Prehospital Lessons From the War in Ukraine: Damage Control Resuscitation and Surgery Experiences From Point of Injury to Role 2

急诊分诊台 医学 医疗急救 紧急医疗服务 军事医学 复苏 重症监护医学 急诊医学 政治学 法学
作者
John Quinn,S. І. Panasenko,Yaroslav Leshchenko,К. В. Гуменюк,Anna Onderková,David Stewart,A J Gimpelson,Mykola Buriachyk,Manuel Martı́nez,T. A. Parnell,Leonid Brain,Luke Sciulli,John B. Holcomb
出处
期刊:Military Medicine [Oxford University Press]
卷期号:189 (1-2): 17-29 被引量:18
标识
DOI:10.1093/milmed/usad253
摘要

ABSTRACT The ongoing war in Ukraine presents unique challenges to prehospital medical care for wounded combatants and civilians. The purpose of this article is to identify, describe, and address gaps in prehospital care, casualty evacuation, and medical evacuation throughout Ukraine to share lessons for other providers. Observations and experiences of medical personnel were collected and analyzed, focusing on pain management, antibiotic use, patient assessment, mass casualty triage, blood loss, hypothermia, transport immobilization, and clinical governance. Gaps identified include limited access to pain management, lack of antibiotic guidance, inadequate patient assessment and triage, access to damage control resuscitation and blood, challenged transport immobilization practices, and challenges with clinical governance for both local and foreign providers. Improved prehospital care and casualty and medical evacuation in Ukraine are required, through increased use of empiric pain management, focused antibiotic guidance, enhanced patient assessment and triage in the form of training, access to prehospital blood, and better transport immobilization practices. A robust and active lessons learned program, trauma data capture, and quality improvement process is needed to reduce preventable morbidity and mortality in the war zone. The recommendations presented in this article serve as a starting point for improvements in prehospital care in Ukraine with potential to change prehospital training for the NATO alliance and other organizations operating in similar areas of conflict. Graphical Abstract
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