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Philosophy of tactical medicine

https://doi.org/10.17238/2072-3180-2024-4-171-182

Abstract

Introduction. The nature of modern wars and armed conflicts has changed significantly, new types of weapons have begun to be used, and combat tactics have significantly transformed. It is obvious that in such conditions, the medical care must undergo significant changes and adapt to modern realities. It is required to develop new and improve existing forms and principles of assistance based on taking into account, analyzing and rethinking their positive and negative aspects. One of the possible ways to accelerate the adaptation of the domestic medical care system to new realities should be considered the possibility of applying a number of provisions formed and actively used abroad in the concept of “tactical medicine”.

Materials and methods of research. Based on the analysis of a number of publications by leading domestic and foreign experts, as well as existing guidance documents, material is presented that allows us to form or supplement the understanding of the concept of “tactical medicine”.

Results. The main problems of organizing and providing medical care to the wounded at the prehospital stage are identified, and possible ways to solve them are outlined.

Conclusion. Failure to follow the agreed-upon charters, norms, and principles regarding prohibited methods of warfare, as well as the use of indiscriminate and excessive methods of destruction by the combatants, has led to a change in the pattern of combat casualties among soldiers and an increase in civilian casualties. Under these circumstances, it is crucial to develop new and enhance existing methods and principles of medical care. It is also necessary to organize a systematic, continuous, and comprehensive education process that covers a wide range of individuals who are trained and capable of providing first aid to victims. The findings should be integrated into a modern medical support system.

About the Authors

P. E. Krainyukov
Federal Institution "Central Military Clinical Hospital named after P.V. Mandryka" Ministry of Defense of the Russian Federation; Federal State Autonomous Educational Institution of Higher Education "Russian Peoples' Friendship University"
Russian Federation

Krainyukov Pavel Evgenievich – Doctor of Medical Sciences, Doctor of Military Sciences, Associate Professor, Major General of Medical Service, Head, 107014, Bolshaya Olenya 8A, Moscow;

Professor of the Department of Hospital Surgery with a course of pediatric surgery, 117198,
Moscow



V. V. Kokorin
Federal Institution "Central Military Clinical Hospital named after P.V. Mandryka" Ministry of Defense of the Russian Federation; Federal State Budgetary Institution “National Medical and Surgical Center named after N.I. Pirogov" Ministry of Health of the Russian Federation
Russian Federation

Kokorin Viktor Viktorovich – Senior Resident of the Surgical Department, 107014, Bolshaya Olenya 8A, Moscow;

MD, PhD, Associate Professor, Associate Professor of the Department of Thoracic and Cardiovascular Surgery with courses in X-ray endovascular surgery, surgical arrhythmology and surgical infections of the Institute for Advanced Medical Studies,105203, Moscow



N. O. Travin
Federal Institution "Central Military Clinical Hospital named after P.V. Mandryka" Ministry of Defense of the Russian Federation
Russian Federation

Travin Nikolay Olegovich – Doctor of Medical Sciences, Associate Professor, cardiovascular surgeon,

107014, Bolshaya Olenya 8A, Moscow



V. V. Rybkin
Federal State Budgetary Institution “354th Military Clinical Hospital (Military District) of the Central Military District” of the Ministry of Defense of the Russian Federation
Russian Federation

Rybkin Vasily Vadimovich – senior resident of the Center for Anesthesiology and Resuscitation, Intensive Care,

620144, Dekabristov St., 87, Yekaterinburg



References

1. Kraynyukov P.E., Samokhvalov I.M., Reva V.A. Tactical medicine is a new concept for «new type» wars. Military Medical Journal, 2021, vol 342, № 5, рр. 4–17. (In Russ.)

2. Pisarenko L.V., Gumenyuk S.A., Potapov V.I. Features of modern local wars and armed conflicts and problems of providing medical care to the population in the pre-hospital period. Disaster Medicine, 2022, № 4, рр. 68–72. (In Russ.)

3. Yusupov A.K., Lubyanoi V.I. The essence and classification of wars and military conflicts: the content and analysis of the problem in modern conditions. (In Russ.) URL: https://scienceforum.ru/2019/article/2018014030. (date of access: 07.11.2023)

4. Butler F.K.Jr., Hagmann J., Butler E.G. Tactical combat casualty care in special operations. Mil Med., 1996, Aug; № 161, рр. 3–16. https://doi.org/10.1007/978-3-319-56780-8_1

5. Kozolup A.P. On the question of the term «tactical medicine». Military Medical Journal, 2021, vol. 342, № 2, рр. 20–24. (In Russ.)

