When I was a student I was on duty at the Sklifosovsky Research Institute. Sklifosovsky Institute: from a charity home to modern medicine

History of the Research Institute of Emergency Medicine named after. N.V. Sklifosovsky originates from the Hospice House, founded for charitable purposes by Count N.P. Sheremetev in 1803 and officially opened in 1810. The house consisted of a hospital for 50 “suffering from illnesses” and a shelter for 25 orphan girls. It was one of the first institutions in Russia to provide medical care to the poorest segments of the population and to care for orphans and homeless people.

During the Patriotic War of 1812, the building of the Hospice House housed a hospital, first for the French and then for the Russian army, and later - a hospital for those wounded in the Russian-Turkish War of 1887. The wounded from the fronts of the Russian-Japanese and the First World War were also received here. Permanent surgical practice has been carried out here since 1815. In 1923, on the basis of the Sheremetevsk hospital (former Hospice) the Institute of Emergency Care was organized, bearing the name of N.V. since 1929. Sklifosovsky and widely known to Muscovites and residents of other Russian cities as a medical institution that provides highly qualified care at any time and to any patient. As a department, the Institute was assigned an Emergency Medical Station located on its territory, which was headed by the chief physician of the Sheremetev Hospital G.M. Gerstein. In the same 1923, the Ambulance Station was headed by A.S. Puchkov. Under his leadership, organizational principles were developed, a documentation and reporting system was created, technical re-equipment was carried out, as a result of which the work of the station reached a new qualitative level. The station remained part of the Institute until 1940, and then was separated into an independent organization. The Institute’s staff was one of the first in the country to begin the development and practical construction state system providing emergency medical care for acute illnesses and injuries. The Institute was the first to raise the issue of the need for preventive work to prevent accidents and contributed to the adoption of a number of measures that protected various aspects of everyday life of the Moscow population. The Institute was also a pioneer in establishing an emergency surgical service. Here its basic principles are formulated and developed: qualified prompt assistance at any time, uniformity of tactics and surgical techniques, participation in diagnostics of radiologists and clinical laboratory staff, practice of morning conferences to discuss the results of work over the past day. During the Great Patriotic War, the Research Institute named after. N.V. Sklifosovsky received tens of thousands of wounded. Here, the most complex operations were carried out to save the lives of soldiers and return them to duty. Many surgeons nurses and orderlies worked at the front. At the end of the war, the surgical and therapeutic services of the Institute were reorganized and brought into line with peacetime tasks. The pre-war and war periods of the Institute's activity were marked by major scientific achievements in the field of medicine. Through the works of outstanding scientists V.A. Krasintseva, A.S. Puchkov, academicians of the Academy of Medical Sciences S.S. Yudina, B.A. Petrova, A.N. Kryukov, corresponding member of the Academy of Medical Sciences D.A. Arapov, professors P.I. Androsova, B.S. Rozanova, A.V. Rusakov and other prominent specialists of the Institute laid the foundations for the theory and practice of emergency medical care as a special branch of healthcare. The principles of emergency surgical care developed by the luminaries remain in force today, which convincingly demonstrates their correctness. The development of medical science was facilitated by the creation at the Institute of the Dissertation Council for the Defense of master's theses in the field of surgery, traumatology and orthopedics, anesthesiology and resuscitation. In 1978, under the Presidium of the USSR Academy of Medical Sciences, the Scientific Council on Emergency Medical Care was formed, created to plan, coordinate and manage scientific research in this area. The head institution was determined to be the Research Institute of Emergency Medicine named after. N.V. Sklifosovsky, who began to implement unified management of scientific research work on a city and country scale. The need to open multidisciplinary emergency hospitals in the country was scientifically substantiated. Thanks to the emergence of almost two hundred such hospitals in a short time and the creation of specialized emergency teams (cardiological, toxicological, intensive care, etc.), the quality of treatment of emergency conditions has significantly improved. The commissioning of a clinical and surgical building with 15 well-equipped operating rooms in 1982 contributed to the further development of emergency surgery, as well as neurosurgery and traumatology. As a result, the Institute has become a leading center for emergency surgery not only in Moscow, but also in the country. During the period 1992–2006. Significant changes were made at the research institute, brought to life by the requirements of modern medical science. Departments of acute endotoxicosis, liver transplantation, emergency plastic and reconstructive microsurgery, a laboratory of new surgical technologies, a department of emergency cardiac surgery and the City Burn Center have been created. The buildings where the departments of acute thermal injuries (City Burn Center) and acute poisonings (City Toxicology Center), the liver transplantation department and the department of crisis conditions and psychosomatic disorders are located have been reconstructed. A new building for the emergency cardiac surgery department was built. The restoration of the first building of the old building of the institute - an architectural monument - has been completed early XIX century. The Museum of Surgery and History of the Institute, created in 1948 on the initiative of Academician S.S., will reopen here. Yudina. A number of other historical buildings have been restored, including the chapel. The ancient park, which is an integral part of the unique institute ensemble, is maintained in exemplary order. In order to significantly speed up and improve the quality of the treatment and diagnostic process and improve the working conditions of personnel, in recent years, reconstruction of the admission department, operating unit, a number of intensive care units, a complex of laboratory and instrumental diagnostic units and a disinfection unit has been carried out. Today, the Research Institute of Emergency Medicine named after. N.V. Sklifosovsky is the largest multidisciplinary scientific and practical center for emergency medical care in Russia. All of its divisions provide free, round-the-clock, highly qualified medical care to everyone who seeks it. Objectives of the institute - scientific activity, medical care for sick and injured people, training and consulting specialists in the field of emergency medicine. The Institute has formed over 40 scientific units, more than half of which are clinical. The great scientific and practical