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Aspects of military prehospital care

04 February 2011
Volume 3 · Issue 2


The military prehospital care experience has adapted civilian practice to reflect the nature of injuries sustained in recent conflicts. The main adaptations stem from differences in the mechanism of injury, clinical timelines and personnel. The large number of blast injuries and resulting extremity trauma means that an emphasis is placed on the control of catastrophic haemorrhage using a number of novel haemostatic strategies. This paradigm of <C>ABC is now universally followed and differs from civilian practice in a number of other ways— particularly in the management of C-spine, airway, chest injuries and circulatory access. This review highlights these differences in practice and outlines military techniques and protocols. It also emphasizes those areas in which civilian practice has borrowed from its military counterparts and successfully employed their techniques. This may become more relevant in the modern, post-September 11th era, in which urban mass casualty incidents are no longer a fictional fear.

Both military and civilian prehospital care provision are constantly evolving. Whereas the nature of conflict has changed in recent years, that change has also been reflected in the challenges faced by civilian prehospital care practitioners. Most notably since September 11th, 2001 (Cushman et al. 2003) and also following other large, urban mass casualty incidents (Bland et al, 2006; Carresi, 2008), civilian practitioners can also be faced with injuries similar to those seen in modern combat environments.

In recent years, military deployments in Iraq and Afghanistan have seen service medical personnel gain considerable experience in the prehospital management of severely injured casualties (Owens et al, 2008). This has necessitated the rapid evolution of both management algorithms and the equipment carried and used by prehospital teams (Hodgetts et al, 2006b).

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