Crisis Tech Solutions Ltd

07/02/2026

The illustration depicts the venous system and dural venous sinuses of the brain in a lateral view, rendered with high anatomical accuracy and labelled entirely in Latin in accordance with Terminologia Anatomica. Colour coding is used to clearly differentiate between superficial cortical veins, the deep venous system, and the dural venous sinuses.

Along the superior midline, the sinus sagittalis superior is shown, collecting venous blood from the superficial cerebral veins, including the vena frontalis anterior, vena frontalis posterior, and venae parietales. The connection between the superficial venous network and the dural sinuses is illustrated by the vena anastomotica superior (vena Trolardi), which drains into the superior sagittal sinus.

The deep venous system is represented by the vena cerebri interna, which on both sides converges to form the vena cerebri magna (vena Galeni). This major venous trunk drains into the sinus re**us, which continues posteriorly and empties into the sinus transversus.

Venous drainage from the basal regions of the brain is demonstrated by the vena basalis (vena Rosenthali), which collects blood from deep temporal and diencephalic structures and contributes to the deep cerebral venous outflow towards the vein of Galen.

In the posteroinferior region of the illustration, the transition from the sinus transversus to the sinus sigmoideus is clearly shown. The sigmoid sinus exits the cranial cavity as the vena jugularis interna, the principal venous pathway responsible for draining blood from the brain into the systemic circulation.

Overall, the illustration provides a clear and structured overview of the anatomical relationships between the superficial and deep venous systems of the brain. It is particularly suitable for educational and clinical reference in neurology, neurosurgery, diagnostic imaging, and emergency medicine.

31/01/2026

Fall From Height: Mechanism of Injury and Clinical Implications

Author: Dimitar Nenchev | Crisis Tech Solutions | Medical Practice | Prehospital Care | Emergency Medicine

🔹 Mechanism of Injury
A fall from height represents a high-energy transfer of force. The mechanism involves vertical acceleration followed by abrupt deceleration, resulting in the transmission of kinetic energy through the body. This energy is primarily absorbed by the spine, pelvis, lower extremities, and internal organs. Even from a height such as the first floor, the forces involved are sufficient to cause significant internal damage, regardless of external appearance.

🔹 Possible Injuries
🦴 Fractures are commonly seen in the ankles, heels (calcaneus), tibia, femur, and pelvis due to axial loading.
🦴 Compression fractures of the spine, particularly at the thoracolumbar junction (T12–L2), are frequent and may initially be clinically silent.
🧠 Traumatic brain injury can occur even in the absence of loss of consciousness.
🫁 Pulmonary contusion may result from rapid deceleration and blunt chest impact.
🫀 Internal hemorrhage involving solid organs such as the spleen or liver must always be considered.

🔹 Clinical Classification
From an emergency and trauma medicine perspective, a fall from height is classified as high-energy blunt trauma. Until thorough assessment and imaging exclude serious injury, the patient should be managed as having a polytrauma mechanism.

🔹 Key Clinical Rule
The absence of severe pain or visible injuries does not rule out serious internal trauma. Delayed presentation of symptoms is well documented, and clinical deterioration may occur hours after the initial event. A high index of suspicion and appropriate monitoring are essential.

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24/01/2026

The Human Skeletal System
Author: Dimitar Nenchev | Crisis Tech Solutions | Medical Practice | Prehospital Care | Emergency Medicine

🦴 The skeletal system is the structural framework of the human body. It is made up of 206 bones, along with cartilage, ligaments, and joints, working together to support the body and protect vital organs.
🧠 It safeguards critical structures such as the brain, spinal cord, heart, and lungs, while also maintaining posture and stability.
🏃 Movement is made possible through the interaction between bones and muscles, allowing everything from basic actions to complex physical activity.
🩸 Bone marrow plays a crucial role in producing blood cells, while bones also store essential minerals such as calcium and phosphorus, vital for overall physiological balance.

Strong bones mean a strong foundation for life and clinical performance, especially in emergency and prehospital care.

