Fire "nine": how children are saved after burns in Moscow
Thousands of children with burn injuries are operated on in Moscow at the N. Speransky State Clinical Hospital No. 9. Despite the fact that the number of operations has not increased significantly compared to the past decade, doctors note an increase in the number of victims of chemical burns. The details are in the Izvestia report.
Don't cling, you won't get burned.
The pediatric surgeon of the highest category of the burn department No. 1 of the Speransky State Clinical Hospital No. 9, Candidate of Medical Sciences Varvara Valeryevna Stepanovich, is in a hurry: in the operating room, the medical staff has already prepared a 15-year-old child with burned body tissues for surgery and is waiting only for her. "Zaceper, climbed onto the roof of a train car, the body burn is 7%. Both right limbs were burned. It's a typical story for such people. The situation is difficult, but we have received children in a condition worse than this child's," says Dr. Stepanovich in short phrases.
Any patient from zero to 18 years old is considered a child here, they get here in different ways and for different reasons that led to injuries. According to hospital statistics, there are few Zatsepers: two or three people per year, but their injuries can become a benefit for students and, without exaggeration, are terrible. Almost the thrill is paid for by the lack of tissue on the face and body, many doctors remember one guy who had both legs burned to the bone. In the case of Dr. Stepanovich's current patient, everything is relatively easier, but the surgeon, for ethical reasons, refrains from giving details. The guy who decided to ride an electric train has bandages and months of rehabilitation ahead. "Everyone knows that you can't ride on the roofs of trains, but many people take risks. If they hadn't done that, they wouldn't have had to get burned," Dr. Stepanovich emphasizes, as if making it clear that the audience with her is over.
The windows of her office overlook the helipad in the hospital courtyard. They say it's used a couple of times a year. Most of the patients come either by themselves or by ambulance. There are two departments here: the first of 25 beds, where children under the age of three are monitored and treated, and the second, designed for 25 beds, treats older children from three to 18 years old. Both departments mainly serve Muscovites, but a child from any Russian region can come here for medical reasons, doctors say. Consultations are often provided by tele-communication.
Once there was a malaria hospital here, then an orphanage, and during the Great Patriotic War the wounded were housed. In the late 40s, the hospital became the clinical base of the Department of Pediatrics under the leadership of Professor Georgy Speransky, to whom it owes its name, and since the mid-60s, the Research Institute of Pediatrics and Pediatric Surgery has settled here. In the late 70s, the All-Union children's burn center was located here, but in recent years it has been reduced to two departments of the city children's hospital.
Bandaging and nervous shaking
Daria Oborkina, a thin, blue-eyed blonde, looks like a student, but in fact she is an experienced pediatric surgeon, a specialist in the treatment of burn injuries, has long graduated from her Second medical degree, residency and postgraduate studies, and is writing her PhD. Dozens of children pass through her hands every day. Over the years of working at this hospital, she has learned to determine the degree of damage very quickly and knows which patients should be expected depending on the time of year. For example, in summer, during the hot water shutdown season, there are more patients with burns caused by hot water from pots of boiling water. With the onset of cold weather, patients who have poured hot tea or coffee over themselves predominate.
We are talking in the cramped hospital kitchen, and a nurse opens the door — we urgently need to go to the dressing room to a two-year-old girl with a huge scarlet spot on her left foot. The doctor interrupts the conversation, gets up and goes to the dressing room, closes the door behind him, leaving the outsiders and the girl's mother behind her.
Wound dressing is a torment for everyone, and in order not to lower the pain threshold, they are done to children no more often than two or three days and with anesthesia. There are no parents in the dressing room during this process. Oborkina does not know who and when introduced this seemingly cruel rule, but says it is quite reasonable. "Here he is, a yearling with an injury that needs to be treated. But he sees my mother, rushes to her, and the dressing turns into a common torment, and in the process I can injure his own wounds. If mom is outside the door, of course, he will also cry loudly, but at least he will not move as actively as he could. We certainly anesthetize children with good medicines, because if a child is in pain today, the pain threshold will decrease tomorrow," says Oborkina.
