Managing medical care for victims with thermal burn injuries caused by emergency accidents in megacity settings

Relevance. In emergency settings, medical care for thermal burn injuries remains a crucial problem of disaster medicine. In industrially advanced countries with ongoing urbanization, burns represent a most frequent and severe type of injuries requiring emergency medical care. The study objective is to analyze the efficiency of emergency medical care provided in Moscow over the 6 year’s timespan (2018 to 2023) to victims of emergency accidents presented with thermal burns.

Methodology and methods. The study relies on the data obtained from the Disaster Medicine of Moscow automated analytical information system with a focus on the victims of emergency accidents presented with burns throughout the past 6 years (2018 to 2023). The platform is managed by the Moscow Territorial Scientific and Practical Center for Disaster Medicine (CEMP) and the N.V. Sklifosovsky Research Institute of Emergency Medicine.

Results and discussion. Over the past 6 years (2018 to 2023), the emergency accidends affected 1989 victims presented with thermal burns, including 438 (22.0 %) declared dead at the scene prior to the arrival of CEMP medical and specialized emergency response teams. 1,216 patients (61.1 %) were evacuated to referral centers at multidisciplinary hospitals, 315 patients (15.9 %) travelled to medical hospitals by passing-by vehicles to apply for medical help independently, and 20patients (1 %) were referred for outpatient follow-up. Overall, 597 patients were admitted to burn injury department at the N.V.Sklifosovsky Research Institute. Those included 33.1 % in extremely severe and severe condition, with 1.7 % requiring tracheal intubation and respiratory ventilation support.

Conclusion. At pre-hospital stage, deployment of the medivac ICU teams is the most promising strategy to ensure high quality medical care. Given the high incidence of multiple injuries (up to 49.6 %) in emergency accidents, sophisticated medical care shall be provided by a multidisciplinary team of reconstructive burn surgeons, ICU staff specializing in inhalation injuries, and medical professionals.

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