11/01/2026

🫀 The Sixth Heart Sound – the Bulgarian Discovery That Changed Cardiology

Did you know that one of the very few world-recognized medical discoveries made by a Bulgarian is related to the sound of the heart? 🔊🫀 This is not a myth, but science — and behind it stands Professor Ivan Mitchev.

📌 For decades, medicine accepted that the heart has four sounds, with only the first and second used routinely in clinical practice. In 1968, however, Professor Mitchev proved the existence of the sixth heart sound — objectively recorded, scientifically analyzed, and accepted by the international cardiology community. This was not a hypothesis, but a fact that entered medical textbooks.

🔍 What makes this discovery so important? The sixth heart sound provides additional insight into the functional state of the myocardium, especially in early pathological changes. This allows for better diagnostics, earlier disease recognition, and more informed clinical decision-making.

🎓 Professor Mitchev was not only a discoverer. He was a physician, a teacher, and the founder of a medical school — a man who demonstrated that Bulgarian medicine can contribute at a global level, not merely follow established foreign models.

❗ In an era of fast medicine and rigid protocols, it is worth remembering that true progress comes from observation, critical thinking, and the courage to challenge what is “accepted.” That is exactly what Ivan Mitchev did.

09/01/2026

The Manual Ventilation Bag – The Importance of Tactile Feedback During Anesthesia Induction

Author: Dimitar Nenchev | Crisis Tech Solutions
Medical Practice | Prehospital Care | Emergency Medicine

The manual ventilation (reservoir) bag is a fundamental component of the anesthesia breathing system and represents the clinician’s first direct connection to the patient’s respiratory mechanics during induction. Beyond its basic function of delivering tidal volumes, it provides immediate, real-time tactile feedback regarding lung compliance, airway patency, and resistance within the respiratory system.

During anesthesia induction, the transition from spontaneous to assisted or controlled ventilation is a critical phase. By ventilating manually, the clinician can assess changes in lung compliance, detect increased airway resistance, and evaluate the effectiveness of mask seal or airway positioning. This information is transmitted directly through the hand, often before changes are visible on monitors such as pulse oximetry or capnography.

The “feel” of the bag is a clinical skill developed through experience. Increased stiffness may indicate laryngospasm, bronchospasm, airway obstruction, or poor positioning of the airway device. Conversely, an unusually compliant or easily compressed bag may suggest circuit leaks, hypoventilation, or inadequate airway seal. This tactile assessment allows for rapid clinical decision-making and immediate corrective actions.

From a patient safety perspective, manual ventilation with continuous tactile feedback enables early recognition of potentially life-threatening conditions before hypoxemia, hypercapnia, or hemodynamic instability develop. Timely adjustment of ventilation pressure, volume, and rate helps prevent barotrauma, volutrauma, and hypoxic injury, particularly during the most vulnerable moments of anesthesia induction.

Despite advances in ventilator technology and monitoring systems, the manual ventilation bag remains irreplaceable. It conveys information that cannot be fully quantified or digitized. Proper understanding and skilled use of the manual ventilation bag, as emphasized by Crisis Tech Solutions, are essential elements of safe anesthesia practice and high-quality patient care in acute and critical settings.

04/01/2026

3% Sodium Chloride – How It Reduces Brain Swelling
Author: Dimitar Nenchev | Crisis Tech Solutions
Medical Practice | Pre-Hospital Care | Emergency Medicine

Brain swelling (cerebral oedema) is a serious condition in which the volume of brain tissue and fluids increases, raising intracranial pressure and the risk of ischaemia or herniation.

How does 3% NaCl work?
This hypertonic solution draws water from brain cells into the bloodstream via osmosis, reducing cellular and interstitial oedema.
This lowers intracranial pressure and improves cerebral perfusion, ensuring the brain receives the oxygen and nutrients it needs.

💧 Osmotic effect – water moves from swollen cells into the blood
❤️ Supports cerebral perfusion pressure (CPP)
⚖️ Restores electrolyte balance and reduces the risk of further injury

Emergency medicine applications
3% NaCl is commonly used in acute situations such as trauma, stroke, or brain tumours. Its administration requires careful monitoring of serum sodium to avoid hypernatraemia.