potential of the staff, modern equipment make it possible to successfully develop new and improve existing methods for diagnosing and treating the most severe injuries and complicated acute surgical diseases. The Institute employs more than 800 researchers and doctors, including 2 academicians and 2 corresponding members of the Russian Academy of Medical Sciences, 37 professors, 78 doctors and 167 candidates of medical sciences. There are 918 inpatient beds, including 90 intensive care beds. During the year, more than 20 thousand different operations are performed at the Institute’s departments. Scientific research is conducted in five main areas: diagnosis and treatment of mechanical and thermal injuries; diagnosis and treatment of acute diseases and damage to blood vessels of the heart, brain, aorta and its branches; diagnosis and treatment of acute surgical diseases of the abdominal organs; diagnosis and treatment of acute exo- and endotoxicosis; organization of specialized emergency care for sick and injured patients at the inpatient stage. Over the past 10 years, approximately 235 case studies have been carried out to improve the quality of diagnosis and treatment. 62 monographs, about 4,100 scientific articles and other publications, including 86 collections of works, have been published. The staff of the Institute also wrote a large number of chapters and sections in books published by other institutions. 43 patents and certificates of invention were received, 32 improvement proposals were accepted for use. 140 dissertations were defended, including 25 doctoral dissertations. Implementation of results into practice scientific research has a positive effect on improving medical work. The growth of the level of scientific research led in 2001 to the creation at the Institute of a Dissertation Council for the defense of doctoral dissertations in the field of surgery, anesthesiology and resuscitation, traumatology and neurosurgery. To improve the professional level of doctors, more than 100 scientific and practical conferences and seminars were held, more than 130 information and methodological books were published documents. Problem commissions play a major role in solving scientific and practical problems and in coordinating scientific research on the territory of the Russian Federation Scientific Council on emergency medical care in the field of combined trauma, cardiology and clinical toxicology and the Problem Commission on Emergency Surgery. The research results are analyzed in the external scientific connections. This significantly accelerates the implementation of advanced achievements of medical science. Many employees of the Institute have been awarded State awards, awards from the Government of the Russian Federation and the Moscow City Hall. 8 employees were awarded the honorary title “Honored Scientist of the Russian Federation,” and 32 were awarded the honorary titles “Honored Doctor of the Russian Federation” and “Honored Health Worker of the Russian Federation.” Therapeutic work. The Institute provides free emergency medical care to the general population. Over the past 10 years, more than 450 thousand patients have received it. In 2005 alone, medical care was provided to 48,895 patients, 24,186 of whom were hospitalized (the main channel of receipts was emergency medical care); About 20,700 operations were performed. At the same time, the mortality rate was the lowest in recent years - 4.5%. 62% of hospitalized patients (about 15 thousand patients) were diagnosed with different kinds injuries, including mechanical, thermal and chemical. Research Institute named after N.V. Sklifosovsky has the opportunity to provide specialized care, which is often unavailable in other medical institutions; for this reason, in just one year, 1074 patients were transferred to the Institute from hospitals in Moscow, the Moscow region and other regions of Russia. In addition, Moscow hospitals are provided with advisory and specialized assistance by specialists from visiting teams in neurosurgery, endoscopy and endotoxicosis. Resuscitation in critical conditions. The Institute has created the most powerful resuscitation service in Russia, consisting of 9 intensive care units. Over the course of a year, more than 8,500 patients with traumatic brain and associated injuries, burns, acute poisoning, diseases of the heart, blood vessels, kidneys, liver, and gastrointestinal tract undergo intensive therapy. In a special department, severe clinical and laboratory manifestations of endotoxicosis that develop as a result of multiple organ failure are treated. Thanks to the well-equipped Institute and highly qualified personnel, the mortality rate for traumatic brain injury, vascular diseases of the brain, extensive burns, and acute poisoning is the lowest in Russia and corresponds to the international level. Scientific research allows the Institute to develop recommendations for other emergency medicine institutions. This concerns the introduction of a number of unique technologies - emergency multicomponent detoxification systems, neuromonitoring, hyperbaric oxygenation with the possibility of prosthetic breathing, blood-saving methods in emergency surgery, etc. Trauma. The most common causes of mechanical damage are road trauma, falls from great heights, as well as gunshot and stab wounds. The most numerous are patients with mechanical trauma (in 2005 alone there were 8,672). The most severe contingent are patients with concomitant, combined trauma, whose share was about 35%. For the treatment of such patients, the anti-shock suit “Kashtan” was developed and introduced into industrial production (Gold Medal of the Brussels Exhibition in 1996). Its use in the prehospital stage allowed a threefold reduction in the incidence of deaths associated with the development of severe shock. Submersible osteosynthesis for severe fractures and ruptures of the pelvic joints and blocking osteosynthesis for “large” fractures with multiple trauma were also introduced - more than 800 such operations have been performed in recent years. A system for diagnosing, preventing and treating life-threatening complications has been developed, which has made it possible to reduce their frequency by 2–4 times. Thanks to the introduction of scientific developments, mortality from combined trauma has been reduced in recent years from 29 to 18% - more than 1.5 times. In addition, endoprosthetics have been introduced as an early surgical treatment for injuries. hip joint, osteosynthesis with cannulated screws, replacement of the patella and endoprosthetics of the cruciate ligaments of the knee joint in case of ruptures. For 2005 at the Research Institute of Emergency Medicine named after. N.V. Sklifosovsky admitted 800 victims with chest and neck trauma and 230 with trauma or diseases of the esophagus (135 and 95, respectively). In a significant proportion of cases (more than 160), there were combined wounds of the chest and abdomen, which are among the most severe types of open trauma, as they are often accompanied by damage to many internal organs and massive blood loss. For such cases, the department of emergency thoracoabdominal surgery actively uses video thoracoscopy, with which you can quickly determine the nature of damage to the chest organs and