Children's mine blast injuries

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Relevance. Due to the close location of Belgorod to the combat contact line, military actions also affected civilians. The number of bombardments of the Belgorod region can reach up to 30 times a day [1].
Since 30 December 2023, when the first major tragedy occurred with a massive number of wounded and killed, the shelling of civilians in Belgorod itself has led to multiple explosive injuries (MBT), including among children [2].
According to the latest data, as of February 2024, child deaths due to bombardments since the beginning of the SFOR have been 8 children [3].
Unfortunately, the Belgorod region is not the only region of the Russian Federation that suffers from ongoing military operations, which particularly highlights the relevance of the selected topic [4].
Keywords: wartime, mine-blast trauma, medicine, children, intensive therapy
Objective: analysis of severe mine-blast injuries to children in the Belgorod district.
Tasks:
1. Allocate the age group , most exposed to MTA as a result of the shelling of Belgorod district.
2. Analyze the localization of MBT injuries in children of the study group.
3. To define primary tasks of assistance in the case of MBT in children.
Research materials and methods. We examined the medical records of 28 children with a diagnosis of MBT, who were in a serious condition in the department of anesthesiology and resuscitation (OR) OGBUZ DKB of Belgorod from 30.12.2023 to 30.12.2024. The patient was treated by the MBT team. This period was chosen because of the mass bombardments of the city of Belgorod and the Belgorod district, which led to a large influx of civilians into the region’s medical facilities and then into federal centres. All cases were ranked according to age of children, localization of received MBT, transfer needs to federal centers and outfalls.
Results and discussion.
Ranked by sex and age shown in Figure 1

Figure 1. Distribution by age group and sex in the study group (n=28).
As shown in the figure, it was found that the largest number of patients admitted were between 13 and 18 years old - 10 patients (36%).
Among the patients admitted to the SAR, 17 (61%) were predominantly male.
Localization of MBT in children in the study group is shown in Figure 2.

Figure 2. Distribution of patients by area of injury (n=28).
As shown in the figure, the most frequent area of injury was the lower limbs - 16 patients (42%). This is due to the mechanism of the fragmentation of the projectile falling on the ground, which fragments are broken up in a downward trajectory Injuries to head and neck - 8 patients (21%) were less frequent, caused by injuries from falling fragments of the explosive device (in the work of anti-aircraft missiles and drones).
The MBT outcomes in the study group are shown in Figure 4.

Figure 4. Outcomes of treatment under RA conditions (n=28).
Most of the children needed high-tech medical care, which was provided only in federal centers, so they were transferred to another medical institution, 6 patients continued treatment in BOKB Belgorod. 1 patient died in hospital.
The need for respiratory support is shown in Figure 5.

Figure 5. Need for respiratory support of patients with MBT in the US (n=28.)
Exactly half of the patients needed artificial ventilation - 14 patients (50%).
The ratio of number of injuries in MBT is shown in Figure 6.

Figure 6. Ratio of patients by number of injuries (n=28).
About 13 affected children received a political rehabilitation - 9 children (32%).
Duration of stay depending on the severity of injuries received, transport possibilities and need to continue treatment in different conditions is presented in figure 7.

Figure 7. Patients ranked by time of stay in the SAR (days) (n=28).
The average time (days) of patients with MBT diagnosis in the US was 3.3 days. Three patients (%) spent 1 day in OR conditions due to minor injuries, rapid stabilization of their condition and subsequent transfer to the specialized ward due to no need for further intensive care. Almost half of the children ( 13-%) spent 2 days in the SAR, 7 more patients - 3 days. This time is related to the stabilization of patients' condition for subsequent transfer to federal centers. One of these patients died from life-threatening injuries. Another 4 patients spent 4 or more days in the conditions of the RA, which is justified by prolonged intensive therapy, due to the severity of the condition, followed by a transfer to the relevant departments of the OGBUZ DKB in Belgorod. .
Conclusions.
1. The largest number of children affected by IMT - boys aged 13 to 18, which is related to greater autonomy and neglect of compliance with security rules in these geopolitical conditions .
2. The most frequent localization of MBT was in the lower limbs (16-42%), which is due to the mechanism of splintering when the projectile fell to the ground, with about 1 3 affected children (9-32%) having injuries to several areas of the body.
3. The primary objective of medical care for children with MBT in the region, which is subject to regular bombardment of civilians, is to stabilize vital indicators in order to effectively and timely treatmentdiagnostic measures in the specialized departments or by severity of the condition of the most rapid transfer of the patient to federal hospitals.

About the authors

Mikhail Igorevich Rezepin

Federal State Autonomous Educational Institution of Higher Education “Belgorod State University”

Author for correspondence.
Email: rezepin.edu@mail.ru
ORCID iD: 0009-0008-6782-6620

student

Russian Federation, 308000, Russia, Belgorod, Pobedy str. 85

Marina Andreevna Esina

Federal State Autonomous Educational Institution of Higher Education “Belgorod State University”

Email: marinaesina1502@yandex.ru
ORCID iD: 0009-0008-7359-7895
Russian Federation, 308000, Russia, Belgorod, Pobedy str. 85

Svetlana Vladimirovna Shishova

Областное Государственное Бюджетное Учреждение Здравоохранения "Детская Областная Клиническая Больница" города Белгорода

Email: rezepin.edu@mail.ru

врач АиР

Russian Federation, 308000, Russia, Belgorod, Gubkina str. 44

Olga Vladimirovna Shvedova

Областное Государственное Бюджетное Учреждение Здравоохранения "Детская Областная Клиническая Больница" города Белгорода

Email: rezepin.edu@mail.ru
Russian Federation, 308000, Russia, Belgorod, Gubkina str. 44

Elena Vitalievna Matvienko

Federal State Autonomous Educational Institution of Higher Education “Belgorod State University”

Email: tabletka-2013@mail.ru
ORCID iD: 0000-0002-0609-6889

an associate professor of pediatrics

308000, Russia, Belgorod, Pobedy str. 85

Elena Aleksandrovna Balakireva

Federal State Autonomous Educational Institution of Higher Education “Belgorod State University”

Email: balakireva26@mail.ru
ORCID iD: 0000-0002-3919-7045

Prefessor, head of pediatrics

Russian Federation, 308000, Russia, Belgorod, Pobedy str. 85

Alina Igorevna Balakireva

Federal State Autonomous Educational Institution of Higher Education “Belgorod State University”

Email: rezepin.edu@mail.ru
ORCID iD: 0009-0004-6162-1190
SPIN-code: 4917-6451

Pediatric Assistant

Russian Federation, 308000, Russia, Belgorod, Pobedy str. 85

References

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