Tourniquet use on the battlefield

This article examines the history of battlefield tourniquets. The tourniquet, if used properly, is perhaps the leading lifesaving device available to soldiers in the field. However, tourniquet use has been surrounded throughout history by controversy and dogma which continue today. Only after examining the historical context of warfare, weapons, injuries, and medical thought can we gain insight into the proper role of the tourniquet on the modern battlefield.     

远程医学和远程医疗野战化

远程医学是借助电子通信手段把医学信息从一处传送到另一处,其目的是提高医疗诊治水平。远程医疗野战化则是将远程医学系统和特殊装置应用于战场上,为伤病员提供优质医疗服务。该文综述了远程医学的发展历史和系统的组成;美军远程医疗野战化的基础装备,主要内容及其在卫勤中的实际应用。     

Logistics of parenteral fluids in battlefield resuscitation.

The paper discusses the substantial reduction in weight and volume of the fluids of resuscitation that is possible and desirable on the basis of sound physiology and the vast experience of the U.S. Army in four major wars in this century. We note the major shift in emphasis from massive colloid and whole blood in World War II and Korea to massive crystalloid and packed cells in Vietnam and the serious complications with which this was associated. These complications were edematous in nature and best known as the Da Nang lung, or adult respiratory distress syndrome, multiorgan dysfunction syndrome, and systemic inflammatory response syndrome. The advantage of colloid in reducing the weight and volume of resuscitation fluids in forward areas by 60% to 90%, as well as in avoiding the edematous complications of crystalloid-, are emphasized.     

战伤救治研究的需求探讨

通过对国内外有关研究的现状与发展的调查，探讨战创伤救治研究优先发展的方向。     

战场战伤救治技术概论

本文从止血、气道管理、固定搬运和后送四个方面,系统介绍了战场战伤急救技术。为了适应未来综合战场的形势,要加强战士战场战伤急救技术的训练和普及创伤相关知识。     

Prediction of simulated battlefield physical performance from field-expedient tests

Predictive models of battlefield physical performance can benefit the military. To develop models, 32 physically trained men (mean +/- SD: 28.0 +/- 4.7 years, 82.1 +/- 11.3 kg, 176.3 +/- 7.5 cm) underwent (1) anthropometric measures: height and body mass; (2) fitness tests: push-ups, sit-ups, 3.2-km run, vertical jump, horizontal jump; (3) simulated battlefield physical performance in fighting load: five 30-m sprints prone to prone, 400-m run, obstacle course, and casualty recovery. Although greater body mass was positively associated with better casualty recovery performance, it showed trends toward poorer performance on all the other fitness and military performance tests. Regression equations well predicted the simulated battlefield performance from the anthropometric measures and physical fitness tests (r = 0.77-0.82). The vertical jump entered all four prediction equations and the horizontal jump entered one of them. The equations, using input from easy to administer tests, effectively predict simulated battlefield physical performance.     

Data-based resource planning for battlefield trauma management.

Optimal medical care of the wounded soldier can be provided only if clinicians have appropriate supplies present in adequate quantities. At the same time, the battlefield environment requires maximum efficiency in resource utilization. Logistical support for field surgical units can be allocated more efficiently without compromising the quality of care by using a database derived from trauma patient management. The records of patients treated for gunshot wounds at an urban level I trauma center were reviewed and the use of medications at each stage of treatment was quantified. From this information, a database was compiled that could be used to predict medical resource requirements for combat scenarios. Such a database could be used to assist in planning logistical support, resulting in better tailoring of deployable medical unit resources to meet the actual needs of injured soldiers.     

海上伤病员智能担架系统的构建

海上伤病员智能担架系统是一种根据海上作战及水系灾难救援特点而研制的,集伤病员转运、生命保障系统、生命体征监测系统及信息储存处理系统、无线通讯系统于一体的现代化伤员转运装置,是未来海战和水系灾害救援中必备的卫生装备,具有对提高伤病员生存质量和部队战斗力起着重要的作用。海上伤病员智能担架具有材料坚固、轻便,抗电磁干扰,耐高盐、高湿、低温,数据采集与接收自动化、无线化、智能化,安全性能好等特点。海上伤病员智能担架将是未来海上作战及水系灾难救援担架的发展方向,并将发挥更为重要的作用。     

Cricothyroidotomy bottom-up training review: battlefield lessons learned

Challenges with surgical cricothyroidotomy on the battlefield can be attributed to limited frequency of use, procedure unfamiliarity, and limited knowledge base of anatomical landmarks of which is further heighten in the tactical environment. The objective was to identify ways to enhance the cricothyroidotomy training to minimize potential preventable procedural errors. A training review was conducted to determine the gaps in the cricothyroidotomy training in a 4-day Tactical Combat Casualty Care course at the Naval Medical Center Portsmouth. An ad hoc Working Group team identified five specific gap areas in the cricothyroidotomy training: (1) limited gross airway anatomy review; (2) lack of "hands-on" human laryngeal anatomy; (3) nonstandardized step-by-step surgical incision skill procedure; (4) inferior standards for anatomically correct cricothyroid mannequins; (5) lack of standardized refresher training frequency. Specific training enhancements are recommended across each day in the classroom, simulation laboratory, and field exercise.     

Issues related to the use of tourniquets on the battlefield

On the battlefield, a properly applied tourniquet can be an extremely effective means of controlling severe extremity wound hemorrhage. However, a great deal of confusion exists among soldiers, medics, and military medical officers on a number of tourniquet-related issues. What is an appropriate combat tourniquet? When is it appropriate to use a tourniquet? When and by whom should a tourniquet be removed? Under what conditions should a tourniquet not be released or removed? What are the most effective ways to increase limb salvage while using a tourniquet? These and other issues were addressed by a panel of experts at the 2003 Advanced Technology Applications for Combat Casualty Care Conference, August 21 and 23, 2003, St. Pete Beach, Florida. Here we review those issues and present a summary of the panel's recommendations.