perform the necessary surgical interventions, which often eliminates the need for extensive operations and allows you to plan the treatment process much more accurately. In addition, the department performs unique interventions that are performed only at the Institute: surgical treatment of wounds and damage to the esophagus and the consequences of its chemical and mechanical trauma, as well as emergency and reconstructive operations for mechanical damage to the trachea and their consequences (tracheoesophageal fistulas, tracheal strictures ). Great progress has been made in the field of immunoprophylaxis and immunotherapy of purulent-septic complications in victims with penetrating wounds of the chest and abdomen. A technique has been developed for the treatment of clotted hemothorax, which allows to reduce the number of traumatic thoracotomies. An undoubted achievement of the institute is the reduction in mortality due to injury from 5.7% in 2002 to 3.7% in 2005. Thermal injury. In 2005, 1,740 patients with burns received care in the department of acute thermal injuries. One of the most effective methods of treating burn injury is early active surgical intervention (removal of non-viable tissue, skin grafting), thanks to which it is possible to save victims who until relatively recently were considered doomed. Other methods are also being developed to improve the quality of treatment: cell therapy, complex treatment of burns of the upper respiratory tract with irradiation of the affected mucosa of the tracheobronchial tree (TBT) with a low-energy laser, supravenous laser irradiation of blood. Their use significantly reduces the healing time of burns with good functional and cosmetic results. On average, the healing time of defects in the LBD mucosa was reduced by 4–5 days, the number of pneumonias decreased by more than 20%, and economic indicators improved. Lesions of the brain and spinal cord. Over the course of a year, the neurosurgical clinic admits more than 2,500 patients and performs about 1,000 operations using modern technologies. Scientific developments relating to various areas of emergency neurosurgery are reflected in more than 20 monographs and 800 printed works and reports at international and all-Russian scientific conferences. For more than 40 years, the Institute has hosted annual city scientific and practical conferences and seminars in the specialty, and since 2003, master classes have been held on the basis of the department. Many department employees trained in foreign clinics (Italy, France, USA, Belgium, Holland, Germany). Since 1998, on the initiative of the head of the department, corresponding member of the Russian Academy of Medical Sciences, Professor V.V. Krylov and Professor V.V. Lebedev publishes the journal “Neurosurgery”; it now has over 2,000 subscribers and is sent out free of charge. Mortality in the department is 1.5 times lower than the Moscow average. The priority of the department is early surgical treatment of cerebral hemorrhages resulting from rupture of vascular aneurysms, which makes it possible to reduce the incidence of deaths in these conditions by almost 3 times (from 25 to 9%). The results of treatment of subdural hemorrhages are also significantly better than all-Russian indicators. Methods for minimally invasive treatment of hemorrhagic strokes using microsurgical techniques have been developed. The treatment of peacetime weapons-related craniocerebral wounds and complications of spinal trauma has been significantly improved. The use of osteoplastic trephination, drainage of hematomas through burr holes, microsurgery of aneurysms and malformations, and local fibrinolysis of traumatic intracranial hematomas is expanding. Neurovideoendoscopy, minimally invasive thoracoscopic spinal fusion, the Stryker neuronavigation system and systems for correction and stabilization of the damaged spine are used. Emergency surgery. In 2005, emergency surgical interventions were performed in 1,560 patients. In the field of emergency surgery last decade methods for early topical diagnosis and surgical treatment of mechanical liver damage using minimally invasive technologies have been developed and put into practice, thereby significantly reducing the frequency of re-operations. For the diagnosis and treatment of perforated pyloroduodenal ulcers, diagnostic video laparoscopy is widely used, and, if necessary, a direct transition to minimally invasive operations from laparoscopic access, which is possible in 90% of cases. Methods for the staged treatment of complications of cholelithiasis have been developed, including - in case of high postoperative risk - the use of video laparoscopic technology, which significantly improves the prognosis for this pathology. In the treatment of pancreatitis, preference is given to minimally invasive puncture-drainage and video-laparoscopic interventions and manipulations for fluid accumulations containing large amounts of toxic substances. Videoretroperitoneoscopy and minilaparotomy using the MiniAssistent apparatus are being introduced. For more than 20 years, a specially created department has been conducting big job in such a difficult area as the prevention and treatment of purulent complications in surgery. Methods for eliminating sources of purulent complications have been improved, including in the treatment of the most severe of them - peritonitis and intestinal fistulas. The principles of highly effective closed aspiration and lavage treatment of suppurative processes have been developed and widely introduced into practice; equipment for its implementation; antibacterial suture materials and preparations for local treatment of wounds. Surgical stapling devices (AKA-2, AKA-4, AKA-5M and LPK) have been created and are used in many hospitals across the country, the use of which significantly improves the results of operations on the digestive tract. The Institute is one of four centers in Russia where liver transplantation has been performed since 2000. To date, of the 47 patients who underwent this operation, 31 (66%) are alive. The department also performs other high-tech operations - hemihepatectomy, segmental and atypical liver resection. Blood-saving technologies have been introduced. In the departments of emergency vascular surgery and emergency cardiac surgery of the Institute, operations are performed for ruptured aneurysms of the thoracic and abdominal aorta, and for the prevention of ischemic strokes - operations on the vessels of the neck, aorta and its branches. The number of coronary bypass operations in 2005 was 139, of which 95 were emergency. At the same time, the Med-IR thermal imaging complex is actively used for visualization of blood vessels during the diagnostic period and during cardiac surgery. Autoarterial grafts are used to achieve more durable long-term results of coronary artery bypass grafting. Together with the department of emergency thoracoabdominal surgery, in the department of emergency plastic and reconstructive microsurgery, in addition to emergency reconstructive operations (replantations) for traumatic amputations of fingers and larger segments of the limbs, as well as operations for damage to blood vessels and nerves of the hand and forearm, microsurgical methods are being introduced using our own tissues