An Emergency Physician's View from Ukraine

As an emergency physician, we are trained and ready to do just about anything necessary in a crisis. But, in my hospital we typically manage civilian trauma. We are now working around the clock to prepare for the more significant injuries that undoubtedly come with war. In Kyiv, we are preparing for a mass casualty situation —we know each day is unpredictable and it could happen at any time.

In my hospital, we can’t worry about bombs. Our staff is brave and when the alarms go off, we cannot run into the basement, we must continue to provide care. It is very hard to describe the feeling of working with the understanding that our hospital could be destroyed at any moment. But when situations become tense, I will not think of myself. I choose instead to focus on my patients, my family and friends, and my country.

The fighting has a huge impact on the Ukrainian medical system. To adapt to the rapidly changing needs of our patients, we are creating systemic approaches and new protocol for transfusion, surgery, and other procedures while many of our hospitals are under constant threat of attack. The challenge adding complexity to every effort is that the supply chain is broken. On top of that, we are still dealing with COVID-19. But we are working to close gaps in care, and we will do everything we can to protect patients.

We have mass casualty protocol, but we have never had an incident before. There are many practical questions, which entrance or exit to use, how many people to allocate in certain areas, what are the most effective ways to triage and treat patients, and how to get materials where they are needed. Many physicians are sleeping in the hospitals because it is the safest place to be and we are truly living the values of emergency medicine, we must be ready for anything at any time.

We are also training civilians to provide first aid. Hundreds of professionals are training civilians to apply tourniquets, to stop bleeding, and do CPR. Many civilians are working with our military to protect people and help guard their cities. We will need training supplies to teach people what to do when severe injuries occur. Hopefully this effort will limit preventable deaths, improve real time response, and take some of the strain off the medical system.  

It is worth mentioning that we will treat Russians in my hospital if we have the chance. We will treat any injured people because that is what emergency physicians do, and, in our hearts, we are a peaceful nation. We are doctors for all who need medical attention. I am so proud of my colleagues and my country. We are living and working in an incredibly difficult situation, but emergency physicians are prepared to save lives and save Kyiv.

Vitaliy Krylyuk, MD, is the ACEP liaison to Ukraine and an emergency physician with the Ukrainian Scientific and Practical Center of Emergency and Disaster Medicine, a division of Ukraine’s Ministry of Health.  

ACEP proudly supports emergency physicians in Ukraine but does not organize direct response. The association and its international membership section have extensive resources for physicians who work, or wish to work, in areas where coordinated response to disasters and crises is required across the world.

Emergency physicians who wish to assist during a disaster or crisis are encouraged to join an international medical response team. If you’re interested in donating money or resources to Ukraine, you can find a list of charities and disaster relief organizations here

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