Main Features of Medical Evacuation by Rail of the Wounded in Modern Armed Conflict

Summary. The purpose of the study is based on the analysis of medical documentation and the work experience of medical specialists of the Center for Air Ambulance and Emergency Medical Care (CAS and EMS) of the Federal State Budgetary Institution “State Research Center – Federal Medical Biophysical Center named after A.I.Burnazyan” FMBA of Russia for medical evacuation by rail (MEZHT) of the wounded to determine the main features of medical evacuation measures (MEM) and the structure of the contingent evacuated during armed conflicts.
Materials and methods of research. Research materials – primary medical documentation of 8 flights of a temporary military medical train (VVSP) of the Russian Ministry of Defense. Study period: July–August 2023. The study used methods of mathematical analysis and direct observation.
Research results and their analysis. Currently, temporary military ambulance trains evacuate mainly walking and low-mobility lightly wounded patients, which is due both to the lack of operational need for long-distance MET for this category of patients due to the stable operation of air ambulances, and to the not entirely satisfactory conditions for placing seriously wounded bedridden patients in the air ambulance. 
Currently, the Air Forces operate in accordance with the scheme of routing the wounded from the zone of armed conflict to medical treatment organizations (HMO) in the rear of the country. At the same time, the existing difficulties in MEVT of bedridden, seriously wounded patients, including those in intensive care, require improvement of railway ambulance transport. In the author’s opinion, the most rational option for such an improvement in modern conditions is the further development of schemes for modifying passenger cars to meet the needs of the MEZhT of the seriously wounded and sick.