quiet life. this is me alexey fedorov, the developer of the first quantum blockchain and quantum algorithms. and this is the moment when i decided to go into science. since childhood how

to make the life of people in the regions more comfortable increase the availability and quality of social services in the agency for strategic initiatives decided that it is necessary to collect the best practices and solutions that have already been tested in a project called the regional social standard document is part of the national social initiative, which, on behalf of the president asi sells all over the country. this is 13 points in many regions. they have already been implemented and are working effectively, for example, the developed regulations for the interaction of different structures in the subject of the social strategy council for the quality of life, which is personally headed by the governors. the first is the work that we launched, within the framework of, uh, the analysis of those life situations that a person faces, from birth and throughout his life. and this is such a process of self-examination, and feedback from people and those problems of barriers with which

faced people professionals working in education health care social support. and that's based on that feedback. i don’t know that more than 100 life situations have already been worked out in the region, and for which new services have already been formed. 35 regions have already decided to implement the social standard. this is only the first wave, with which the agency begins work among the pilot subjects of the sakhalin and nizhny novgorod regions, the republic of mordovia, the leningrad novgorod region, the republic of udmurtia, kaluga, irkutsk regions, bashkortostan north ossetia alania and many others. investments are made for what , in order to make people's lives better and the main indicator. uh, people's lives is their social well-being, the official well-being depends on the simple things of health comfort environment. this

is what is called the social standard. it is on the third that we work together with everything. and we are the pilot projects to be implemented. the first step is the self-assessment of the region, that is, the analysis of which elements of the social standard need to be created from scratch. which ones are already working in this case in the subject, their effectiveness will be evaluated by the authorities of the region and an independent expert group. these are representatives of the healthcare sector, education, social protection, non-profit organizations , social entrepreneurs, as well as the recipients of standard services themselves. it also provides for the work in the region of the institute of regional service commissioners, where they develop a solution to improve the quality of the provision of social services based on the service design methodology with the support of the agency for strategic initiatives such an institute has already been created in 27 regions, including in mordovia . it is for ourselves and in the republic. this project was landed

and worked out, but this applies to all regions, so, for each life situation, the loss, the breadwinner and the receipt of subsidies. the first trip to school in kindergarten . we will not just not force a person to rummage through documents to look for. and what, or something , and so many problems have appeared, different household and others, therefore, uh, here the situation will change somewhat. we will go and offer ourselves. well , also in each region, project participants there will be a multicenter for people with disabilities . health, multicenter will include rehabilitation and habitation services of apartments and houses for assisted living of people with disabilities, day care centers and family centers for children with disabilities and special needs. health, family palliative care center and multifunctional centers. crisis centers for the safe stay of women and children affected by violence, and in addition, the standard provides for a navigator around the world

support that a person can count on, depending on their life situation, according to the head of the axes svetlana chupshiva, 13 points of the social standard are not exhaustive. this is only the first step of the task of making sure that the principles of open friendly communication with people who apply for support work together on social support with a hundred business. wow, in nizhny novgorod , an action was held to collect humanitarian aid to the residents of energodar, organized by the state corporation rosatom of the zaporozhye region, warm clothes will be sent books toys, in addition, organized the collection of financial assistance. it will be spent on the purchase of furniture for the school, computers, heaters or medicines. in just a few days, russat employees collected more than 42 million rubles. in any journey,

a faithful and reliable descender is important, who will support you along the way and who is always near rosneft's largest networks, where warm meetings and profitable loyalty programs await you. we are always responsible for quality and take care of those for whom the rosneft gas station works as a reliable companion. on all roads of the country rosneft drives us better.

servicemen who were wounded in the zone of a special military operation in 10 minutes receive first aid, within an hour they enter the medical organization of the military level, and within 24 hours they enter the hospital immediately after the advertisement. watch the interview with the head of the main military medical directorate of the russian ministry of defense, doctor of medical sciences, honored health worker of russia dmitry trishkin. dmitry vyacheslavovich thank you very much for taking the time to come to our studio. hello we we continue the conversation about the organization of medical care during the special military operation in ukraine, please tell us about how the route is created and works, and for the soldiers who were injured during the hostilities and should receive high-quality timely medical care. i want to say that a special military operation, probably, for the entire military medicine of the armed forces of our country. in

general, this is a new page in history, because in terms of the intensity of how it proceeds and in terms of the amount of assistance that we are already providing today practically after 10 months. this suggests that for military medicine today , military prices are really on the shoulders, a big burden has fallen. we have a very well -organized system of providing medical care, like military units directly in the zone of a special military operation and medical companies and medical battalions and uh. there is such a peculiarity as we have special medical detachments beyond the border hospital. and of course the hospital base center. these are our leading medical organizations. this is the main military clinical hospital of the vishnevsky mandryk and, of course, the military medical academy. also, these are other hospital bases in the military districts and the central and

