Features of treatment of victims of the terrorist attack in St. Petersburg metro (03.4.2017) with severe explosive injuries

Abstract

Relevance.The realities of modern life do not exclude the risks of terrorist attacks. During explosion, heterogeneous factors simultaneously affect the body, thus involving organs and systems in various combinations in the pathological process.Intention.To analyze results of the treatment of victims with severe explosive wounds resulted from the terrorist attack of April 3, 2017 in the train car of the St. Petersburg metro.Methodology.As a result of the terrorist attack, 10 passengers and the terrorist himself died on the spot, 102 people were recognized as victims. On April 4, 2017, 57 wounded were admitted to the city hospitals, of which four did not survive. Twenty five wounded in the terrorist attack in the St. Petersburg metro car were admitted to the St. Petersburg Research Institute of Emergency Medicine n.a. I.I. Dzhanelidze within the “golden hour”. In 15 of them, injuries were combined with surface thermal burns.Results and Discussion.Five cases with the most severe injuries are described. It was established that multifactorial, combined and multiple of injuries were typical for this pathology. Most victims had severe cranial-brain trauma, shrapnel wounds of soft tissues and gunshot bone fractures. Specialized medical care at the Level I Trauma Centers was characterized by simultaneous admission of several seriously injured, the need to organize several surgical teams, Damage control approach, multidisciplinary and a long-term, multi-stage and very expensive treatment with the participation of surgeons and doctors of various specialties.Conclusion.To achieve the best results, victims with severe explosive injuries should be sent as soon as possible to the Level I Trauma Centers, where up-to-date treatment and diagnostic technologies (spiral-computed tomography, magnetic resonance imaging, angiography, selective arterial embolization, computerized 3D modeling, etc.) and comprehensive rehabilitation measures are available.