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Report the Russian Disaster Medicine Service
Written by .., . -   
, 29 2002
REPORT
The Russian Disaster Medicine Service task force medical response
During the Moscow hostage crisis October 2526, 2002
In ‘Gazeta’, October 29th, 2002, 7:48 pm
At 11:00 am on October 25th, 2002, the teams arrived at Veterans Hospital #1, the scene of the emergency. Lawenforcement officers establish a strict pass control procedure for entry into the hospital.
In the inner courtyard of the hospital, the Center for Disaster Medicine (CDM ‘Protection’) set up a pneumatic module from a mobile field hospital, and organized a duty roster for the Rapid Response Team. Itconsisted of 8personnel from the field hospital under team leader L.N.Doroshenko, 3personnel from the aero-medical team, and Y.N.Pavlov, the CDMrepresentative to the operational headquarters. Atotal of 12members of CDM‘Protection’ were on the Rapid Response Team.
Liaison was established with: A.P.Nezamaev, team chief of the Moscow health department center of disaster medicine; Lt. Col. A.P.Semenchenko from the operational headquarters; Col. V.A.Garanenko from the eastern administrative district Civil Defense headquarters; and Chief PhysicianG.G.Kirtadze from the admissions department of Veterans Hospital #1.
The following teams were on duty at the hospital: from the Center for Emergency Medicine 1, from the media 5, from hospital security 2, From CDM‘Protection’ 2, from the hospital’s medical and nursing staff 2. 19surgical teams from the N.V.Sklifosofsky medical research institute were on duty in the hospital’s surgical department.
A center to assist the hostages’ relatives was deployed in another mobile field hospital, located near Veterans Hospital #1, but outside the police cordon. Thefollowing teams were on duty: from the Center for Emergency Medicine 1, from the ambulance services 3, from the medical and nursing staffs of medical facilities in the central administrative district 2, from psychological-psychiatric dispensaries 1. Atotal of 32psychologists were on duty to receive patients.
Total teams on-site at the scene of the emergency were 38, including: the Center for Emergency Medicine 2, CDM‘Protection’ 2, ambulance services 8, hospital security 2, medical and nursing teams from Veteran’s Hospital #1 2, medical and nursing teams from other medical facilities in the central administrative district 2, medical and nursing teams from psychological-psychiatric departments 1, and surgical teams from the N.V.Sklifosofsky medical research institute 19.
During the first day (October 24th) medical assistance was provided to 232persons, including 5hospital admissions. Psychological assistance was provided to 152persons. Thetotal number assisted was 384.
The hospital cafeteria organized three hot meals a day for specialists working during the emergency situation. Operational leadership of the medical teams was under Center for Emergency Medicine chief A.P.Nezamaev. Working in the operational headquarters was A.P.Selydovsky, chief of the Moscow health department’s center for emergency medicine.
The following arrivals were recorded at the operational headquarters: Y.M.Luzhkov, V.I.Matvienko, Yastrzhembsky, V.Vasilyev, L.Narusova, J.D.Kobzon, A.B.Pugacheva, E.Primakov, R.Aushev, Politkovskaya, and others.
At about 2:00 pm on October 25th, 2002, L.Roshal led from the theater center 8children who had been among the hostages.
At 4:00 pm the Deputy Minister of Health of the Russian Federation, V.B.Korbut, arrived at Veteran’s Hospital #1. Heperformed an inspection of the hospital and the mobile field hospital, and checked the readiness of the Rapid Response Team and the aero-medical team from CDM‘Protection’.The Deputy Minister visited the operational headquarters and then left the scene at 5:30 pm.
At 5:00 pm a group of demolitions experts arrived at the scene.
At about 8:00 pm the last group of negotiators left the building that had been seized by the terrorists (E.Primakov, R.Aushev, and others).
From 8:00 pm to midnight there was a decrease in activity by various services, and movement in the inner courtyard of Veteran’s Hospital #1 virtually ceased.
At 5:45 am on October 26th, 2002, the theatrical center building was stormed. Intense gunfire was heard, and there were frequent explosions, two of which were very large.
At 6:30 am, the operational headquarters and the Center for Emergency Medicine received the order: “All teams to the main entrance of the theatrical center. Masscasualties.” The ambulance services, the Center for Emergency Medicine, the aero-medical team from CDM‘Protection’, and others, went out on command.
At 6:35 am the first hostage, on his own, left the building.He was taken to the emergency room of Veteran’s Hospital #1. Atthe same time, teams brought in casualties to the surgical department. Casualties were loaded two to three per vehicle. Dueto congestion, the movement of emergency vehicles was complicated. Somecasualties had to reach the hospital by being physically carried by rescuers and commandos.
The clinic diagnosed all casualties as suffering from poisoning from the inhalation of an unidentified substance. Theyhad pronounced pallor, hypotension, ‘bralycardia’ (sic: bradycardia or slowed heart rate ed), bradypnea (low respiratory rate ed), and laryngospasm. Somecasualties suffered from repeat bouts of vomiting, and had chemical burns of mucous membranes of the respiratory tract.
At 6:45 am, law enforcement officers placed hostages that were able to move on their own into specially designated passenger buses for transport to medical facilities in Moscow. Atthe same time, officers from the Interior and Emergencies ministries began to collect and load corpses into a separate bus for transport to city morgues.
A total of 103persons were admitted to Veteran’s Hospital #1, of which 2suffered from gunshot wounds (cranial and thoracic-abdominal). 9of the admissions died. Rapid Response Team specialists worked on the most seriously affected in the hospital's intensive care unit.
The aero-medical team made 9trips with casualties, carrying 21. During transport, patients were administered naloxone and respiratory analeptics. 2victims regained consciousness after the administration of naloxone. Dueto the small supply, only 7received the drug. There were no deaths during transport.
By 7:30 am, all casualties had been removed from the scene to medical facilities in Moscow.
There did not arise any requirement for additional manpower or medical resources. Rapid Response Team specialists continued to work in the hospital’s intensive care unit.
At 9:30 am, the mobile field hospital team from CDM‘Protection’, headed by chief physician I.A.Nazarova, arrived at the intensive care unit. Sheheld a consultation with: Y.N.Ostapenko, Russian Health Ministry chief toxicologist; T.G.Kirtadze, chief medical officer of Veterans Hospital #1; the Moscow health department deputy chief; Y.N.Pavlov, the CDMrepresentative to the operational headquarters; and the head of the intensive care unit of Veterans Hospital #1. Itwas determined that the unknown poison affecting the hostages was neurotropic in action, and recommendations were made to treat the patients symptomatically. Itwas noted that not all casualties received naloxone.
At 10:30 am, the mobile field hospital of CDM‘Protection’ was dismantled.
At around noon, after consultation with the director of CDM‘Protection’, teams left the scene of the emergency and returned to their center.
 
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