6. Handbook of Tactical Medicine. S-Pb: S.M.Kirov Mil Med Acad, 2022, 36 p. (In Russ.)

7. Mazurenko O.V., Roshchin G.G. Voloshin V.O. Tactical medicine as the main element of emergency medical care during anti-terrorist operations. Emergency Medicine, 2014, № 8 (63), рр. 96–99. (In Russ.)

8. Holcomb J.B., McMullin N.R., Pearse L., et al. Causes of Death in U.S. Special Operations Forces in the Global War on Terrorism: 2001-2004. Ann. Surg, 2007, v. 245, № 6, рр. 986–991. URL:10.1097/01.sla.0000259433.03754.98

9. Usov S.A., Schmidt T.V. Fundamentals of tactical medicine: the essence and content of the subject. Military-legal and humanitarian sciences of Siberia, 2023, № 1 (15), рр. 68–74. (In Russ.)

10. Вlасkbournе L.Н., Baer D.G., Eastridge B.J. et al. Military medical revolution: prehospital combat casualty саrе. J. Trauma Acute Саrе Surg., 2012, vol. 73, № 6 (Suppl. 5), рр. S372–S377.

11. Savage E., Forestier C., Withers N., Tien H., Pannell D. Tactical Combat Casualty Care in the Canadian Forces: lessons learned from the Afghan war. Can. J. Surg., 2011, vol. 54, Suppl. 6, рр. 118–123.

12. Samokhvalov I.M., Goncharov A.V., Chirsky V.S. [et al.] «Potentially salvageable» wounded are a reserve for reducing prehospital mortality in wounds and injuries. Emergency medical care, 2019, vol 20, № 3, рр. 10–17. (In Russ.). https://doi.org/10.24884/2072-6716-2019-20-3-10-17

13. Evich Yu.Yu. Tactical medicine of modern irregular warfare. Donetsk People’s Republic, 2016, 111 p. (In Russ.)

14. Zaitsev D.V., Fedorov K.S., Mezhin I.A., Katulin A.N. First aid (tactical medicine) in combat conditions. Educational and methodical manual. M., 2022, 114 p. (In Russ.)

15. Samokhvalov I.M., Shelepov A.M., Severin V.V. [et al.] Modern approaches to the study of sanitary and irretrievable surgical losses in military conflicts. Military Medical Journal, 2016, vol 337, № 5, 10–16. (In Russ.)

16. Lupentsov V.A., Kamenskaya E.V., Panov N.I., Maksimov D.N. First aid for damage to large blood vessels. Improving the system of organizing daily activities in formations, military units and organizations of the Ministry of Defense of the Russian Federation. Problematic issues and ways to solve them. Materials of the IV All-Russian scientific and practical conference. Omsk, 2023, pp. 168–176. (In Russ.)

17. Order of the Minister of Defense of the Russian Federation dated 09.12.2022 № 760 «On approval of the List of Conditions in which first aid is provided to Servicemen of the Armed Forces of the Russian Federation, Troops of the National Guard of the Russian Federation, Rescue military Formations of the Ministry of Civil Defense, Emergencies and Elimination of Consequences of Natural Disasters, the Foreign Intelligence Service of the Russian Federation, bodies of the Federal Service security, state security agencies, military prosecutor’s offices, military investigative bodies of the Investigative Committee of the Russian Federation, the Main Directorate of Special Programs of the President of the Russian Federation in wartime Conditions, conducting military (combat) operations, performing combat (combat training), service-combat (operational-service) tasks in the field of defense, as well as the rules for its provision» (In Russ.)

18. Kulnev S.V., Zhuravlev V.K., Taranov S.P., Elizariev S.V., Reva V.A. First aid to military personnel in combat conditions – organizational and legal aspect. Proceedings of the Russian Military Medical Academy, 2020, vol 39, № 4, рр. 3–10. (In Russ.)

19. Lamont T., Surkitt-Parr M., Scarpello J. et al. Insertion of chest drains: summary of a safety report from the National Patient Safety Agency BMJ, 2009, № 339, рр. b4923.

20. Helling T., Gyles N., Eisenstein C. Complications following blunt and penetrating injuries in 216 victims of chest trauma requiring tube thoracostomy. Journal of Trauma, 1989, № 10(29), рр. 1367–1370.

21. Millikan J., Moore E., Steiner E. et al. Complications of tube thoracostomy for acute trauma. Am J Surg., 1980, № 140, рр. 738–741.

22. Akoglu H., Akoglu E., Evman S. et al. Determination of the appropriate catheter length and place for needle thoracostomy by using computed tomography scans of pneumothorax patients. Injury, 2013, Sep; № 44 (9), рр. 1177–1182.