of patients (autotransplantation) for plastic surgery of the esophagus and trachea. In the laboratory of new surgical technologies, new methods of endosurgery are intensively developed. The following are performed: elimination of adhesive intestinal obstruction, suturing of perforated ulcers, thoracoscopic operations for wounds and complications of closed chest trauma, for bullous disease complicated by spontaneous pneumothorax, evacuation of coagulated hemothorax, pneumolysis, pleurectomy, decortication, suturing of lung wounds, coagulation of lung and pleural wounds, removal foreign bodies, revision and drainage of the pleural cavity, lung resection. Together with the emergency thoracoabdominal surgery clinic, we introduced new operation in case of severe closed chest injury - thoracoscopic extrapleural subfascial fixation of floating rib fractures with knitting needles. Video laparoscopic operations are also being introduced in emergency gynecology. In the endoscopic department, low-energy laser irradiation of the mucous membrane of the tracheobronchial tree in case of thermal inhalation injury, chromogastroscopy and esophagogastroimpedance manometry are introduced into practice to monitor gastroesophageal reflux in case of burns of the esophagus, as well as endoscopic ligation of varicose veins of the esophagus and cardia. In 2005, 10,270 therapeutic and diagnostic procedures were performed. X-ray surgical methods of diagnosis and treatment are also being developed - angiographic studies, X-ray endovascular embolization of cerebral aneurysms, gastric and uterine arteries in case of bleeding from them. In 2005, about 3,600 therapeutic and diagnostic interventions were carried out. Acute complications of coronary heart disease. Among 318 patients with acute myocardial infarction (AMI) admitted in 2005, the mortality rate was 8.8%, which is almost two times lower than the Russian average. The Institute widely uses thrombolytic therapy (including at the prehospital stage), emergency angioplasty and coronary artery bypass grafting. The Institute is one of the few medical institutions in the country where PCI - percutaneous coronary interventions - is being developed and successfully used, not only in the first 12 hours, but also for several days from the onset of a heart attack. PCI is successfully practiced in AMI with a high risk of death, and in various forms of unstable angina, the use of PCI allows for complete restoration of working capacity. At the same time, mortality from AMI is reduced by 5–7 times and is absent in unstable angina and myocardial infarction without “Q”. In the latter case, the incidence of AMI is reduced by more than 10 times, and the length of hospital treatment is significantly reduced. The Institute has the largest experience in the world and the first in Russia of five successful PCIs for traumatic myocardial infarction with damage to the intima of the coronary artery, accompanying concomitant chest injury. Acute poisoning and endotoxicosis. The Institute is the founder of the toxicological service in the country. Following the example of his toxicology department, it was decided to organize similar specialized centers in the USSR, the number of which today exceeds 40. The mortality rate for acute poisoning has decreased in them by 2-3 times. This is especially important since injuries and poisonings are the second leading causes of death in the population. Improving the quality of treatment of severe poisoning has become possible thanks to the use of technologies for accelerated removal of toxicants from various sectors of the body (blood, intestines). These technologies, developed in recent years in the department for the treatment of acute poisoning (headed by Academician of the Russian Academy of Medical Sciences E.A. Luzhnikov), are based on the step-by-step application of methods that help cleanse the body (hemosorption, hemodialysis, intestinal lavage) and stimulate its own defenses during blood irradiation ultraviolet and laser rays, exposure to it magnetic fields and indirect electrochemical oxidation. With this approach to the treatment of acute poisoning, the safety of the interventions used is significantly increased due to the use of reduced intensity effects. In 2005, 4,362 patients were hospitalized with poisoning from drugs and toxic substances for non-medical purposes (alcohol, etc.). About half of them (1954) were treated, due to the severity of their condition, in the intensive care unit. The gradual introduction of highly effective treatment technologies in this department led to a significant reduction in the frequency of deaths - from 14% in 1983 to 7.7% in 2005. The Institute also operates the Federal government agency“Scientific and Practical Toxicology Center”, associated in its activities with the toxicology clinic. Behind last period Every year, up to 4–6 thousand telephone consultations (clinical and laboratory) are provided to emergency medical teams, hospitals, the population of Moscow, as well as other cities and institutions of Russia. In addition, on-site consultations are practiced in the city and beyond, as a result of which a significant part of patients are transferred from other hospitals to the toxicology department of the Institute. The service operates around the clock (tel. 628–16–87). For the treatment of acute endotoxicosis, the relevant department uses modern high-tech methods of extracorporeal detoxification, including prolonged intensive sorption-membrane apheresis (PRISMA technology), the advantages of which are mobility and wide therapeutic capabilities. In 2005, 1,060 extracorporeal detoxification procedures were performed in the departments of the institute. Hyperbaric oxygenation. During 2005, 6854 sessions of hyperbaric oxygenation were performed for acute surgical and neurosurgical pathology, trauma, acute poisoning, endotoxicosis, somatopsychiatric and other diseases, as a result of which it was possible to reduce the frequency of purulent-septic complications, accelerate detoxification processes, regression of psychoneurological disorders and other painful manifestations. Rehabilitation treatment. Rehabilitation treatment includes physiotherapy and exercise therapy and is carried out for patients in all clinics of the institute, as well as for outpatients who need follow-up treatment after discharge from the hospital. This allows you to as soon as possible achieve physical rehabilitation of patients after severe operations and various injuries. In 2005, 3,903 patients were treated with restorative treatment and a total of 48,450 procedures were performed. Crisis states and acute psychosomatic disorders. The Institute has created a unique department to provide emergency care to patients with acute mental disorders combined with injuries to internal organs requiring surgical interventions. Over the past year, about 2,300 patients were treated in this department. In recent years, there has been a significant increase in the influx of people injured as a result of man-made accidents, plane and car accidents, terrorist attacks and other emergency situations. These patients experience severe mental stress, which requires psychological help to eliminate. In 2001, a group of psychotherapists was formed and is functioning within the