Immediate Care of the Wounded (original) (raw)

Management of Wounds Sustained by British Forces on the Western Front, 1914-18

Topics in the History of Medicine Volume 3, 2023

This paper uses relevant primary and secondary sources to present the most important surgical advances which saved lives and limbs during the First World War. The first such advance was wound excision, the complete resection of devitalised and contaminated tissue, a procedure which had to be performed early before potentially lethal organisms had the chance to become established. Inappropriate over-reliance on antiseptics during the opening months of the conflict, coupled with delayed operative intervention, had resulted in many avoidable deaths from aerobic and anaerobic infections. Management of chest wounds was transformed when unsubstantiated fears about thoracotomy were dispelled and excision of such wounds became standard practice. Urgent laparotomy for penetrating abdominal wounds spared many an early death from blood loss or a later one from peritonitis. Effective resuscitation including blood transfusion and a better understanding of anaesthesia in severely compromised patients significantly improved chances of survival.

Combat casualty care research at the U.S. Army Institute of Surgical Research

Journal of the Royal Army Medical Corps, 2009

The Institute of Surgical Research is the U.S. Army's lead research laboratory for improving the care of combat casualties. The Institute follows a rigorous process for analyzing patterns of injury and the burden of disease to determine where research can be conducted in order to positively impact care. These analyses led the ISR to focus research on: preventing death from bleeding; developing improved pain control techniques; developing improved vital signs analysis techniques; improving the treatment of extremity injuries; preventing burn injuries on the battlefield; and improving critical care for combat casualties. This process has resulted in numerous improvements in care on the battlefield. Highlights include development, fielding, and efficiency testing of tourniquets and improved dressings for bleeding control. Significant progress has also been made in the resuscitation of combat casualties using blood products instead of crystalloid or colloid solutions. Improvements i...

Medical emergency and battlefield medicine

Disaster and Emergency Medicine Journal, 2019

A victim in a life-threatening situation is a big challenge for rescue services around the world. Especially in a situation where assistance is to be provided in conditions that also threaten rescuers. Such an event may occur, for example, in the conditions of the battlefield. In order to provide effective assistance, separate rescue systems had to be implemented, which on the one hand included effective assistance to the victim, and on the other, they adapted it to the battlefield. These systems allow limited exposure to the risk of health or life-threatening situations to the rescuers. The paramedic operating in the emergency medical system operates in the safe zone with the equipment in emergency backpacks, along with an ambulance and entities supporting the State Medical Rescue system. The victim is to receive full assistance according to current standards. The patient is to have all the tests done to confirm or rule out life-threatening injuries. Evacuation to the hospital takes place, if the situation requires, using equipment to fully immobilize the spine. Acting in combat conditions, a paramedic in a dangerous zone provides assistance to an injured person in the field of authorship or performs only simple activities to protect the basic life functions of the victim. It is only in a potentially safe zone that he uses emergency equipment stored in a rescue pack or a personal first aid kit. Evacuation of the victim takes place on a stretcher, which does not fully protect the victim with a spinal injury.

A Clinical Review on Basic Management of War Injuries / Mass Casualties

Journal of Bangladesh College of Physicians and Surgeons, 2010

Managing war injury is no longer the exclusive preserve of military surgeons. All surgeons require a sound grasp of the subject. Increasing numbers of non-combatants are injured in modern conflicts, and peacetime surgical facilities with expertise may not be available 1-2. One of the hallmarks of war injury is the early lethality of wounds to the head, chest, and abdomen; therefore, limb injuries form a high proportion of the wounds that present at hospitals during conflicts 3. However, it is still appropriate to be aware of the "Gold standard" of management 4. Aim The aim of this clinical review article is to describe the sequence of events of managing war injuries including mass casualties with triage, resuscitation and initial wound surgery by non-specialist surgeons with limited resources and expertise. Objectives 1. To understand the epidemiology of warfare injuries / mass casualties. 2. To know the fundamentals of wound ballistics and injury mechanisms. 3. To understand the principles of wound management. 4. To have a sound grasp of initial management principles when dealing with mass casualties .

Treatment of war wounds: a historical review

2009

The treatment of war wounds is an ancient art, constantly refined to reflect improvements in weapons technology, transportation, antiseptic practices, and surgical techniques. Throughout most of the history of warfare, more soldiers died from disease than combat wounds, and misconceptions regarding the best timing and mode of treatment for injuries often resulted in more harm than good. Since the 19th century, mortality from war wounds steadily decreased as surgeons on all sides of conflicts developed systems for rapidly moving the wounded from the battlefield to frontline hospitals where surgical care is delivered. We review the most important trends in US and Western military trauma management over two centuries, including the shift from primary to delayed closure in wound management, refinement of amputation techniques, advances in evacuation philosophy and technology, the development of antiseptic practices, and the use of antibiotics. We also discuss how the lessons of history are reflected in contemporary US practices in Iraq and Afghanistan.

ABC of conflict and disaster : principles of war surgery

Bmj British Medical Journal, 2005

Managing war injury is no longer the exclusive preserve of military surgeons. Increasing numbers of non-combatants are injured in modern conflicts, and peacetime surgical facilities and expertise may not be available. This article addresses the management of war wounds by non-specialist surgeons with limited resources and expertise. One of the hallmarks of war injury is the early lethality of wounds to the head, chest, and abdomen; therefore, limb injuries form a high proportion of the wounds that present at hospitals during conflicts. Wounding patterns Gunshot wounds The incidence of gunshot wounds in conflict depends on the type and intensity of the fighting. In full scale war the proportion of casualties injured by gunshot is generally less than in low intensity or asymmetric warfare. Bullets cause injury by: x Direct laceration of vital structures x Stretching of tissue (cavitation), causing fracturing of blood vessels and devitalisation of tissue