Contents
«The basis of combat medicine is fire advantage. The best medic is first and foremost a soldier and another rifle. (…) The first rule? Fire back, fire back, fire back, change magazine, fire back. This is medicine too. We save our lives and those of everyone around us, including the wounded »- says Cpt. Magdalena Kozak, a military doctor, in an interview with Piotr Zychowicz, who runs the Historia Realna channel on YouTube.
- Magdalena Kozak is a captain of the Polish Armed Forces, a doctor of emergency medicine. It served, inter alia, in Afghanistan, where she provided medical aid to wounded soldiers and civilians
- In an interview with Piotr Zychowicz, he talks about how battlefield medicine differs from civilian medicine, how to help the wounded who are under fire, how to evacuate them when the enemy retreats and how to work in a field hospital which is under fire
- During one of the missions, she herself was injured. A rocket was aimed at the part of the base where the medics were staying
- The captain also referred to the current situation in Ukraine. «The work of medics in Ukraine is a work in the reality of a mass incident. The number of injured people exceeds the strength and resources of medical personnel. Then we are not able to provide everyone with sufficient medical care at the best possible level. This is disaster medicine, we aim to save as many people as possible »- he explains
- You can follow the current situation in Ukraine in our live coverage
- More current health information can be found on the Onet homepage
Battlefield medicine – the most important «rules of the game»
“Battlefield medicine takes place in completely different conditions than our civil medicine” – said Cpt. Magdalena Kozak, emphasizing that on the battlefield we cannot count on reaching the hospital in half an hour, an ambulance or a helicopter.
«In war medicine, a medical helicopter will or may not be (…). We have a medic who has what he carries with him in his medical backpack. So we have very limited possibilities of providing medical assistance »- he emphasizes.
During a military conflict, medical assistance is provided primarily to soldiers. However, this is not the only group of people who need help. Civilians who were wounded during the fighting as well as enemy forces, if necessary, are also sent to the field hospital. A doctor is always a doctor, committed to saving every life, no matter what side of the conflict the victim is on.
As the military doctor explains, the “rules of the game” that govern tactical and combat care over the injured are based on lessons learned from previous wars. Based on these experiences, patients are assigned to specific categories of injured. This is done in a similar way to the basic medical procedure of tria.
- See also: The red patient is the priority, the black patient cannot be saved. What is medical segregation – trio?
The first group includes people for whom there is no rescue. “If someone has a head torn off, the best medic will not help” – says Cpt. Cossack.
The second group of patients includes those whose injuries are not serious enough to be life threatening. These are, for example, people with a sprained ankle or a torn tendon. “It is unpleasant, painful, but even if the medic does not lift a finger in his shoe, such a person will live” – explains the doctor.
The third group consists of patients who are the focus of battlefield medicine, that is, people who will die if medical attention is not given to them, in the right place and at the right time. This is called death to be avoided. Among the most common injuries included in this category are hemorrhages and bleeding from the limbs, but also upper respiratory tract obstruction and tension pneumothorax (pulmonary, pleural).
The rest of the text below the video.
What does helping a wounded during the war look like?
When it comes to helping a soldier, it all depends on at what stage of the fights the injuries occurred. There are three phases of helping the injured person. The first is care under fire, the second is care after the attack, when it is calmer, the third is evacuation from the battlefield.
“There is not much we can do in the first phase” – admits Capt. Cossack. «If a soldier is shot in the leg during a firefight, all that can be done is self-help. Each soldier is trained to use a tactical tourniquet. For example, if he’s hit in the thigh, which is nasty, because you can bleed to death from a femoral artery in three minutes, he’ll help himself and… keep shooting. (…) The first rule: answer with fire, answer with fire, answer with fire, change the magazine, answer with fire. This is medicine too. We save our lives and those of everyone around us, including the wounded »- he adds.
In a situation where a wounded soldier is under a hail of bullets, it is only possible to develop an evacuation plan, always considering the consequences of such action. The doctor’s story shows that sometimes a soldier is able to reach a safer place on his own, or rather crawl. Sometimes his companions are able to help him, but the medics will certainly not run into the very center of the fire to evacuate the victim. The best they can do is prepare to dress him up when the attack is repelled.
