From Big Medical Encyclopedia

RAILWAY MEDICAL AMBULANCE — the special or adapted railway transport intended for transportation of wounded and patients. From. - of the cars used for these purposes create the military dignity. trains (MD.T) and the military dignity. short meetings (MD.SM) which are institutions military medical services in which treatment of wounded and patients and their consumer services along the line is performed.

Thanks to a number of advantages (big capacity, speed, relative conveniences in placement of evacuated). page of t. it is considered the main egress of wounded and patients from field army to the deep back of the country (see. Evacuation medical ).

For the first time evacuation of wounded and patients on. by it was carried out in Austria and Italy during the avstro-italo-French war (1859). First military dignity. the train was created in Germany (Wurtemberg) in 1862. In escalating sizes. - transport was used by for evacuation of wounded and patients during the civil war in the USA (1861 — 1865), in avstro-Prussian (1866) and French-Prussian (1870 — 1871) wars. For transportation of wounded and patients passenger and commodity cars were used.

In Russia. page of t. it was for the first time used for evacuation of wounded during the Russian-Turkish war of 1877 — 1878. According to «The provision on military and sanitary trains» in 1876 constant and temporary VSP formed. Constant VSP consisted of the adapted cars in which it was possible to place from 200 to 300 wounded and patients, the car kitchen, the car laundry, etc.; temporary VSP — from the wounded adapted for transportation cargo and cars in which depending on number of cars it was possible to place from 200 to 400 wounded and patients.

In the Russian-Japanese war of 1904 — 1905 formation military dignity. trains 1904 was carried out on the basis of «The provision on military and sanitary trains». According to this situation constant VSP from the adapted cars of the 3rd class were created. They included cars for seriously wounded (on 18 places in everyone) in whom passenger seats were replaced with special machines for installation of a stretcher in two tiers, and also cars for placement lightly wounded (on 32 places in everyone). In addition to these cars turned on 10 — 15 adapted freight cars in structure of constant VSP that allowed to increase the capacity of the train to 420 — 450 places. Temporary VSP usually included 7 passenger and apprx. 28 freight cars, with a total capacity from 400 to 600 places. Due to insufficient quantity of VSP for evacuation of wounded the «teplushechny» trains consisting usually of the freight cars equipped with two-story plank beds, and in the winter — and furnaces were widely used.

The «Provision on military and sanitary trains» which is put into operation in 1912, constant VSP on the device and appointment were divided on field and rear. For them the constant component of the train including cars for accommodation of staff of the train and also the cars equipped under kitchen, a drugstore dressing room, a warehouse and the so-called variable part consisting from passenger (or cargo) cars which joined in the train and were as appropriate equipped only for flight of VSP with wounded was provided. Field VSP intended for transportation of wounded on short distances, within the rear area of army, the front. Rear VSP, besides, were used for evacuation of wounded to internal regions of the country. Situation provided also formation of temporary VSP in cases of a shortcoming field or rear a military dignity. trains.

The principles of use and the organization of work of military and sanitary trains were regulated by the «Provisional regulations for evacuation of wounded and patients» approved in 1914.

After the victory of Great October socialist revolution by order of the National commissioner on military affairs in 1918 all a dignity. trains turned into maintaining the military of department, and the resolution of Council of Work and Defense against 30/111 1921 signed by V. I. Lenin, available then the 154th dignity. trains were given to the order of the Head sanitary department of Workers' and Peasants' Red Army (GSU RKKA).

During civil war of VSP were used not only for evacuation of wounded and patients, but also as receivers, hospitals on wheels, dressing short meetings.

In 1923. Were developed by a commissariat of means of communication «An album of drawings of devices for transportation of wounded and patients in military and sanitary trains», and in 1925 — «An album of drawings of the equipment of the rolling stock of rear and field military and sanitary trains» (the annex to «Rules of drawing up and the equipment of rear and field military and sanitary trains»). The order of use of VSP in army, front and internal regions of the country was defined by «The guide to sanitary evacuation of RKKA» (1929).

