of life of
chronically ill and those entering for treatment, rehabilitation and prevention
from the system of Defense and Armed Forces of the Republic of Bulgaria, as
well as social and health insured citizens. This is achieved by using preformed
and no preformed SPA and physical factors.
9. INDICATIONS
Diseases which are indicated for the treatment and rehabilitation in subacute
and chronic stages:
Kidney - urological diseases;
Gastrointestinal and hepatobiliary diseases”
Diseases of the musculoskeletal system
Diseases of the peripheral nervous system
Gynecological and andrological diseases
10. Medical facilities
In medical facilities, according to the disease are included:
physiotherapy procedures performed in doctors' offices for electric and light
treatment;
locomotor therapy;
various types of therapeutic massage;
hydrotherapy / mineral pools, baths - ordinary hydro, pearl, jet;
curative mineral waters as drinking treatment
mud therapy with mud from Pomorie;
inhalation and herbal treatment
enemas and rectal infusions
aromatherapy
sauna
11. Highly specialized medical activities
The hospital provides some of the highly specialized medical activities by
doctors - specialists in Physical Medicine and Rehabilitation, with successful
completion of additional training, as follows:
manual diagnosis and therapy;
reflexotheraphy;
infiltration techniques;
postisometric relaxation;
laser therapy
12. Treatment block.
All medical and rehabilitation procedures are performed in separate Treatment block.
Area, location, furnishing and equipping of all sectors and facilities is in accordance with
medical standards 'Physical Medicine and Rehabilitation’. They are provided with an
audible indication for connection and control of the patients.
Available physiotherapy and spa treatment equipment meets all the requirements of
medical standards.
13. Hot water is mineral
This is one of the most popular and used mineral waters in Bulgaria.
Hot water is mineral from a Drill, located in the region of the base which comes from a depth of 318
m., with a flow rate of 8.7 l/sec. and the water is at a temperature of 51,2C.
Water is alkaline /RH-9.09/, hyper / t - 37-54 C /, slightly mineralized, hydrocarbonate - sodium -
fluorine and has the following composition:
Anions mg./liter
- fluorine 5,50
- chlorine 8,35
- sulphate 32,00
- carbonate 18,00
- hydrogencarbonate 67,12
- hydrosilicate 2,11
ALL: 133,09
Cations mg./liter
- sodium and potassium 56,86
- calcium 3,42
- magnesium следи
- aluminum 2,48
ALL 195,85
metasilicic acid 58,91
Total content 254,85
14. Hospital rooms
Hospital rooms are furnished with modern furniture - beds, lockers, dresser,
mini refrigerator, footstools, mobile coffee table. The rooms are equipped with
TV, refrigerator and air conditioning.
15. Bathrooms
All rooms have private bathrooms - tiled with terracotta and faience equipped
with all necessary supplies / toilet, sink with mixer combined shower, mirror,
luxury accessories, and in some - douche cabins or baths /. Hot water in the
bathrooms is from own mineral water source.
16. Standards
According to the requirements strict standards are met for distribution of areas
and spaces in the ward / 8 square meters on 1 bed /., for illumination;
temperature; humidity and air movement in the corridors, hospital rooms,
offices.
17. Medical registration
Admission is by medical registration. Anyone in need can obtain precise information
about the terms of use and payment of the services at the hospital - the time and place of
the primary survey and the name of the attending physician.
Examinations are performed in a foster-consulting offices where patients register with
ambulatory journals and are assigned treatment complex. Before starting treatment and
rehabilitation process, patients sign an informed consent form by which declare that they
are familiar with the proposed medical complex and agree with it.
In a private conversation at the primary examination or on subsequent office visits, the
patient can get answers to all concerning him questions about his health.
18. Emergency assistance
Organization of emergency assistance to patients in hospital is implemented as
follows:
first aid from medical team on duty
if appropriate and possible on their part, service to the sick by a team of EMCC
- Hissar
19. Treatment throughout the year
The favorable geographical location and climatic factors of the city, combined
with the wealth of the 22 mineral springs, creating conditions for full balneo-,
the climatic and terrain treatment throughout the year.
Natural factors BDPLR-Hissar used in therapeutic and rehabilitation activities
primarily and predominantly mineral water, besides the climatic and terrain
treatment, mud from Pomorie.
20. Dietary and therapeutic feeding
As part of a medical-rehabilitation program is widely accepted dietary
and therapeutic feeding. Performing all major diets - by Pevzner,
combined and individual.
In BDPLR Hisar are created all necessary conditions to facilitate the
access of disadvantaged people to the hospital room, dining room,
procedure rooms.
Ground floors of first, second and fourth building units have trestles for
movement of wheelchairs.
For hard moving patients are provided adjuvants - supporting walkers,
crutches, wheelchairs.
Units № 1 and 4 are provided according to the European requirements
with special rooms for disabled, located near the elevators.
21. Additional services
Besides treatment, rehabilitation and diet, the hospital offers patients
additional services associated with the comfort and convenience of
everyday life, as well as opportunities for relaxation and sport time out
medical procedures.
For patients are available - swimming complex, tennis court; table
tennis; volleyball and basketball.
23. Surrounding areas
Periodically, companies that make presentations of their products in the base
organize trips to surrounding areas
24. Conference halls
2 available conference halls and a movie theater are available for conducting
medical seminars and scientific congresses. The halls are used for health
education of patients by presentations of companies offering medical products.
25. Conditions for treatment and
rehabilitation and prophylaxis
1. Treatment and rehabilitation of Ukrainian military personnel is carried out in
BDPLR - Hissar in the structure of MMA, according to Bulgarian legislation
and in particular Regulation H-5 / 11.03.2013 of the Minister of Defence,
establishing the terms of use and payment of medical services in hospitals for
post treatment and rehabilitation in the structure of the Military Medical
Academy.
2. Ukrainian side provides Bulgarian side the necessary information on the date
of arrival of the military personnel and medical specialists at BDRLP - Hisar by
Bulgarian Embassy in Ukraine, not later than 5 days prior to rotation.
26. Indications for treatment and
rehabilitation in BDPLR-Hissar
Damage to the locomotor system
Injuries of the peripheral nervous system of the
upper and lower limbs
27. Contraindications for treatment
in BDPLR-Hissar
Severe and chronic diseases occurred after the selection with
complications requiring further observation and treatment
Complications requiring additional surgery;
Epileptic symptoms;
Expressed cardiac and central nervous system pathology;
Febrile-intoxication conditions;
Drug allergy;
Incapability of self-service;
Reactive psychosis;
Diagnosed neoplastic processes;
Insulin dependent diabetes.