What is the procedure for saving a wounded person’s life? First, it is always checked whether the visible wound is the only one, or there are others that cannot be seen at first glance. Later, a physical and physical examination is carried out, in the meantime, evacuation is organized. «Evacuation can be a cassette or a medic. Kasewak, that is, just about anything, just home, to the base, to the hospital. Medywak is when a medical helicopter arrives » – explains the captain.
How does a field hospital work?
The injured person goes to a field hospital at a military base. There, medical personnel is waiting for him: surgeon, emergency medicine doctor, orthopedist, nurses, paramedics. As the doctor explains, they are all well informed about how many injured people are arriving or arriving and what is wrong with them. «Usually they are gunshot wounds, injuries, because, let’s agree, nobody will come with diabetes, high sugar, asthma attack or other internal diseases. Healthy young men go to war »- he reminds.
The wounded first goes to the so-called trauma, i.e. the equivalent of the civil SOR. There, it undergoes preliminary examinations, X-rays, basic laboratory tests, complete physical examination, often also trauma fast ultrasound. Only later does he go to the operating room. Interestingly, the victims rarely undergo full surgery.
«In the operating room, damage control surgery takes place, but in the field of damage control. The field hospital won’t do the entire operation. There are situations when the wounded is so badly injured that (…) the surgeon will catch what to catch, stop the bleeding, sew up temporarily and send [the patient – ed.] By helicopter to another hospital » – explains. Only there is the victim completely and ultimately operated on. “We want him to survive, live,” adds Capt. Cossack.
Operations are also taking place under fire
The job of a military doctor on a mission is full of challenges. One of the biggest is working under fire. Capt. Magdalena Kozak has a lot of experience in it. «There were times when there was shelling at the base, and we have a patient on the table, anesthetized, asleep. And what, we say: you will wait here, and we will go to the shelter, when the shelling ends, we will come back and deal with you further? It is known that it is not done like that »- he points out, adding how fast one operates under fire and how slowly, on the other hand, time passes.
As an example, she mentions a situation where a victim is put on a plaster. It takes very quickly, and the longest, though still only a few minutes, is for the material to set. “When there is fire, the cattle lasts five times longer” – he says.
Everyone is at risk in the event of an attack on the base, including the medics. The captain herself repeatedly assisted in operations while the shelling was in progress. Doctors try to focus on the operation as much as possible. During the mission in Afghanistan, the signal that the danger had increased was the behavior of one of the instruments, who was walking to the corner of the operating room, putting on a bulletproof vest and a helmet and sighing in resignation: “They’re shooting again.”
Bulletproof vests certainly increase the safety of medical personnel, but as Piotr Zychowicz’s interlocutor emphasized, it is impossible to work in them. She once went for an operation wearing such a vest, but she regretted it quickly – the spine was extremely strained, which was very troublesome during a long operation.
Doctors can also be injured
The fact that the danger is real is also evidenced by the rocket attack that the doctor experienced firsthand. She was then in the base, the rocket hit the place where the medics – a captain, an orthopedist and two lifeguards – were staying overnight. Luckily, the wounds she sustained weren’t serious. The doctor was able to go outside on her own, but instead of taking care of herself, she started to look for the wounded and try to help them. It was only when one of the soldiers approached her and noticed her wounded, bare feet that she realized she was injured.
Capt. Magdalena Kozak also answered the question of what is the difference between battlefield medicine in the Middle East and the work of doctors in Ukraine.
«The work of medics in Ukraine is a work in the reality of a mass incident. The number of injured people exceeds the strength and resources of medical personnel. We are unable to provide everyone with sufficient medical care at the best possible level. This is disaster medicine, we aim to save as many people as possible»- he explains, emphasizing that what we are talking about here are only our ideas about the situation there. It is difficult to imagine how tragic the situation of the victims is there and what challenges the doctors working there have to face on a daily basis.
- Also read: The war in Ukraine through the eyes of a doctor. “The sick ask for any help”
We encourage you to listen to the latest episode of the RESET podcast. This time we devote it to yoga. How to start your yoga adventure? How to benefit from it not only because of pain in the spine, joints or muscles? Check what non-obvious benefits this practice brings and what are the contraindications for practicing it. Listen:
You might also like:
- What is phantom pain?
- Post-traumatic stress disorder (PTSD) – causes, symptoms, treatment [EXPLAINED]
- These diseases and ailments exclude him from serving in the army. You won’t get category A