By the beginning of the Great Patriotic War in Red Army for evacuation of wounded on. was provided to have constant and temporary VSP. The equipment, an order of formation and the organization of work in them were regulated by the documents coordinated between the National Commissariat of defense of the USSR and the National Commissariat of means of communication of the USSR and put into operation in 1941: «Provision on military and sanitary trains», «Rules of drawing up constants and temporary voyennosanitarny trains and equipment for them of the rolling stock», «Instruction for loading and unloading of military and sanitary trains». In addition to these documents the Head military and sanitary department of Red Army in 1942 enacted «The guide to the organization and work of military and sanitary trains», in Krom functional duties of officials and the organization to lay down were defined. works in VSP.

Fig. 1. The equipment of the car for seriously wounded three-storied machines in the constant military and sanitary train (the period of the Great Patriotic War of 1941 — 1945).

Constant VSP used generally for evacuation of wounded and patients from hospital bases of fronts in hospital bases of internal regions of the country. They were created, as a rule, of eight-wheel cars. In the cars intended for transportation of seriously wounded, the internal equipment was replaced with special devices — machines on which three tiers a stretcher for wounded and sick (fig. 1) was placed in two or. Depending on type of machines in the car it was possible to place from 20 to 30 people.

In total constant VSP accepted from 400 to 500 wounded and patients.

Temporary VSP intended for evacuation of wounded and patients on short distances, hl. obr. from hospital bases of armies in hospital bases of the front (see. Hospital base ). They consisted of the constant component and a variable given only on travel time of the train with wounded and patients. In temporary VSP it was possible to place up to 860 wounded and patients.

For lightly wounded used regular eight-wheel cars, in each of which it was possible to place at normal loading 46, and during the use of upper (luggage) shelves of 60 people.

In 1942 in addition to constant and temporary VSP in armies and fronts it was authorized to create VSL. They were used by hl. obr. for evacuation of wounded and patients within army and front rear areas. The basis of VSL was made by a constant component of cars, edges included cars for a drugstore dressing room, kitchens, a product warehouse and a warehouse of sanitary and economic property, for staff and office.

Fig. 2. Placement of stretchers on Kruzhilin's springs in the freight two-axis car.

Variable part of VSL included from 20 to 40 freight two-axis cars which were equipped previously with a usual military flooring. In each car it was possible to place from 20 to 30 people. Cars for transportation of seriously wounded were equipped with removable podressorivayushchy devices — Kruzhilin's (fig. 2) springs on which established a dignity. stretcher. In each car 12 — 16 people accommodated. Depending on number of cars the capacity of VSL made 500 — 600 wounded and patients and more.

The order of formation, the equipment and use of VSP and AF JI is defined by the relevant documents. VSP intend preferential for evacuation struck and patients on long distances from hospitals of field army to the back of the country and their treatment along the line. As a part of VSP usually equip cars for seriously wounded, lightly wounded, the insulator, under a drugstore dressing room, cars for material and hozyaystvennobytovy service evacuated struck and patients (kitchen, a food warehouse, a ware warehouse, etc.), and also for staff of VSP.

For formation of VSP and VSL use the existing park of passenger and freight cars. At re-equipment of cars for transportation heavy struck delete all longitudinal regiments and partitions from them between them.

Fig. 3. A compartment in the car for seriously wounded: 1 — little tables trays; 2 — safety belts.

Average cross shelves equip with safety belts and little tables trays (fig. 3). In one of cars for seriously wounded the dressing room can be equipped.

In the cars intended for lightly wounded in addition establish only safety belts and little tables trays.

Objects of care of wounded (vessels, ducks, etc.) are stored in a toilet. In addition install flexible pipes on cranes of wash basins, on the Crimea water for washing of vessels and ducks is pumped.

