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TACTICAL MEDICINE: BASIS

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Tactical medicine has the following slogan: “Right action at the right time!”

Early medical care is a factor that significantly improves the chances of survival and restoration of function in the wounded. That is why there is a concept of “golden hour” – the time after an injury during which qualified medical care should begin.

The main causes of death for 80-90% of the wounded were massive blood loss and shock. Injuries that occur in modern armed confrontations significantly limit the time for providing first aid on the battlefield. Death occurs from several tens of seconds to one hour.

There are three stages of providing assistance to the wounded in the field:

  1. Helping in the “red zone” (English. Care Under Fire” in the shelling zone); It mainly consists of using a tourniquet and moving the victims to a safe place as soon as possible.
  2. Assistance in the “yellow zone” (English. Tactical Field Care – “providing assistance on the battlefield/shelter zone”). Procedure:
https://sprotyv.mod.gov.ua/storage/2022/03/tac-med_01.png
https://sprotyv.mod.gov.ua/storage/2022/03/tac-med_02.png
  • Assess the condition of the wounded using the C-A-B-C rule (Critical Bleeding – Airway – Breathing – Circulation) and provide the wounded with the necessary assistance. Alternatively, you can fill out an adapted Protocol – a card similar to the picture above, which is filled out by a doctor or paramedic when providing first aid to a wounded person; This card can be filled in by the wounded or his fellow soldiers.
  • Examine the wounded for life-threatening bleeding.
  • Take the necessary measures to restore airway patency, including the insertion of a nasopharyngeal airway if necessary.
  • Treat any open chest injuries. In case of tension pneumothorax, decompress.
  • Check the condition of the tourniquet, if used. If you applied a tourniquet to a wounded person to stop bleeding from limb wounds during the stage of medical care under fire, check the bleeding.
  • Examine the wounded for minor bleeding.
  • Examine the casualty for any untreated wounds on the extremities that could be life-threatening and treat them.
  • Continue to treat other injuries (splinting fractures, dressing other wounds, burns, etc.).
  • Administer painkillers and antibiotics, preferably from the wounded person’s first aid kit if he or she has one. Do not use your own first aid kit if possible, as you may need it yourself.
  • Take the necessary measures to prevent the development of shock or provide assistance in case of shock that has already developed.
  • Pass the information about the wounded to medical personnel – a military paramedic (medical instructor) nearby, or a civilian doctor or paramedic, or call 103.
  • Keep an eye on the wounded. Monitor the level of consciousness every 15 minutes and the wounded person’s breathing. If he is conscious, you should talk to him whenever possible – to encourage him, to calm him down.
  • Record clinical examination data and information about the treatment measures taken.

3. Assistance during evacuation to medical facilities “green zone” (English. Tactical Evacuation Care) are mobile field hospitals, military or civilian hospitals, and specialized clinics. It mainly consists of timely escort to the place of non-medical or medical evacuation.

The procedure for providing first aid for bleeding:

https://www.facebook.com/okorniychuk/videos/198061995875826

Examples of stopping bleeding:

1. Apply a dressing package:

https://www.facebook.com/okorniychuk/videos/337544578309419

2. Use a pressure bandage: https://www.facebook.com/okorniychuk/videos/803943860564777

3. Imposing a turnstile:

https://www.facebook.com/okorniychuk/videos/999546567637886

https://www.facebook.com/okorniychuk/videos/507895160670937

4. C.A.T. turnstile installation – photo

The tourniquet is applied with one hand for 5-10 cm. above the wound site, usually as a self-help procedure on the upper limb (shoulder or forearm). When applying the tourniquet, apply maximum pressure until the bleeding stops.

https://sprotyv.mod.gov.ua/storage/2022/03/c-a-t-combat-application-tourniquet.png

5. Applying an improvised tourniquet with a belt folded in the form of a double loop:

https://sprotyv.mod.gov.ua/storage/2022/03/tac-med_03.png

Source: Center for National Resistance

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