western and eastern military districts. here for this period of time. the system has tuned in so much that, well, for me, as an organizer of military value , the question has always been interesting, how is it with time? and we began to work better compared to how we started working from the first months of this operation and we got amazing data, which is practically, and there were no significant changes precisely in time in the quality of assistance during this period ; we achieved great results just a little bit in time intervals. today we provide first aid within 10 minutes. within an hour, military personnel enter the medical organization of the military level and within a day. he is now admitted to the hospital. we set up the system in such a way that today even in central and the main lord , military personnel who have received complex severe injuries arrive within a day of such, of course,

earlier in general, probably in the experience of our country's previous ones. ah, there was no such thing as a warrior, a very competent specialist working in sorting. this is probably the basis for success, because competent sorting today determines very important things. today, it is necessary to unload military units as much as possible in terms of timely evacuation of the patient to the nearest hospital ; case. naturally, patients who are already undergoing treatment are immediately evacuated to our hospitalization center and are completing, so to speak, treatment in the main hospitals. in the future, he is evacuated to other medical organizations, where the daughter of the war is already undergoing treatment, or he is hospitalized with an anatomy by a resort organization in our revolutionary center in order to restore health there completely. therefore, this system

for these almost 10 months. she showed. that we are able to handle almost any export. today, our doctors work very unitedly, such a large united friendly team. each of the half- word. the bosses understand the orders. we have rebuilt the medical support system. today, there are no problems with the provision of medicines, not with consumable medical equipment. well, in public society. basically. uh. i would like to note that today for the first time, probably, another area has appeared that was not previously mobilized. these are military personnel who today actively began to take part in the special military operation. if a contractor is us, uh, who entered into an agreement on a contract for military service for military personnel. we were clear. we examined him twice a year. we knew his state of health and his

health group, then a soldier. and let's say in the framework of mobilization. this is a slightly different level and list of examinations that was carried out on his preliminary examination, uh, only not fit and limited fit with certain categories, and today they can perform tasks within mobilization of a special military operation, therefore it is natural that the age of the presence of a chronic pathology. this is another, so to speak, group of not only injuries, but also diseases that military medicine is already beginning to confront with today. well, we are ready for it today. uh, many military units, the hospital base and the border and central hospitals are heavily reinforced by specialists with additional medicines and not only dressings and not only antiviral, but also for the treatment of any other pathology, which may be in a serviceman specifically called up as part of mobilization. thank you very much for such a clear, understandable and extremely capacious a route that you just described, and you

said that there are lightly wounded. who receive assistance locally or at local institutions in the territory. uh, there, as i understand it, luhansk lugansk donetsk republic. but there are those who need to be withdrawn, but the percentage, taking into account the characteristics of this military operation and uh, weapons uh, murders that use uh, our uh, corporate side. uh, the percentage of minor severe injuries. you can talk about it. today, we do this sort of, uh, analysis all the time. and let’s say that for the first 3 months since the start of the special military operation, we have been conducting this analysis of military personnel who are coming for treatment , and we have received data that the patients are in a serious and extremely serious condition. in the first 3 months, 27% received. now comes 24%. that is, there are fewer severe and extremely severe people in a state of moderate severity somewhere somewhere somewhere around 50%. well, lungs, respectively, the

father of the figure remains. there is about 20-2% ah, i guess i want to say that the degree of injury can not affect the provision of medical care. just the very course of hostilities using different types of weapons. e, as before, as before, 70% are accounted for by ministry of health injuries, 10% are for diseases, 10% are for bullet gunshot wounds and 10% for injuries proportions. very clear, 70 10, so we traced the same numbers at the beginning of the special operation. and then the same is about now, so this is also very important for us, because we need to understand which specialists to involve more. in what direction are we in the medical teams of appointment, which work directly in their zone? there is already specialized assistance, that is, not qualified, but already specialized. that is, there are specialists, neurosurgeons and traumatologists and taracal and

vascular surgeons, because sometimes there is absolutely no time for patients to be evacuated even in a border hospital and thus more to the hospital of the center, so this amount of assistance should be provided already there on the spot, in fact, the most demanded specialties. yes, push surgeons, neurosurgeons, traumatologists , orthopedists, and you said that help is provided in the first 10 minutes. and how is this possible, and who provides it, we are talking about medical assistance, which turns out to be the most important thing, and we are well aware that more than 90-two percent, and unfortunately, patients die. e our military personnel die it all the same. uh, on time, first aid was not provided, not even medical care, but first aid. this is to stop bleeding. this is the lion's share goes to all cases, and the death of military personnel. this is an obstruction of the airways due to severe contusion injuries, which means bruises. well, uh,