The drugstore dressing room is equipped in the all-metal car of the interregional message, from to-rogo chairs for sitting are removed. In a drugstore it is provided to have necessary quantity of medicines, pharmaceutical furniture and objects (assistant tables, cases for medicines) and other equipment ensuring its normal functioning.

In a dressing room establish the corresponding medical equipment (tables, cases for medicines and tools, the narcotic equipment, the operating table, etc.) providing performance of the established volume of medical care evacuated along the line.

The car insulator is equipped in the all-metal car of open type. Delete all longitudinal sofas, regiments and partitions dividing them from the car, except for longitudinal luggage shelves. The car is divided into two half (for different infections). In extreme compartments of each half install the rangette, a case for medicines and a tank for dirty linen. In toilets instead of toilet bowls establish toilet seats with buckets, vessels, the ducks disinfecting solutions are stored in the same place. For disinfection of stock and rooms of the car there is a hydropanel. During the loading (unloading) of wounded and patients on a stretcher in cars open the stvorny partition located between a toilet and the platform.

In VSP there is a telephone switch and a broadcasting center by means of which communication of medical staff on duty and command of the train with all divisions both on parking is provided, and at the movement.

VSL form from freight cars and consist of a constant and variable component. The constant component includes cars under a drugstore dressing room, kitchen, staff of VSL and cars for a dignity. - economic needs. A variable part of cars is given only for flight of VSL with wounded and includes cars for seriously wounded and lightly wounded, and also the car insulator.

The regular staff with use of organic medical equipment of VSP can provide treatment of wounded and patients, and also rendering the first medical and qualified medical aid according to vital indications.

The volume of medical aid in VSL in connection with short-term stay of wounded in a short meeting and due to the lack of intercarriage transitions to time of the movement can be limited to urgent actions of the first medical assistance.

Loading of wounded and patients in VSP and VSL shall be carried out to limited terms. As devices for acceleration of loading in the absence of loading platforms (a dignity. stages) it is necessary to use an organic collapsible planked footway, and also staircases, ladders, temporary ramps from cross ties and rails.

For creation of the conditions facilitating service struck and patients in way, it is necessary to place them in VSP or VSL cars taking into account character and weight of defeat or a disease.

In order to avoid loading in VSP or VSL nontransportable struck and sick such loading is preceded by evakotransportny medical sorting (see. Sorting medical ), edges it is carried out in sorting hospital (see), evacuation receiver (see) or other to lay down. establishment. By the time of arrival of VSP or VSL on the station of loading a part of the subjects of evacuation struck and patients beforehand focus in the railway receiver which is intended for their temporary placement before loading on VSP or VSL.

In way to lay down. actions (bandagings, hemotransfusion, medicamentous therapy, etc.) are carried out on site placements. Only for more difficult manipulations struck and patients are transferred to dressing (operating room).

Can be used by flight from the back to field army In the joint venture and VSL for delivery to troops of necessary medical property.

See also Medical ambulance .

Bibliography Arolovich S. M. Work of the doctor in the military and sanitary train, Voyen. - a dignity. business, No. 3, page 50, 1942; To Bar E. C. Sanitary short meetings in the army area, in the same place, No. 5-6, page 50, 1943; Bogatyrev M. F. Work of the front sanitary train in days of the Great Patriotic War, Owls. medical No. 10, page 28, 1942; Military medicine in the Great Patriotic War, under the editorship of E. I. Smirnov, century 2, page 346, M., 1945; Zaglukhinsky V. V. Tools of sanitary tactics, field covers, perenosochny and transport vehicles, M., 1912; Kapitonov G. I. ibaranovskiyg. Ya. Komplekt for installation of stretchers in the freight covered cars, Voyen. - medical zhurn., No. 10, page 77, 1975; T to them about f e e in with to and y P. P. Vehicles of sanitary evacuation, M. — L., 1940; In about s e H. Der Verwundetentransport aiif der Schiene, Schweiz. Z. Militarmed., Bd 46, S. 65, 1970.

F. A. Ivankovich.