From Big Medical Encyclopedia

INFECTIOUS FIELD MOBILE HOSPITAL (IFMH) — the field medical institution intended for rendering specialized medical aid and treatment of infectious patients within field army. It is a part to lay down. institutions, hospital base (see).

Need of isolation and treatment of infectious patients within field army for the prevention of spread of infections in troops and their drift to the back of the country was rather obvious long before identification of true nature of infectious diseases. So, in Situation for temporary military hospitals at Big field army (1812) in Each main thing or mobile hospital it was provided to have chamber for «obsessed with catching diseases». According to

S. A. Semeki, already during the Russian-Turkish war of 1828 — 1829 the prototype of modern IPPG — a so-called mobile quarantine as a part of three departments at mobile hospital appeared. In the instruction for sorting of wounded and patients in wartime (1893) it was prohibited to evacuate infectious patients to the back before recovery. However in Russian army implementation of this requirement was not provided neither during the Russian-Japanese war (1904 — 1905), nor in World War I (1914—1918) in connection with misunderstanding of value of timely isolation of infectious patients, and also because of a lack of field hospitals.

During civil war the situation on fronts very often forced to evacuate infectious patients from troops in the country in civil to lay down. institutions. From the beginning of the Great Patriotic War in Red Army the necessary quantity of IPPG was created that allowed to carry out the principle of evacuation of infectious patients, since regimental first-aid posts and MSB, to destination in the next or IPPG developed directly in the center and to provide their treatment within field army. Practical implementation of this principle was one of the important conditions which provided during the Great Patriotic War epidemic wellbeing of troops of the operating Red Army and prevention of a drift of infectious diseases to the back of the country.

The main objective of IPPG is rendering specialized medical aid and treatment till a final outcome of the infectious patients, including and the faces affected bacterial, weapon who came to it (see. Biological weapons ). Besides, the hospital shall provide evacuation with the transport of infectious patients and persons, suspicious on infectious diseases, from insulators of first-aid posts of parts and connections, from hospitals of GB, and also disinfection of transport, on Krom infectious patients, and sanitary cleaning of the accompanying personnel are brought to hospital; the timely notification of command, doctors of military units and the senior medical chief about the diagnosis of a disease at the persons which arrived on treatment; assistance in carrying out protivoepid, actions in parts in connection with the arisen infectious diseases. The staff of hospital can be involved also in carrying out various protivoepid, actions: to identification of bacillicarriers among the wounded and patients who are in other hospitals among staff of rear parts and institutions, epidemiol, to inspection in the centers of infectious diseases, to carrying out a dignity. - epid, investigations and to participation in elimination of infectious incidence among the civilian population.

IPPG can be developed or as a part of hospital base for reception of infectious patients from MSB and directly from PMP, or around epid, the center which arose, e.g., as a result bacterial. attacks of the opponent, or near karantinizirovanny military units (see. Karantin, karantinization ).

It is reasonable to IPPG to develop in nek-rum removal from other hospitals, «on an entrance» to the district occupied by hospital base. For prevention of dispersion of an infection in the place of expansion of IPPG deratization works shall be preposted, places of breeding of flies are liquidated, it is necessary to avoid platforms on which there are flowing water sources.

At expansion and the organization of work of IPPG shall be provided separate accommodation of patients with various infectious diseases, movement of patients in hospital taking into account recovery and release from a disease-producing factor, and also transfer of hospital into a particular treatment in case of arrival of patients with especially dangerous infections. The actions excluding infection of service personnel and dispersion of an infection out of limits of hospital shall be provided also.

The state of IPPG finally developed during the Great Patriotic War; it provides separate accommodation generally of two groups of infectious patients.

IPPG as specialized to lay down. establishment is staffed by the corresponding specialists and necessary medical and sanitarnokhozyaystvenny property. The main divisions of IPPG are reception and diagnostic, two medical and laboratory departments.

Reception and diagnostic department is intended for expansion of the functional division of the same name, in Krom reception, sorting and sanitary cleaning of all arriving patients, rendering acute medical aid to persons in need, and also temporary accommodation of patients for specification of the diagnosis of a disease is carried out.

To lay down. departments are intended for expansion of the same name funkts, divisions of hospital in which rendering specialized medical aid and treatment of the arrived patients till a final outcome is carried out; in one of departments faces with intestinal infections, in another — with airborne can be placed, e.g.

Laboratory department provides expansion a wedge, and bacterial. laboratories where are carried out a wedge., serol, and the bacterial, researches necessary for diagnosis of diseases, and also for control of completeness of recovery of patients.

