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Is There One Optimal Medical Treatment and Evacuation Chain for All Situations: “Scoop-and-Run” or “Stay-and-Play”

Published online by Cambridge University Press:  28 June 2012

Maarten J.J. Hoejenbos*
Affiliation:
Colonel Royal Netherlands Navy (retired)
John McManus
Affiliation:
US Army Research Program for Combat Casualty Care, US Army Institute of Surgical Research; San Antonio Uniformed Services Health Education Consortium
Timothy Hodgetts
Affiliation:
Academic Department of Military Emergency Medicine, Birmingham Research Park, Birmingham, UK
*
Col (Royal Netherlands Navy) retired Van Kempenhof 20, 2111 TN Aerdenhout, the Netherlands E-mail: mjjhoejenbos@quicknet.nl

Abstract

In 2006, the Ministry of Defense of the Netherlands initiated a targeted agenda program for the World Congress on Disaster and Emergency Medicine in Amsterdam in 2007 (15WCDEM). The issue to be discussed was if there is one “golden” treatment and evacuation system that is applicable for different military and civilian situations. And, if there is not such a system, which parameters are important to construct the most optimal system for each different situation. This issue is related to the applicability and evidence base of the standards of the North Atlantic Treaty Organization.

A group of experts started a website discussion on the issue during December 2006. During the 15WCDEM, several other participants were active in the discussion.

Using the different experiences and the outcome of the discussions, it was concluded that there is not one “golden” medical emergency system, there are no “golden” timelines, and no “golden” skills. A medical system should be flexible and be able to adjust on each specific, local situation. First responder and non-medical people with medical skills (first responders) are essential in the front line of the emergency medical systems. More research is needed on the medical techniques and skills that are most effective early in the treatment and evacuation systems. Lessons learned from the military system are relevant for the civilian emergency medical services and vice-versa. The World Association for Disaster and Emergency Medicine can be an important platform to share and exchange information between these two systems.The target of the platform should be to obtain a generic picture of the important elements in prehospital emergency medical care.

Type
Tap Report
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2008

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References

1. North Atlantic Treaty Organization Allied Joint Publication 4-10, Allied Joint Medical Support Doctrine. North Atlantic Treaty Organization MC 326/2, Nato Principles And Policies Of Operational Medical Support.Google Scholar
2.Tadmor, B, McManus, J, Koenig, KL: The art and science of surge: Experience from Israel and the U.S. military. Acad Emerg Med 2006;13(11):11301134. Epub 2006 Oct 2.CrossRefGoogle ScholarPubMed
3.Holcomb, JB, Salinas, J, McManus, JM, Miller, CC, Cooke, WH, Convertino, VA: Manual vital signs reliably predict need for life-saving interventions in trauma patients. J Trauma 2005;59(4):821828; discussion 828–829.Google ScholarPubMed
4.Walters, TJ, Wenke, JC, Kauvar, DS, McManus, JG, Holcomb, JB, Baer, DG: Effectiveness of self-applied tourniquets in human volunteers. Prehosp Emerg Care 2005;9(4):416422.CrossRefGoogle ScholarPubMed
5.Do, JR, McManus, J, Harrison, B: Use of ultrasonography to avoid an unnecessary procedure in the prehospital combat environment: A case report. Prehosp Emerg Care 2006;10(4):502506.CrossRefGoogle Scholar
6.Holcomb, JB, Niles, SE, Miller, CC, Hinds, D, Duke, JH, Moore, FA: Prehospital physiologic data and lifesaving interventions in trauma patients. Mil Med 2005;170(1):713.CrossRefGoogle ScholarPubMed
7.McManus, J, Yershov, AL, Ludwig, D, Holcomb, JB, Salinas, J, Dubick, MA, Convertino, VA, Hinds, D, David, W, Flanagan, T, Duke, JH: Radial pulse character relationships to systolic blood pressure and trauma outcomes. Prehosp Emerg Care 2005;9(4):423428.CrossRefGoogle ScholarPubMed
8.Eastridge, BJ, Owsley, J, Sebesta, J, Beekley, A, Wade, C., Wildzunas, R, Rhee, P, Holcomb, J: Admission physiology criteria after injury on the battlefield predict medical resource utilization and patient mortality. J Trauma 2006;61(4):820823.CrossRefGoogle ScholarPubMed
9.Wedmore, I, McManus, JG, Pusateri, AE, Holcomb, JB: A special report on the chitosan-based hemostatic dressing: experience in current combat operations. J Trauma 2006;60(3):655658.CrossRefGoogle ScholarPubMed
10.Cooke, WH, Salinas, J, McManus, JG, Ryan, KL, Rickards, CA, Holcomb, JB, Convertino, VA: Heart period variability in trauma patients may predict mortality and allow remote triage. Aviat Space Environ Med 2006;77(11):11071112.Google ScholarPubMed
11. North Atlantic Treaty Organization/RTO-MP-HFM-109: Combat Casualty Care in Ground-Based Tactical Situations: Trauma Technology and Emergency Medical Procedures. Report 2004.Google Scholar
12. North Atlantic Treaty Organization/RTO/HFM-131 Validation of Medical Surveillance Algorithms Phase 1: Combat Casualty Registry (no report yet).Google Scholar
13.Hodgetts, TJ, Hanlan, CG, Newey, CG. Battlefield First Aid: A simple, systematic approach for every soldier. J R Army Med Corps 1999;145(2):5559.CrossRefGoogle ScholarPubMed
14.Bar-Dayan, Y, Levy, G, Goldstein, L, Erez, Y, Levite, R, Bar, U, Marmor, M, Linn, G, Onn, E, Levi, Y: Physician versus paramedic in the setting of ground forces operations: Are they interchangeable? Mil Med 2007;172(3):301305.Google Scholar
15.Sohn, VY, Miller, JP, Koeller, CA, Gibson, SO, Azarow, KS, Myers, JB, Beekley, AC, Sebesta, JA, Christensen, JB, Rush, RM Jr : From the combat medic to the forward surgical team: The Madigan model for improving trauma readiness of brigade combat teams fighting the Global War on Terror. J Surg Res 2007;138(1):2531.CrossRefGoogle Scholar
16.Chapleau, W: PHTLS (Prehospital Trauma Life Support) overseas. Emerg Med Serv 2001;30(5):140143.Google ScholarPubMed
17.Butler, FK Jr : Tactical medicine training for SEAL mission commanders. Mil Med 2001;166(7):625631.CrossRefGoogle ScholarPubMed
18.Butler, FK Jr, Hagmann, J, Butler, EG: Tactical combat casualty care in special operations. Mil Med 1996;161 Suppl:316.CrossRefGoogle ScholarPubMed
19.Weldon, CB, Silberfein, E, Chehardy, PL, McSwain, NE Jr.: ATLS training: A novel approach. Bull Am Coll Surg 2002;87(4):1519.Google ScholarPubMed
20.Thies, K, Gwinnutt, C., Driscoll, P, Carneiro, A, Gomes, E, Araujo, R, Cassar, MR, Davis, M: The European Trauma Course—From concept to course. Resuscitation 2007;74(1):135141.CrossRefGoogle ScholarPubMed
21.Battlefield Advanced Trauma Life Support (BATLS). J R Army Med Corps 2004;150(1):3240.CrossRefGoogle Scholar