Aviation evacuation in cases of gunshot wounds of the chest

Abstract

Aim. To systematize the results of air transport evacuation of patients with gunshot wounds of the chest.
Material and methods. From 1994 to 2021, the Central Military Clinical Hospital of the Ministry of Defense of
the Republic of Uzbekistan carried out medical evacuation «on oneself» from garrison hospitals, medical institutions of the Ministry of Health of 78 wounded wounded with gunshot wounds to the chest. Air transport
was required to evacuate 46 of them. The severity of the general condition of the wounded was as follows: in
5 (10,86%) of the wounded it was mild, in 11 (23,91%) it was moderate, in 21 (45,65%) it was severe and in 9
(19,56%) – extremely severe. To objectify the volume of the lesion, the scale of gunshot wounds to the chest of
military field surgery (VPH-P (OR) chest) was used. The indicator of the scale of the VPH-P (OR) chest varied
from 0.05 points to 13,8. In total, thoracotomy was performed on 31 wounded, in particular, suturing of lung
wounds in 19 cases and non-penetrating wounds of the apex of the heart in 2 cases. Pre-evacuation preparation consisted of adequate anesthesia and sedation, mainly with narcotic analgesics, in the provision of mask
humidified oxygen, if necessary, patients were evacuated on an artificial lung ventilation (ALV) machine.
Results. Evacuation was carried out within 6 hours in 9 (19,56%) cases, 13 (28,26%) wounded were evacuated on day 1, 21 (45,65%) on day 2, 1 (2,17%), on the 4th day – 2 (4,34%). Flight duration during evacuation by aircraft ranged from 50 minutes to 150 minutes, 87,5±36,9 minutes on average, by helicopter
from 30 minutes to 75 minutes, 55,8±20,8 minutes on average. For the entire period of evacuation, blood
pressure in the wounded was on average 116,5/74,2±5,5/4,8 mm Hg, pulse 82,5±4,2 beats/min, saturation 96,1±1,4%. No lethal cases were observed during evacuation of the wounded to the chest.
Conclusion. Despite the severity of the condition in case of gunshot wounds of the chest and the amount
of surgical intervention undergone, with proper organization and provision of medical evacuation of those
wounded in the chest, air transport is the most gentle.