As a part of IPPG there are also divisions of service: drugstore, economic and transport departments, mechanical hospital laundry, power plant, etc.

On a sorting post at arrived check documents, carry out radiation control and presort of patients on the nature of a disease. Further sorting is carried out in reception and diagnostic department where separate reception of patients with diverse groups of infectious diseases shall be provided. Viewing tents need to be boxed and equipped with the medical property and other stock providing rendering acute medical aid. From viewing tents of patients send for full sanitary cleaning to sanitary inspection rooms, and then in corresponding to lay down. department.

Fig. 1. Schematic diagram of expansion of IPPG: 1 — a sorting post; 2 — viewing; 3 — sanitary inspection rooms; 4 — the disinfection and shower car (DSC); 5 — the platform for disinfection of transport; 6 — the platform for deactivation of property; 7 — diagnostic tents; 8 — laboratory; 9 — tents of the 1st and 2nd medical departments; 10 — a dressing room; 11 — divisions of service; 12 — a drugstore; 13 — rooms for staff.

In to lay down. departments of patients, the allocating activators, it is necessary to place in tents or boxes taking into account the nature of an infection. Convalescents can be placed jointly and be involved in performance of some obligations for patient care. The schematic diagram of expansion of IPPG and the movement of patients on functional divisions of hospital are shown in the figure 1.

In the conditions of possible use an aggressor biol, weapon of IPPG shall be ready to reception of patients with especially dangerous infections. In these cases of IPPG it is necessary to understaff with the corresponding medicines and prophylactics, sanitary and economic property, etc.

At transfer of IPPG into a duty with especially dangerous infections the territory of hospital is fenced, the exchange office through which supply of hospital with all types of an allowance is carried out will be organized; the territory of hospital is divided into a zone of a so-called high security where take place reception and diagnostic and to lay down. departments, and a zone of the usual mode where other divisions are located. Communication between zones is carried out only through transfer points. On border of zones of the high and usual security the sanitary inspection room where the personnel put on protective clothes is equipped, upon transition to a zone of a high security and before escaping it undergoes full sanitary cleaning. In the same sanitary inspection room are exposed to full sanitary cleaning discharged from hospital.

Fig. 2. The schematic diagram of IPPG for reception of patients with especially dangerous infections: 1 — a sorting post; 2 — viewing; 3 — a sanitary inspection room for patients with strong indications of a disease; For — the same for patients with suspicion of a disease of especially dangerous infection; 4 — the disinfection and shower car (DSC); 5 — the platform for disinfection of transport; 6 — the platform for deactivation of property; 7 — isolation centers of reception and diagnostic department; 8 — a still-room; 9 — medical posts; 10 — transfer points; 11 — laboratory; 12 — a dressing room; 13 — tents of medical departments; 14 — a sanitary inspection room for personnel and the written-out patients; 15 — a drugstore; 16 — divisions of service; 17 — rooms for staff; 18 — exchange office.

Reception of patients with strong indications of especially dangerous infection and their sanitary cleaning are carried out separately from persons, the diagnosis of a disease at whom is doubtful; the last go to isolation centers of reception and diagnostic department and are late before clarification of the diagnosis there. The schematic diagram of IPPG at reception of patients with especially dangerous infections and their movement on functional divisions are shown in the figure 2.

IPPG is a final stage of evacuation for infectious patients. Therefore need of their evacuation from hospital can be connected only with adversely developing fighting situation (threat of occupation of hospital of the opponent) or other circumstances demanding movement of hospital. In these cases evacuation of patients will be organized by the chief of hospital with use regular and given a dignity. transport. On each car used for transportation of infectious patients there have to be means for disinfection of hands and excrements, a bed-pan, an urinal, etc. Cars with infectious patients shall follow an independent column under team of the officer. The column shall not do stops in settlements or near a disposition. The patients constituting danger to people around, convalescents-bakteriovydeliteley are evacuated in the developed IPPG, the others can be directed in therapeutic field mobile hospital (see) or hospital for lightly wounded (see). After coagulation of IPPG careful disinfection of the territory of the platform, especially rubbish pits and bathrooms is carried out, it is left precautionary piketazh to exclude an arrangement on this place of medical institutions and troops.

Bibliography: Military medicine in the Great Patriotic War, under the editorship of E. I. Smirnov, century 2, page 433, M., 1945; Military-medical preparation, under the editorship of D. D. Kuvshinsky, page 373, M., 1975; Infectious diseases, under the editorship of V. S. Matkovsky and A. P. Kazantsev, page 343, L., 1970; Encyclopaedic dictionary of military medicine, t. 2, Art. 966, M., 1947.

V. I. Agafonov, T. E. Boldyrev.