only 1% of chest injuries are associated with pneumothorax, so uh in any case, if we understand that the military either him. ah, let's say military personnel, who is nearby is capable, and stop the bleeding, apply a tourniquet , plug the wound with hemostatic and bandage it dressing bag this at this stage. well , naturally. anesthetize with promedol. at this stage , this is sufficient in full. and then the task of the paramedic’s self- instructor is to check as quickly as possible, so to speak, if this assistance is possible and evacuate him to the medical unit, the instructor himself is in any medical unit in any unit, so he is always next to military personnel have a medical pack of a slightly different format than the first-aid kit of each individual soldier a more complete set, because he knows how to use it in full and more

harnesses. and harnesses of various modifications and silicone and tourniquet and dressing packages. we have more needles for pneumothorax and occlusive dressings that are applied to the chest to eliminate pneumothorax, so tactical medicine. yes, this is what we did today and yesterday and continue to do. and, of course, today it makes itself felt and gives the positive results that we receive. and in connection with this, you reviewed the contents of first-aid kits and sanitary packings for the time, a special military operation, because it was the topic of many speculations. you know, yes, definitely ah. first-aid kits are individually available for each serviceman. at first, he had a special military operation. we fundamentally changed them. ah, but still, we focused on the fact that this first- aid kit should fundamentally change with a medical specialist, who a can provide medical

care, that is, with a doctor. the doctor at the paramedic at the san instructor at e, arrow of the orderly, so this the first-aid kit should be somewhat different, because after all, he goes through tactical medicine in full in more time, he studies it in a completely different way and knows and can provide this amount of assistance to a soldier. it should be somewhat different. it should be those elements that i said should be an anesthetic drug should be a tourniquet should be a hemostatic should be, uh, a dressing bag. this is the main one, well, the scissors are definitely tactical, which you need to cut and directly means clothing in order to stop the bleeding in time and properly stop the bleeding. how often medics become targets for the enemy. you know what this means and what opportunities there are today to protect them. unfortunately, here is a special military operation revealed that our enemy. today, probably, the target is

not only military personnel, the target is also civilians , the target is, including medical workers, probably, i will not give out a secret. i will say that today many sanitary our vehicles removed crosses from their sides, because a car with a cross is a target, and they also get into medical units, so we removed all medical units from the tent fund, because we perfectly understand any building that can be located at a certain distance with concrete buildings with brick buildings will always be better than, er, a hospital that will be located in a tent fund, so we unconditionally protect medical workers. there is, of course, sanitary losses, because by being on you we provide medical care. he also, on an equal basis with all military personnel, gets and can fall under shelling and receive a corresponding wound. among your colleagues, there are doctors heroes. uh,

well, i mean heroes now, not only heroes in essence, but also people who have been awarded this title or other military awards. you know, i would not like to single out, probably. uh, someone separately, because a very large close-knit team is really working today. i'll probably name two such big figures today state grad. ah, more than 4,000 medical workers received 1,500 of them and received the order of courage and uh, that means u medal for two. % of doctors received such awards. 70% receive the middle junior medical personnel, namely those who are on the front line today and those who save our military personnel, our guys. if today the need for volunteers is asked, because this question is often asked and

actively interested in by your colleagues, civilian doctors who would like to pay their debt to their homeland. today, indeed, yes, we receive an appeal. uh, well, many acquaintances even apply, but tell us how today you can become a volunteer in the armed forces within the framework of mobilization or conclude a fixed-term contract, but in fact today as part of mobilization, and we also called on medical workers. and those who were in reserve, those who passed at one time, uh, military training, who has officer ranks? naturally, this category came across first of all, then another category appeared - military personnel who are years old. well, maybe 10-15 years ago they underwent military service urgently, but then after completing it they entered a medical university and entrusted themselves. there for six years and began to work as surgeons, they came to the military registration and enlistment office on the agenda, and they were called as having a certain specialty.

e, being, and then a shooter and found out that he turns out to be a surgeon today, therefore accordingly, they are attracted and calls for military service and concludes an appropriate contract with them and at the same time signs the order of the minister of defense for the appointment and assignment of the rank of lieutenant of the medical service, therefore, today as part of the mobilization. we have a sufficient number of medical workers. naturally, if there are volunteers who would like to contribute today to the indications of medical care. we are always ready to provide assistance and include them in our large close-knit team. we can today speak and called the percentage of fighters who return to duty after being wounded after rehabilitation. and at least in total numbers and maybe , comparing these figures with the data of previous military conflicts. i want to say that probably any uh

