– Alexander Nikolaevich, seriously wounded soldiers from the battlefield in Ukraine arrive at Vishnevsky’s military hospital. How have recovery technologies changed since the Great Patriotic War?
– It’s changed a lot. There were many stages of emergency evacuation. They were taken first to the first aid station, then to the medical battalion, then to the hospital base at the front and from there to the frontline hospital. Now the air ambulance delivers the fighters from the battlefield in two to three hours. Helicopters are boarded, from there they fly to the Chkalovsky airport, 31 km northeast of Moscow, immediately from the airport by helicopter to the Vishnevsky hospital. To date, this is a new scheme for the provision of medical care.
Why aren’t they helped immediately?
“These are difficult situations. Advanced medical equipment, such as heart-lung machines, is not available to provide this type of care. At the Vishnevsky hospital, two helipads are specially equipped for such an evacuation. We are still working on a road injury – also often urgent evacuation by helicopter is needed. .
— What are these helicopters equipped with?
– Everything you need. Oxygen, ventilator and resuscitation kit.
– Do you need to turn off the fan when the helicopter lands?
— No, there are so-called transport fans. With such a portable device it is possible to reload such patients on stretchers and transfer them to the hospital operating room.
– And who decides on the battlefield that this special soldier should be taken to the Vishnevsky hospital?
– Sanitary structures and first aid doctors in the field – they make a decision. The helicopter already has anesthetists and resuscitators.
“Are the bandages still there?” What is applied to the wound?
– Now we use packages for hemostasis (hemostatic agents – drugs that help stop bleeding). Such a sterile pack with hemostatics is superimposed on the wound and painkillers are injected immediately. Each soldier also has such a drug in his individual first-aid kit – if he has time, he can inject himself. If not, the on-scene medical instructor or paramedic can provide first aid. Then, if necessary, such a fighter is transported to a field hospital, located in a tent near the battlefield.
What if a person stops breathing on their own?
– Immediately the tube is inserted into the throat, the person is intubated, connected to the transport ventilator and evacuated.
– Has narcosis changed much since the Second World War?
– Of course, painkillers have also advanced. These drugs effectively relieve pain for 2-3 hours. The local anesthetic is morphine-based followed by propofol. It has a good effect on the muscles and is excreted from the body.
Hemostatic drugs have also advanced – new developments in the form of powder are well applied to napkins and stop bleeding.
– That is, the fighter is brought to you by helicopter and immediately taken to the operating room?
Yes, everything happens so fast. Recently there was an unusual situation – a bullet was removed from the heart, which blocked the duct like a mushroom, and for a long time the person was on the verge of life and death. The bullet pierced the lung, ruptured the liver, and pierced the heart. The warrior survived, this is a unique situation even for me.
The second case – a piece like a scalpel hit the heart, and we managed to get it. We recruited a large number of soldiers, and all those operated on today are alive. After the operation, the patient enters the intensive care unit, and from there the normal ward, and then the rehabilitation center. There they are restored within a week, two or three, and sent back to their duties.
What are the most injured?
– They are very diverse. But mostly shrapnel wounds.
Which wounds take longer to heal?
– Bone injury. It heals in 2-3 months. We are here and choose prostheses if necessary.
– Do you always understand from which weapon this or that part hurts a person?
– We look more at how sharp this or that piece is, how it can damage a person’s vital organs, because the tactics of intervention depend on it.
Have you met the radioactive parts?
– We have radiometers that can measure the radioactivity of a piece. But I have never seen such people in the entire duration of special operations.