Up to 75% of patients at the Speransky Hospital are patients with burns caused by hot liquid. In the 90s, many patients were brought here who inadvertently fell into open hatches and scalded themselves with hot water, got burned by burning accidentally found liquid on a construction site, etc. "Children existed outside the house, and the injuries were appropriate. And the current patients are children who have received a household burn by overturning a container with water, soup, milk, formula for nutrition, and water for sterilizing bottles," says Daria Oborkina.
In recent years, cases of so-called contact burns, which children get by touching an iron, a hotplate or just a hot battery, have also become more frequent. A three-month-old boy is currently in the ward with his mother. "The bed was next to the battery, the child was sleeping on it next to his mother, and at some point he and the battery touched, you know? We don't know how long a three—month-old child spent in this way, but he has a lot of wounds, and all these wounds, unfortunately, are very deep," says surgeon Oborkina, showing us a photo of a burned baby body from a phone screen. — Do you see these black crusts? These are dead tissues, they can be removed, plastic surgery can be performed and the skin can be replaced."
"I won't do this anymore"
The glazed boxes for three-year-olds are packed with children and their parents, and during bandaging they are filled with children's tears and tension. Three-year-old Rita is lying in one of them. She, like many of her peers, poured her mother's mug of hot liquid over herself, so she celebrates her birthday (which, by the way, was on the day of our visit) in the hospital room, and while her mother fills out consent for the photo shoot, she carefully examines strangers on her territory. Rita's torso is burned, although the burn is not visible under her T-shirt. Rita is cheerful, she's going home soon. In the next room, her sobbing neighbor, a one-and-a-half-year-old girl, is sitting on a cot surrounded by her mother and a nurse, bandaging her swollen, burned fingers on her hands.
All parental explanations of how their child got burned can be summed up in two words.: It just happened. Parents say that at least no one here throws them an insulting "overlooked", for which they are grateful. Why say that? They're already feeling bad. Here is the mother of a one-year-old girl who is being bandaged in a special room. She calmly gives the baby away and waits for it to be returned. "I turned away — she immediately turned the cup of tea over on herself. Well, who's to blame? Well, no one. A child, he is a child," she says calmly.
Artyom's mother Yulia tells a similar story, in which on June 12 she and her three-year-old son, a big boy, very mobile, jumped from bed to bed. The child looks at us and constantly says the same phrase.: "I won't do this anymore." Artyom turned over a pot of chicken eggs boiling on the stove, his older sister was nearby, and his mother was also relatively close, but they didn't have time to run. The ambulance arrived quickly, and we were quickly driven from Kuntsevo to Schmidtovsky Passage. I burned my chest and shoulders. The doctors helped, and I thank them for a lot," says Artyom's mother.
Teenagers can get a burn quite unexpectedly when coloring their nails. Among the patients of the pediatric surgeon of the burn department No. 1, Anna Lagutina, there is a girl with a chemical burn in the ankle area, which was obtained during the removal of varnish. Hair dye can be equally dangerous. "Before the burn, you can paint not only your nails, but also your scalp. The wounds from such a burn are small, but they are located under dead tissues, which causes patients great discomfort, because with chemical burns the wounds are deeper, the subcutaneous tissue and dermis are damaged, such a wound heals for three weeks," says Dr. Lagutina.
Burns in children are different, and the treatment is the same. For children with extensive burns, more than 60% of the body surface, use a special editing bed. From the outside, it resembles a large hammock, but in fact it is a complex medical instrument. Kinetic sand is supplied under the tarpaulin under the air flow, burn injuries are not touched, an anti-decubitus effect is created. There are seven such beds in the Speransky Hospital: two are in the department for children and adolescents, two more are in the department on the second floor for minor burns and three are in the intensive care unit. Beds can be filled in one day. After all, getting burned is a matter of minutes, and everything is ready to receive patients.
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