TACTICAL MEDICINE INSPIRING CIVILIAN RESCUE MEDICINE IN THE MANAGEMENT OF HAEMORRHAGE

Abstract

 Accidents remain to be the most common cause of death amongst men of ages 10–39 and women of ages 5–24. The sudden occurrence of simultaneous multiple events or a mass casualty event with many patients suffering severe injuries, including severe haemorrhage, requires emergency medical personnel to modify the algorithms, which dictate their actions. The military war mission in Iraq and Afghanistan brought many experiences, which were used and applied to guidelines, which are now used for the management of patients experiencing trauma in the civilian sector. The current trauma ITLS (International Trauma Life Support) guidelines suggest to use compression bands or haemostatic dressings in order to control bleeding in case of massive haemorrhage. An example of this recommendation being used can be seen in the regional par­amedic station in Poznan, Poland, where each ambulance is outfitted with “rescue packages” to be used in the event of massive haemorrhage. This practice can also be seen in Great Britain as well as Germany, where local protocols recommend the use of medical equipment taken from tactical medicine. The use of such tools allows for achieving a greater chance of rapid and effective haemostatic control in the event of massive haemorrhaging. These tools allow for more efficient use of time at the scene of the event, reducing the time a patient spends at the scene, allowing more rapid transport to hospital and more specialised surgical support. Reducing the time spent at the scene of an event while carrying out important procedures such as stabilising the patient’s airway, stopping haemorrhage and immobilising the patient, markedly improves the survival of trauma patients.