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When injuries occur on the battlefield, caring for an injured patient is completely different than in “civilian” conditions. You can learn this way of helping – this is what battlefield medicine deals with. How does it work? Agnieszka Słupecka, the head of the Postgraduate Education Center of the Military Institute of Medicine, explains in an interview with PAP.
- Battlefield medicine deals with the specific types of injuries that arise under specific conditions. Intervention, therefore, requires actions outside the “classical” canon
- When treating an injured person, it is necessary, inter alia, to prevent other people from being injured as well
- The issue of weapons can also be a problem. The person providing help must be able to secure it
- More current information can be found on the Onet homepage.
What is battlefield medicine?
Battlefield medicine is – as he says – saving lives in extreme conditions. It is based on the rapid implementation of measures to stop death, which may occur as a result of bleeding, airway obstruction or other injuries.
“In other words, battlefield medicine deals with specific injuries under specific conditions,” he explains.
Słupecka reminds that the nature of injuries suffered by a person as a result of combat measures is different than those known from accidents in civil conditions. In addition, aid is provided in difficult circumstances, and the place where it is provided must correspond to the situation on the battlefield, so that it does not bring more injuries.
Therefore, he says, the principles and guidelines of the TCCC (Tactical Combat Casualty Care), developed by the Americans and which have been used since the mid-90s to minimize the number of deaths, are based on the idea of providing specific help in a specific place.
Słupecka points out that in the Care Under Fire zone, massive haemorrhages are stopped and a safe place is sought.
In the next zone, which is relatively safe (Tactical Field Care), additional tests and other procedures can be performed, such as opening the airway or securing chest injuries. In this zone, the threat from the enemy is still real.
It is only in the next zone, called Tactical Evacuation Care, that the injured is prepared for evacuation to the next levels of assistance, e.g. to a field hospital.
“When assisting the wounded, we follow the MARCHE protocol” – explains Słupecka. «Thanks to the use of the MARCHE protocol, we systematically examine and provide treatment to the wounded, paying attention to the most common causes of death on the battlefield, such as massive hemorrhages, obstructed airways and pneumothorax. The ability to act according to the protocol guarantees the highest possible quality of care, even in difficult and very stressful conditions »- she emphasizes.
Civilians can also help. They must know how to handle the weapon
At the same time, he points out that battlefield medicine is not only its military part, understood as a front on which soldiers suffer combat injuries. The other side of battlefield medicine is – as he emphasizes – events, also with the use of weapons, taking place in the civilian area.
«Here, help is much more likely to victims of incidents by civilians, not by soldiers. The difference is significant, because a civilian is usually a person who has not received training in the use of a firearm, so if he is going to provide help to a person who has a weapon, he must first of all know how to protect it for his own and the victim’s safety, and if the assistance will continue to be provided under conditions threats, for example under fire, must know how to first take care of their own and the victim’s safety, and then effectively start helping the victim »- says Słupecka.
«A civilian will know this after appropriate training. At WIM, we take great care to show and apply this distinction. And so, in the field of medical assistance provided in battlefield conditions, we have two programs, educational paths »- she added.
She pointed out that one of them is intended for soldiers, people who use weapons professionally. This is the TC3 (or TCCC – Tactical Combat Casualty Care) course curriculum.
The second is a program for civilians who have not been trained in the use of weapons. The program for providing tactical assistance, but in the civilian environment, is called TECC (Tactical Emergency Casualty Care) and is intended, inter alia, for non-armed civilian medical personnel, e.g. for paramedics.
“At WIM, we conduct TECC training and, based on TCCC guidelines, TERM-PM training, i.e. tactical and evacuation medical rescue for medical personnel,” he emphasizes.
Słupecka emphasizes that WIM also conducts a completely unique in the country and very specialized EWS (Emergency War Surgery) course, intended for both military and civilian medical personnel, preparing them to care for the wounded as a result of combat measures.
The course – as she said – is several days long. It has a lecture part devoted to the basics of battlefield medicine, types of war injuries and methods of their supply, transfusion therapy in combat injuries and anesthetic care for casualties in combat conditions, but most of the classes are practical classes.
The practical part, he says, is devoted to practicing skills using simulation methods and is conducted by specialists, doctors with experience gained on military and civilian missions abroad.
Słupecka points out that the Military Institute of Medicine is constantly educating medical personnel. Doctors do postgraduate internships and then can study in a selected field of medicine during specialization training.
«At WIM, we are accredited to implement 48 specialization paths. At the Military Institute of Medicine, nurses and midwives also carry out specialist training, as well as qualification and specialist courses. In addition, at the Military Institute of Medicine, on the basis of the Postgraduate Education Center, medical personnel can constantly improve their qualifications at numerous courses and trainings, which are conducted in the Medical Simulation Laboratory with the use of highly specialized training equipment. There are high-fidelity simulators, phantoms, and trainers. These courses are conducted by instructors from the Battlefield Medicine and Medical Simulation Department »- she indicated.
She stated that in recent years, under the project “Improving the security and protection of soldiers on missions by operating in the military-medical and technical areas”, AFGAN for short, a total of nearly 1000 soldiers have been trained in several stages. More than 700 soldiers were trained at the basic level, aimed at soldiers without medical education. They took part in the practical Tactical First Responder training, held on site in units, where rescue procedures were taught in a tactical environment.
At the advanced level (training for medical personnel only) in three stages, in 2017-2021, a total of nearly 250 soldiers were trained. They took part in advanced training in the field of care for the injured – Trauma Room training. It was a training based on the experience gained from the missions in Iraq, Afghanistan and the Military Institute of Medicine Trauma Center. (PAP)
Author: Katarzyna Lechowicz-Dyl
ktl / joz /
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