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Prehospital Lessons From the War in Ukraine: Damage Control Resuscitation and Surgery Experiences From Point of Injury to Role 2.
Quinn, John; Panasenko, Serhii I; Leshchenko, Yaroslav; Gumeniuk, Konstantyn; Onderková, Anna; Stewart, David; Gimpelson, A J; Buriachyk, Mykola; Martinez, Manuel; Parnell, Tracey A; Brain, Leonid; Sciulli, Luke; Holcomb, John B.
Afiliación
  • Quinn J; Prague Center for Global Health, Prague 120 00, Czech Republic.
  • Panasenko SI; East Surrey Emergency Department, Redhill RH1 5RH, UK.
  • Leshchenko Y; Department of Surgery No 3, Poltava State Medical University, Poltava 36039, Ukraine.
  • Gumeniuk K; Armed Forces of Ukraine, 02000, Ukraine.
  • Onderková A; Ukrainian Armed Forces (UKR), Headquarters of Medical Forces of Military Forces, Kyiv 03168, Ukraine.
  • Stewart D; Department of Oncology, Division of Surgery, University College London Hospital, London NW1 2BU, UK.
  • Gimpelson AJ; Emergency & Deployed Medicine San Diego, California, USA.
  • Buriachyk M; New England Health Solutions, Manchester, NH, USA.
  • Martinez M; Shupyk National Healthcare University of Ukraine, Ukraine.
  • Parnell TA; Unconventional Medicine LLC Miami, Miami, FL, USA.
  • Brain L; Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
  • Sciulli L; NewYork-Presbyterian Brooklyn Methodist Hospital Emergency Department.
  • Holcomb JB; Auton Lab, Carnegie Mellon University, Pittsburgh, Pennsylvania, USA.
Mil Med ; 189(1-2): 17-29, 2024 Jan 23.
Article en En | MEDLINE | ID: mdl-37647607
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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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Servicios Médicos de Urgencia / Incidentes con Víctimas en Masa Tipo de estudio: Guideline Límite: Humans País/Región como asunto: Europa Idioma: En Revista: Mil Med Año: 2024 Tipo del documento: Article País de afiliación: República Checa Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Servicios Médicos de Urgencia / