Medical Evacuation of Emergency Situation Victims by Railway Transport: History and Prospects

Abstract. The aims of the article are to define the world tendencies of medical evacuation by railway transport in the 21st century on the basis of analysis of scientific publications, Internet articles and mass media reports, including those carried out during SARS-COV-2 pandemic; to specify the problems and prospects of development of medical evacuation by railway in Russia taking into account global trends and local specifics.

Materials and research methods. A content analysis of 15 scientific articles, 20 Internet articles, and 31 press communications devoted to individual issues of medical evacuation by railway was performed using the method of nonrepeat sampling.

Selection criteria were: message time — later than January 1, 2001; article should have contained the description of a case/evidence of medical evacuation by railway or the discussion of the possibilities of application of the railway transport for medical evacuation in the 21st century.

Results of the study and their analysis. The world has been conducting medical evacuation by railway for over 150 years. Traditionally, the need for medical evacuation by railway has arisen in case of armed conflicts or large-scale natural disasters, which result in great medical and sanitary losses. In the second half of the 20th century the priority importance of medical evacuation by railway was lost due to the development of automobile roads and aerodrome network and the accompanying development of automobile and air medical transport. The occurrence of emergencies in hard-to-reach areas or the inability of public health systems to organize medical care with a sharp increase in the number of victims in emergencies, including those of infectious nature, determine the need to develop additional mechanisms of medical evacuation. The use of medical evacuation by railway can become this compensatory mechanism. In this connection there has been a shift in the world’s focus in the field of medical evacuation by railway from the use of sanitary trains and flying cars to the formation of mobile medical detachments on the basis of re-equipped passenger trains. The use of re-equipped high-speed electric trains for this purpose has its advantages — it makes possible to avoid organizational difficulties and complications in patients, which are typical for sanitary aviation evacuation, as well as to provide mass medical evacuation of victims without overloading highways with sanitary vehicles. An alternative trend in the development of the medical evacuation by railway is the creation of modern civil sanitary trains and medical carriages. It has been noted that so far Russia does not have technical facilities capable to ensure the up-to-date level of the medical evacuation by railway. The future will show in what way the organization of medical evacuation by railway will develop in our country.