department. Clinical and psychological correction is carried out daily with patients experiencing mental stress associated with trauma, burns, detection of surgical diseases and upcoming surgery. About 700 sessions of group and individual psychotherapy were conducted for almost 170 patients who suffered in emergency situations. During recent years Psychotherapy using the developed technology was part of the treatment package for more than 2,000 patients, with whom about 5,000 psychotherapeutic sessions were conducted. The organization of psychological assistance in emergency conditions has no analogues in domestic healthcare. Blood and Tissue Conservation Service. The Institute is the founder of the “Blood-saving surgery in emergency care” program. This important stage in improving the treatment of acute blood loss in surgery using autohemotransfusion, including its implementation during emergency and delayed surgical interventions. Blood spilled inside and collected during operations is processed using special technology and returned to the bloodstream. In emergency surgery, the Institute currently uses up to 1.5 - 2 thousand liters of autologous blood per year (in 2005 - 1.8 thousand liters), which largely solves the problem of the safety of blood transfusion and its components. In case of mass admissions of persons injured as a result of disasters or terrorist attacks, the transfusion service of the Institute accepts big flow gratuitous donors (up to 1800 people per week versus 100 in usual time), while simultaneously working to promote gratuitous donation and its rational use. Among the city's blood transfusion departments, the Institute's department ranks first in the number of attracted relative donors, 98% of whose donation is free of charge. In addition, the laboratory prepares allo-skin, bone, dura mater transplants and cell preparations, which are then used in clinical departments to treat various injuries of the limbs and brain. Laboratory and instrumental diagnostic complex. The Institute has a large laboratory base for early diagnosis of emergency conditions. In 2005 alone, the following were performed: about 27 thousand electrocardiographic, more than 150 thousand radiographic, about 50 thousand ultrasound, more than 20 thousand computed tomography, more than 6 thousand radionuclide and more than 15 thousand functional studies (various types of electroencephalography, spirometry , rheovasography, intragastric pH-metry, etc.), more than 450 angiographies. About 2.3 million clinical, biochemical, immunological, rheological, microbiological and toxicological analyzes were performed. During 2005, the laboratory for the diagnosis of viral hepatitis and HIV infection examined about 330,000 people (patients, donors, population), and performed about 1.2 million studies. Identification of infected persons allows timely implementation of treatment and preventive measures to prevent the spread of infection. Elimination of medical consequences of emergency situations. The Institute's staff actively provided assistance to the wounded and victims of the events of 1993. The Institute also provided assistance to victims of disasters and terrorist acts, such as: earthquake in Armenia (Spitak and Leninakan cities, 1988); gas explosion during the passage of passenger trains in Bashkiria (1989); explosion in an underground passage Pushkin Square(Moscow, 2000); explosion at the Belorusskaya metro station (Moscow, 2001); hurricane in Moscow (2001); helicopter crash in the mountains Khankala (2002); consequences of the terrorist attack in the Palace of Culture on the street. Dubrovka (“Nord-Ost”, Moscow, 2002); explosion at the Wings festival in Tushino (Moscow, 2003); fire in the dormitory of the Peoples' Friendship University of Russia (Moscow, 2003); explosion near the Rizhskaya metro station (Moscow, 2004); explosion at the Avtozavodskaya metro station (Moscow, 2004); collapse of a water park building (Moscow, 2004); consequences of the terrorist attack in Beslan (2004). In addition, the Institute’s employees systematically provide assistance to victims of mass poisonings with various chemicals. Scientific, organizational and educational work. For more than 10 years, the Institute has had postgraduate studies, doctoral studies in 6 specialties, clinical residency in 19 specialties, programs additional education carried out in accordance with federal programs. The Institute trains not only citizens of the Russian Federation, but also citizens of the CIS countries and foreign countries. Every year, about 150 clinical residents, 6–8 graduate students and 500 doctors are trained in additional education programs. The educational and clinical department is developing methodological manuals that allow doctors to use them as board books when providing medical care to the population. The Institute operates departments of higher educational institutions - the Russian Medical Academy of Postgraduate Education (Department of Emergency Surgery and Clinical Toxicology), Moscow State Medical Dental University (Department of Neurosurgery, Faculty of Medicine), Educational and Scientific Center at medical center Administration of the President of the Russian Federation (Department of Emergency Care and Intensive Care). The editorial and publishing department, which has been successfully functioning for more than 10 years, prepares for publication and publishes the works of the institute and its employees. The Institute also has a rich scientific and medical library. The Department of External Scientific Relations coordinates scientific research conducted outside the institute, searches and processes scientific information, and conducts work in the field of the history of medicine. Recognition of the achievements of the Institute staff. Over the long history of the Institute, the merits of its staff have been repeatedly noted by the highest authorities of the state and the city of Moscow. The great achievements of the Institute are described in the documents of the People's Commissariat of Health of the RSFSR and the Presidium of the Moscow Soviet, published already in the first period of its work (1935). The most significant awards of a later period are the Order of the Red Banner of Labor (Decree of the Presidium of the Supreme Soviet of the USSR of July 22, 1960) and the Order of Lenin (Decree of the Presidium of the Supreme Soviet of the USSR of August 14, 1973). The Institute was also awarded a large number of diplomas, certificates and prizes, indicating its significant contribution to the country's healthcare. Hospice House - Sheremetevskaya Hospital - Research Institute of Emergency Medicine named after. N.V. Sklifosovsky have always played a prominent role in domestic medicine. Being a model for building an emergency medical service for many countries in Europe and America, the Institute, despite the changed living conditions of our society, successfully continues its activities. The Institute has a modern material base and employs a large team of highly qualified specialists who preserve and enhance the best traditions of domestic healthcare. This makes it possible to save sick and injured people who were previously considered hopeless, to return them to active work thousands of people, maintaining their physical and mental health.