23. Chan L., Reilly K., Henderson C. et al. Complication rates of tube thoracostomy. Am J Emergency Med, 1997, № 4(15), рр. 368–370.

24. Etoch S., Bar-Natan M., Miller F. et al. Tube thoracostomy. Factors related to complications. Arch Surg., 1995, № 130, рр. 521–525.

25. Laan D., Vu T., Thiels C. et al. Chest wall thickness and decompression failure: A systematic review and meta-analysis comparing anatomic locations in needle thoracostomy. Injury., 2016, Apr; № 47 (4), рр. 797–804.

26. The Advanced Trauma Life Support. Student Course Manual. Tenth edition. American College of Surgeons, 2018. 474 p.

27. Salimov D.Sh., Vorobyov A.A., Vedenin Yu.I., Kraynyukov P.E., Glushkov I.V. Features of drainage of the pleural cavity in penetrating chest wounds at the stages of medical care. A study guide. Volgograd, 2022, 40 p. (In Russ.)

28. Samokhvalov I.M., Golovko K.P., Chuprina A.P. [et al.] The problem of eliminating open and stressed pneumothorax at the advanced stages of medical evacuation and ways to solve it. Military Medical Journal, 2020, vol. 341, № 3, рр. 23–32. (In Russ.)

29. Lupentsov V.A., Kulikovskikh I.R., Shovkun M.A., Rakhmonov F.K. Tactical medicine: first aid, first aid. In the collection: Improving the system of organizing daily activities in formations, military units and organizations of the Ministry of Defense of the Russian Federation. Problematic issues and ways to solve them. Materials of the IV All-Russian scientific and practical conference. Omsk, 2023, pp. 189–195. (In Russ.)

30. Usov S.A., Schmidt T.V. The evolution of prehospital care for the wounded in battle over 20 years of the 21st century and the training of cadets in first aid in combat trauma. Military-legal and humanitarian sciences of Siberia, 2022, № 2 (12), рр. 129–137. (In Russ.)

31. Order of the Ministry of Health of the Russian Federation dated October 28, 2020 № 1165n «On approval of requirements for the complete set of medicines and medical products for stowings and kits for emergency medical care» (as amended. Order of the Ministry of Health of the Russian Federation № 160n dated 13.04.2023). (In Russ.)

32. Pokhodyaev S.V., Krasnoshtanov A.E. Separation of the tactical first aid kit. Improving the system of organizing daily activities in formations, military units and organizations of the Ministry of Defense of the Russian Federation. Problematic issues and ways to solve them. Materials of the IV All-Russian scientific and practical conference. Omsk, 2023, pp. 158–163. (In Russ.)

33. IFAK Contents: What Soldiers Have in their Individual First Aid Kits. URL: https://www.primalsurvivor.net/ifak-contents / (date of access: 20.01.2022).

34. First aid equipment. URL: https://medicine.mil.ru/first-aid/firstaid-complects (date of aссess: 07.11.2023).

35. Miroshnichenko Yu.V., Samokhvalov I.M., Ivchenko E.V. [et al.] Comparative characteristics of domestic and foreign first aid on the battlefield and in the center of an emergency situation. Military Medical Journal, 2016, vol. 337, № 9, рр. 18–27. (In Russ.)

36. Kuzmin S.A., Grigorieva L.K. Organization of classes on the basics of tactical medicine with citizens of the Orenburg region called up for military service as part of a partial mobilization. Disaster medicine, 2022, № 4, рр. 50–52. (In Russ.)

37. Skorik Yu.V., Zaripova Z.A. Tactical and special medical training. Gunshot wounds. Part 1. Moscow: publishing house «Pero», 2022, 76 p. (In Russ.)

38. Elizariev S.V., Kadyrov S.K., Kukhtalyov V.V. Issues of improving the training of military personnel in first aid on the battlefield in modern warfare. Proceedings of the Russian Military Medical Academy, 2020, vol. 39, № S4, рр. 226–228. (In Russ.)

39. Zhdanov A.B., Seregin A.A., Andryushchenko A.P. Features of training reconnaissance units for survival in mountainous conditions. The direction of development of mountain training and sports held in mountainous areas. Collection of articles of the Interdepartmental scientific and practical conference. St. Petersburg, 2022, pp. 43–47. (In Russ.)


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For citations:


Krainyukov P.E., Kokorin V.V., Travin N.O., Rybkin V.V. Philosophy of tactical medicine. Moscow Surgical Journal. 2024;(4):171-182. (In Russ.) https://doi.org/10.17238/2072-3180-2024-4-171-182

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