02/01/2026

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31/12/2025

>Лесно и разбоираемо.

Проводната система на сърцето: електричеството, което поддържа живота.

28/12/2025

Pulse Oximetry – A Key Tool in Clinical Monitoring

Author: Dimitar Nenchev | Crisis Tech Solutions
Medical Practice | Prehospital Care | Emergency Medicine

Pulse oximetry is a non-invasive method used to estimate arterial oxygen saturation (SpO₂) and pulse rate in real time. It is based on spectrophotometry, utilizing red and infrared light to differentiate between oxyhemoglobin and deoxyhemoglobin during pulsatile arterial blood flow.

In prehospital and emergency medicine, pulse oximetry plays a critical role in the early detection of hypoxemia and guides oxygen therapy, ventilatory support, and airway management. Normal SpO₂ values in healthy adults at sea level range from 95–100%, but clinical interpretation must always consider the patient’s overall condition.

Despite its reliability, pulse oximetry has limitations. Reduced peripheral perfusion, motion artifacts, dyshemoglobinemias, and environmental factors can affect accuracy. Importantly, normal SpO₂ does not exclude ventilatory failure or hypercapnia.

Proper understanding and interpretation of pulse oximetry, as emphasized by Crisis Tech Solutions, are essential for safe and effective patient care in acute and critical settings.

03/12/2025

Ние не копираме. Ние не следваме. Ние създаваме стандартите. Защото знаем. Защото можем. Защото имаме опит. Тук сме, за да го предадем на Вас.
7 и 8 февруари, Село Костенец и

Dimitar Nenchev
Георги Кесов
Д-р Георги Кесов, Д.М.
Damyan Raychev

https://outdoorfunbg.eu/bg-product-details-54.html

03/12/2025

Every second is a promise that we will not leave anyone alone 🫡

01/12/2025

🫀 Why Does Pulsus Paradoxus Suggest Cardiac Tamponade?

Author: Dimitar Nenchev | Crisis Tech Solutions | Medical Practice | Prehospital Care | Emergency Medicine

Pulsus paradoxus—a decrease in systolic blood pressure greater than 10 mmHg during inspiration—is one of the most characteristic hemodynamic signs indicating cardiac tamponade. It reflects a pathological form of ventricular interdependence created by elevated intrapericardial pressure, which severely limits normal diastolic filling.

🔍 Normal Physiology

During inspiration, intrapleural pressure decreases. This leads to increased venous return to the right ventricle, which undergoes a slight diastolic expansion. The interventricular septum shifts minimally toward the left, resulting in a minor reduction in left ventricular filling. This causes a small physiological drop in systolic pressure, typically less than 10 mmHg.

⚠️ Hemodynamic Changes in Cardiac Tamponade

In cardiac tamponade, accumulation of pericardial fluid elevates intrapericardial pressure, restricting diastolic expansion of both ventricles. The total intracardiac volume becomes fixed, and any increase in right ventricular filling directly compromises the left ventricle. This phenomenon is known as ventricular interdependence and becomes markedly exaggerated in tamponade physiology.

🫁 Mechanism Behind Pulsus Paradoxus
• During inspiration, venous return to the right ventricle significantly increases.
• Due to the non-compliant, pressurized pericardial space, the right ventricle cannot expand outward.
• The interventricular septum is displaced prominently leftward.
• Left ventricular diastolic filling becomes markedly reduced.
• Stroke volume falls → causing a systolic blood pressure drop >10 mmHg.
• Clinically, this is detected as pulsus paradoxus.

🩺 Clinical Importance

Pulsus paradoxus represents a critical sign of hemodynamically significant tamponade. It indicates severely impaired left ventricular filling and requires urgent evaluation, echocardiographic confirmation, and consideration of pericardiocentesis when clinically appropriate.

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Led by CEO and medical trainer Dimitar Nenchev, our commitment to excellence ensures top-tier instruction for critical safety and medical practices in the UK and Nor