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The authors describe the aims and content of anesthesiologic and reanimatologic care of the medical reinforcement group in the medical institution of the 1st echelon of specialized care. Basing on the experience of treatment of 825 casualties with gunshot injuries the rational methods of anesthesia and intensive care are shown including the prolonged controlled ventilation, infusion-transfusion therapy, early enteral nutrition. The main causes of lethal outcomes are analyzed. The conclusion was made that during counter-terrorist operations it is reasonable to include anesthesiologists and reanimatologists into the medical reinforcement group.

Approaches to validation of indications and contraindications for interventions in wounded patients and victims were developed on the basis of many-year experience. The desirability of intervention is determined primarily by strategic tasks which it solves. The operation is to be performed despite severe clinical condition if it removes the cause of critical state or creates conditions for preventing life-threatening complications of the traumatic disease. All the rest interventions can be postponed till complete or partial compensation of vital systems.

By the present time, many mathematical models have been developed for assessing the status of patients with grave mechanical injuries. However, comparative analysis of the efficacy of predicting the outcomes of shock and traumatic disease with the use of some models in patients with war and other than war traumas showed that these methods are not fit for cases with gunshot wounds. We consider that a differentiated approach is needed in assessment of the status of wounded and injured patients.