200 years ago, on July 10, 1810, the Sheremetyevo Hospital was inaugurated at the Hospice House of Count Sheremetyevo. Now it is the Moscow City Research Institute of Emergency Medicine named after N.V. Sklifosovsky. There are many legends and mysterious rumors associated with the history of the hospital. Many are sure that they are healed here not only physically, but also spiritually.

Sheremetyev's legacy

Count Sheremetyev entered Russian history as a theater patron and founder of the Hospice House (Sukharevskaya Square, 3). In 1801, his wedding took place with the former serf actress Praskovya Zhemchugova (nee Kovaleva). Since childhood, knowing the hardships and hardships of the lives of poor people, the newly-made countess took part in the construction of a charitable institution. The initial design of the hospital was carried out by the talented architect Elizvoy Nazarov. Later, Sheremetyev attracted the Italian architect Giacomo Quarenghi to the work, writes.

Praskovya Zhemchugova-Sheremetyeva died in 1803 from tuberculosis, before the completion of the construction of the Hospice House. In 1804, four outbuildings were founded: Sukharevsky, Spassky, Main Warden and Doctor's. According to legend, ancient silver coins were placed under the foundation of the future hospital, which many patients still find in their rooms to this day. As one legend says, the strange appearance of a coin in a patient’s room - sure sign that the patient is recovering.

Count Sheremetyev himself passed away in 1809, and the grand opening of the Hospice House took place a year and a half after the death of its founder. In addition to the hospital and almshouse, the charitable institution housed the Church of the Holy Trinity.

The Hospital of the Hospice House helped the suffering at all times. So, in 1812, the hospital equally received both Russian and French soldiers. To this day, the medical museum at the Sklifosovsky Institute houses the medical history of Prince Bagration, a war hero. And the revolutions of 1905 and 1917 put whites and reds on adjacent beds. They always tried to help everyone here, regardless of wealth, nationality or position in society. The doctors' policy came down to only one division - into sick and healthy, reports doc-films.ru.

"Burning yourself, shine for others"

In 1918, the name of the Hospice House was eliminated. The Church of the Holy Trinity was closed, and the charitable institution turned into a regular hospital. In 1919, the Moscow city ambulance station was organized here. In 1923, the Sheremetyevo Hospital turned into the N.V. Sklifosovsky Research Institute of Emergency Medicine. And later the so-called " ambulance at home,” and the well-known number “03” was introduced to all of us.

An interesting fact is that Nikolai Vasilyevich Sklifosovsky himself had never been to the Hospice House. But it was no coincidence that the name of the great surgeon ended up on the same line as Sheremetyev and Zhemchugova. After all, he devoted most of his life to charity and people, went through several wars, and wrote many scientific papers. On the doors of his estate there even hung the same inscription as Sheremetyev’s: “Burning yourself, shine on others.”

Many famous names are associated with the history of the hospital. So, for example, it was “Sklif” that brought together people's artist USSR Yuri Nikulin with his future wife Tatyana Pokrovskaya. She studied at the Timiryazev Agricultural Academy and was also fond of equestrian sports. In the stable where the girl worked, there lived a funny horse named Lapot - the head and body were like a normal horse, and the legs were small. The popular clown Karandash found out about this “hunchbacked horse” and took him to the circus. Tatyana came to watch the first joint performance of Laptya and Nikulin, a student of Karandash. The act ended with the clown being hospitalized in Sklif. The girl, feeling guilty before Nikulin, began to visit him in the hospital. And six months later they got married.

Hospital catacombs

There are many legends and mystical stories about the N.V. Sklifosovsky Research Institute of Emergency Medicine. So, in the 90s of the XIX century. A certain nihilist student was doing medical practice in the hospital. He did not believe in omens or higher power. Once he was told about a dungeon under the institute, from where strange sounds were supposedly coming. The student decided to check these rumors himself. No one saw the unbelieving studious again. Everyone thought it was a trick dark forces, but a more prosaic ending is also possible - the half-educated doctor simply left Moscow, disappointed in his superstitious colleagues.

In the early 90s of the last century, various magical sessions, charged water and hypnosis were popular. But that was only the beginning. Later, the sorcerer Yuri Longo amazed viewers throughout the country with a spectacle unusual for all times - the resurrection of a dead man. The magician called on his Lazarus to rebel in the morgue of the N.V. Sklifosovsky Research Institute of Emergency Medicine. Amazed spectators saw how on film the hand of the deceased person first rose, then part of the back, and then the girl present in a white robe fainted. Later, in an interview, the sorcerer’s associate Vladimir Tsukerman exposed the scandalous video recording. According to him, the role of the corpse was played by a living person - Alexey Gaivan, a close friend of the sorcerer, writes Komsomolskaya Pravda.

The magician Alexey Gryadushchy is confident in the unusualness of the place where the N.V. Sklifosovsky Research Institute of Emergency Medicine is located. The parapsychologist believes that two streams of energy converge there - living and dead. Perhaps this is why staff hear unusual sounds from the dungeon under the hospital.

There is also another one circulating on the Internet, no less famous story about a squad of diggers who decided to explore an interesting place. At first everything went well, but then the travelers heard strange sounds and saw a female silhouette. Frightened, the guys rushed back. One of the diggers, as a result of a hasty escape, broke his leg, the second ran into his head on a pin. As a result, the “dungeon people” ended up at the top - in “Sklif” itself. While they were receiving medical attention, they saw a woman lying on a gurney. According to the diggers, it was she who appeared to them in the dungeon.

Director of the N.V. Sklifosovsky Research Institute of Emergency Medicine Anzor Khubutia told another mystical story that happened within the walls of the hospital. Once, a woman was lying in his department, the wife of a pilot. The patient was prescribed bed rest due to heart problems. One night, a woman had a dream: she was walking around the hospital and met her recently deceased aunt, who called her to come with her. The women approach the elevator, and Khubutia himself comes out to meet them. He begins to shout at the patient for disobeying his instructions and takes her to the ward. The next day, Khubutia was supposed to go to a medical conference, but changed his mind. Arriving at the department, he learned that his patient was dying. After quickly giving her a heart massage, the doctor brought the woman back to life. The neighbors in the ward told the doctor about the wonderful dream.