civilian military healthcare organizer will always be interested in two digits - this is the time and this is the quality of the time. i already said today. how much do we spend on first aid medical care qualified specialized second quality question to e say answer two to this question. how well do we treat? there are two main indicators here. this is the hospital mortality. that is, it is the number of military personnel who die. unfortunately, in military hospitals, already being delivered there. today we have reached the figure reached, that is, less than half of the percentage of servicemen who end up in military medical organizations can be called this way, unfortunately, such figures have never been killed for all the time today, 97% percent, because and how talk about who can return to their duties? yes, that's why we say that

there is, of course, who survives, but due to certain severe consequences of injuries, he can not fulfill his immediate duty as a military man, therefore this figure today reaches 97%, if again we take experience, and the great patriotic war war. we all understand that then there was a percentage of 70%. today we have reached a figure of 97%. this is a very serious result. not to say, we did not expect this, but today these are objective data that we are studying. we are watching how did we get to these numbers? well, the second, probably a very important indicator, which also requires constant detailed analysis. these are the so-called potentially rescued patients, that is, er, there is a generally accepted international term. these are potential premitables. even there is terminology in nature. these are the servicemen who, unfortunately, could not be saved on the battlefield. this also requires a very detailed assessment. for us. this is very important about how qualitatively

medical care is provided exactly, uh, directly in word zone. that is, how it provides first aid, how it provides assistance specifically in e, in our medical units of the military level, this percentage today is a little less than five percent. and this suggests that again we are raising this literature of all that are available to us today of all previous conflicts, including nato countries, this is iraq, this is afghanistan, these are our previous conflicts from 18 to 24%. that is, again. this suggests that today a military unit is both in the framework of first aid and directly qualified assistance. today it does its job 100%. well, we have come to the important topic of rehabilitation, but in order for the wounded soldiers to be able to return to duty , including, by the way, there are prostheses, right? this also applies today amputation does not mean the end of a military career. by the way, how were they 200 years ago. this

is not a career final for a long time, but also those fighters who, in general, received disabilities and can no longer continue military service, how is the rehabilitation of such military personnel organized today and uh, what opportunities are you here? you see, in particular, the president recently said that it might make sense to involve civilian medical institutions to solve these problems to help you. i want to say that military medicine managed to save. this is probably the basis of the rehabilitation potential that for many years we had fifty-two sanatorium resort organizations in the structure of the ministry of defense. today we are using 23 rehabilitation centers to provide assistance to military personnel who require full rehabilitation. today we have concentrated all the most severe patients in three hospitals, including, as i said, patients who need prosthetics. uh, due to the loss of a limb. this will crack the core of our hospital base. this is a military medical academy, this is the

burdenko hospital and the hospital of vishnevsky e-e. we are individual. today we work with every serviceman, we select the best that is available today in terms of prosthetics of prosthetic orthopedic products. uh. we, as a rule, prosthesis with third-fourth degree prostheses category, that is, these are multifunctional prostheses that allow the soldier. well , practically, but to perform the range of movements that he did in ordinary everyday life. it 's practically sports prostheses, but who is deeply damaged. eh, well, immersed in the topic of prosthetics , prosthetics are primary, that is, when they are done immediately and there is secondary prosthetics, when prosthetics are already a year later, when the formation of the final structure is already underway, that means the muscles of the bones of the limbs, and then it’s finally a protest is being established, so today we are on an emergency basis, and we are prosthetics with the best prostheses to date, which are, uh, and bionic prostheses and the fourth functional

class. this allows the serviceman to quickly recover and send him for rehabilitation to our revolutionary center. and this modern medical equipment is a biofeedback device, which was called to allow a soldier. well, let's say, as quickly as possible, uh, and psychologically and physically adapt to. well, really this life. thank you very much for this conversation. i think that a lot of important things were heard not only by your colleagues, but also by the fighters themselves and their relatives and friends, who are worried and worried and hope that our doctors will be able to provide, and the defender, it seems, all the necessary assistance. thank you. typical ukraine program we talk about what made ukraine the way

we know it today, typical and, of course, unique. that's what we're interested in, hope it's interesting or as we sometimes see your programs, they are very convincing and profound. for which i want to tell you separately. thank you , we will tell you tuberculosis diphtheria pulitis

brucellosis that the united states is testing and storing biological weapons in ukraine, the americans learned from their own all the details of the leak from the pentagon with the names and names of kiev and lvov institutions. instead of real weapons, a tuning kit. the americans are feeding kyiv again with breakfast. this time they judged the miracle kit any bomb that turns a divorce in the corner again or ukrainians with with its help, they will still be able to make something special even if they put on a sweater with a throat, like a macron at home, it’s cold, the germans go to kaliningrad to spend the winter, it’s cheaper than to warm up their apartments? they are waiting for all of europe's gas storage facilities have lost record weight, is europe enough for this season, rushes to people for a tight dinner and imitates the former president of georgia fainting from the corners