"In short, Sklichosofsky"

They say that the N.V. Sklifosovsky Research Institute of Emergency Medicine has three patrons: Praskovya Zhemchugova, a certain gray-haired old man, and Professor Sklifosovsky himself. They protect against death and help the sick recover. Many patients see a black-haired woman who sits on the beds of patients and strokes their heads. She is also said to leave coins by beds and on nightstands. The staff believes that if the patient finds the old money, then he will recover 100%.

The gray-haired old man is often seen near Sklif. He usually sits quietly or sleeps. But when he jumps up and begins to pace the territory, it means that a famous patient will be brought to the hospital. The elder warns the doctors about who will come and with what diagnosis. It is also believed that he senses bad people and does not take alms from them. Who he is and where he comes from - no one knows. The fortuneteller answers all questions “about himself” with silence.

N.V. Sklifosovsky was never seen at the institute named after him, either during his lifetime or after his death. However, it is believed that it provides moral support to doctors and instills confidence in them. Medical intuition and a flair for diagnoses are the qualities that the famous surgeon “helps” his colleagues discover in themselves.

There is a “dark” joke among students: “If you were accepted into the institute without exams, then it is the Sklifosovsky Institute.” We are also well aware of the phrase of the hero Yuri Nikulin in the film “Prisoner of the Caucasus, or the New Adventures of Shurik” - “In short, Sklichosofsky.” There are many jokes about this saying, but true story catchphrase unknown. Most likely, like all other comedic moments, it was invented by Gaidaev’s witty scriptwriters.

The material was prepared by the online editors of www.rian.ru based on information from open sources

25.02.19 18:34:50

My grandfather, a 96-year-old war veteran, ended up in this terrible prison-hospital. They brought him here with a closed fracture of the surgical neck of the right humerus, mixed, broken off, bruised and lacerated wounds of the soft tissues of the head and with a contusion of the left knee joint. Of course, we were forbidden to visit him. On the day of discharge, after an hour of waiting, a nurse came up to us and asked: “Well, did you order a baby carrier?” This way we know that he is recumbent. And he was on his feet... Why did this happen? They didn't tell us. Subsequently, it turned out that he was drugged with some kind of sedative medications that are contraindicated in Parkinson’s. Because of this, his legs gave out. Then we were driven for 2 hours, first to the collection office, then to the checkpoint, then somewhere else, the main thing is that none of the workers knew exactly where everything was. When we finally sorted it out, we saw my grandfather, a bandage was hanging on his arm instead of a cast, no one organized a carrying for us. But we were told to figure it out ourselves, saying it was none of their business. The doctor didn’t even come down to talk to us; on the day of discharge he wasn’t even in the hospital. They also put him in a psychiatric ward instead of dealing with his injuries. In short, this is the worst thing that has ever happened to me. I have never seen so much indifference and cruelty as in this disgusting place. Thank God, after a week he began to slowly walk and get better. Take care of your family and friends, if someone ends up in a research institute, take him out of there as soon as possible.

27.02.19 14:53:54

Hello! We regret that seeking medical help at the Research Institute for Emergency Medicine named after. N.V. Sklifosovsky of your grandfather left you with a negative impression. Please accept our sincere apologies.
The injuries your grandfather received were completely dealt with at the emergency department level, all the necessary diagnostic tests and medical procedures were performed in full.
Your grandfather’s hospitalization in the somato-psychiatric department was due to the presence of medical indications, which were formulated and reflected in his medical record by a psychiatrist.
While being treated in the somato-psychiatric department, your grandfather was also observed by a traumatologist. Based on his recommendation, a decision was made on conservative functional treatment with immobilization of the right upper limb with a soft Deso bandage. With the type of fracture that your grandfather had, immobilization of the upper limb with a plaster cast is not performed. Analgesic therapy was also prescribed, and after normalization of the mental state, physical therapy was recommended to restore movements in the right shoulder joint.
Considering your grandfather’s age and concomitant pathology, he was not given psychopharmacotherapy.
The ban on relatives visiting your grandfather is determined by the internal regulations of the somatic-psychiatric department, which is a closed department, and its work is regulated Federal law No. 227-FZ of July 3, 2016 “On psychiatric care and guarantees of citizens’ rights during its provision.”
Your trip to the collection service was probably due to the need to receive valuables, documents and money accepted for safekeeping from your grandfather on the day of hospitalization. Apart from the patient himself or his close relatives, no one else had the right to perform this procedure.
The doctor informed the relatives about the condition of your grandfather, including the possibility of transporting him home while sitting, accompanied by relatives, the day before his discharge from the hospital. There were no indications for transportation by ambulance. On the day of discharge, the attending physician was at work. Neither the attending physician nor the head of the department received any requests from you that you would like to receive any additional information about your grandfather.
The administration expresses gratitude to you for your appeal, since the opinions of patients and their legal representatives help in improving the quality of medical care at the institute.

Sincerely,
Head of Quality Control Department
providing medical care to S.V. Stolyarov
e-mail: [email protected]

Legends were made about the love of Count Nikolai Petrovich Sheremetev and the serf actress Praskovya Kovaleva-Zhemchugova during their lifetime. The Count fell in love with his serf actress at first sight. But since he could not marry her, he vowed never to marry. In 1798, the count gave Praskovya and her entire family their freedom. And in 1801, having received permission from Emperor Alexander I, 50-year-old Count Nikolai Petrovich Sheremetev and 33-year-old Praskovya Kovaleva-Zhemchugova got married. By that time, the great actress had already left the stage, as her tuberculosis had worsened. In 1803, a few weeks after the birth of their son Dmitry, she died. The Count outlived his beloved by only six years.

During Praskovya Ivanovna’s lifetime, in 1792, construction of a hospice house began. This is what they used to call shelter hospitals for the poor and crippled. At the request of his beloved, Count Sheremetev decided to create an almshouse for 100 people of both sexes and a hospital for free treatment for 50 people. The place chosen for construction was called “Cherkassy vegetable gardens”, the current address: Bolshaya Sukharevskaya Square, 3. The work was started by the serf architect Elizvoy Nazarov, who was a relative of the famous architect Vasily Bazhenov.

A real lordly city estate was planned, with a main building, a church, a park and a garden set back from the street. In 1803, when Praskovya Ivanovna died, it was built central building and left wing. The count decided to radically rebuild everything and create a monument to his wife.

The Splendor of Quarenghi

To realize his monumental plan, the count invited famous architect Giacomo Quarenghi, according to whose designs, among other things, the Smolny Institute of Noble Maidens and the Horse Guards Manege in St. Petersburg were built. Quarenghi was given the task of building nothing less than the Palace of Mercy. And the architect coped with it. The already built portico of Quarenghi's building was replaced with an elegant semicircular colonnade, and porticos were erected in the middle parts of the wings of the house and along its ends. Figures of evangelists were installed in four niches, and the façade was decorated with numerous stucco moldings. There were rumors that Count Nikolai Petrovich was a member of the Masonic lodge, which is why Masonic symbols are still found in the decorations on the facade. The interior decoration of the temple, which is located in the center of the building in a semi-rotunda, was also made according to Quarenghi’s design. The paintings of the ceiling and sails in the church, as well as its other decorations, were made by the artist Domenico Scotti.

Behind the house there was a vast park, the exit to which from the house is decorated with a double colonnade and a marble staircase in two descents, with elegant carved lanterns. In the left wing there was an almshouse for 50 men on the first floor and 50 women on the second. The almshouse wing of the house ended in a majestic two-tone dining room. On the right there was a free hospital for the poor with 50 beds.

The count spent 2.5 million rubles on construction, but did not live to see its grand opening - it took place a year and a half later. The event was timed to coincide with the birthday of Nikolai Petrovich Sheremetev - June 28, 1810.

Angels and portraits

In the temple, which is still in operation, there are three altars: the central one is in honor of the saint Life-Giving Trinity, southern - St. Nicholas the Wonderworker (patron saint of Nikolai Petrovich), northern - St. Demetrius of Rostov (patron saint of the count's son). After the revolution, the temple was closed and became very dilapidated. Restoration was carried out in the 70s of the 20th century and in the 2000s. The restorers used Quarenghi's original sheets depicting the facades and temple interior and numerous

photographic materials from the beginning and middle of the century. Employees of the Spetsproektrestavratsiya organization managed to restore the interior of the hospice house to almost its original form. Urban legend says that the two angels on the fresco in the dome are portraits of Praskovya Kovaleva-Zhemchugova and her son, little Dmitry. When you are in the temple, take a closer look at the images of an angel with a tambourine and an angel with a palm branch and ears of corn.

The hospice house was governed by a special council. According to the will of Count Nikolai Petrovich, the son and his descendants should be trustees, and representatives of non-count branches of the Sheremetev family were always chosen as the main caretakers.

During the War of 1812 and the Russian-Turkish War of 1877-1878, the hospice turned into a hospital. The medical history of Prince Bagration is still kept in the museum. During the Crimean War, Count Sergei Dmitrievich Sheremetev, at his own expense, forms a sanitary detachment of hospital doctors, who set up a hospital with 50 beds on the battlefields. During the Russo-Japanese War, he created an infirmary on a charitable basis.

The hospital at the hospice home almost immediately began to be called Sheremetevskaya. It was considered one of the best Moscow private clinics.

The famous "Sklif"

In 1919, instead of a hospice house, the Moscow City Emergency Medical Service Station was opened, and since 1923, one of the buildings of the Research Institute of Emergency Medicine named after Nikolai Vasilyevich Sklifosovsky, the founder of emergency surgery in Russia, has been located here. The name of this hospital, which the townspeople transformed into the short “Sklif”, is familiar to everyone. Dozens of talented doctors and surgeons have worked and continue to work here, creating schools and directions in domestic medicine. Among them is the outstanding surgeon Sergei Sergeevich Yudin, who in 1930 saved a patient by transfusing him with the blood of a deceased person for the first time.

Yudin, who for a long time was the chief surgeon of the research institute, advocated the creation of a museum. In addition, he proposed to restore the historical building and former temple, to “reveal the brilliant architectural creations of Quarenghi,” and he himself participated in the work. In 1953 he received Stalin Prize the surgeon sent for the restoration of the paintings of the house Trinity Church, within the walls of which a museum of medicine was being created, and handed over his archives to him. In 1986 he cherished wish came true - in the house of Count Sheremetev he settled Central Museum medicine, which in October 1991 received the status of the Medical Museum Research Center of the Russian Academy of Medical Sciences.

Institute of Emergency Medicine named after N.V. Sklifosovsky is located in historical building Sheremetevskaya Hospital at the address - 3 (metro station Sukharevskaya).

The institute is sometimes called for short - Sklif.

On the building, from the Garden Ring side, there is a historical inscription: “Hospital House of I.P. Sheremetev.”

History of the building

As you know, Count Sheremetev Nikolai Petrovich (1751 - 1809) married an actress from peasant family- Praskovya Ivanovna Zhemchugova (1768 - 1803). He loved his young wife very much. But in 1803, after giving birth to a son, she died. She was buried in St. Petersburg in the Sheremetev family crypt. The Count decided to immortalize his wife’s name and dedicate the Hospice House to her. A special Charter was developed for the institution under construction, the first paragraph of which read: “To provide assistance to the poor and wretched, without asking family and tribe.” To complete the building, he invited the architect Giacomo Quarenghi. The hospital was opened in 1810. Here they provided assistance to the wounded during the Patriotic War of 1812 and the Sevastopol campaign, the Russian-Turkish, Russian-Japanese wars and during the December events in Moscow in 1905.

During the Soviet era, the hospital was the clinical base of the Faculty of Medicine of Moscow University and the Medical-Surgical Academy. IN war time was used as a military hospital.

Now the building houses the Institute of Emergency Medicine named after N.V. Sklifosovsky (since 1923).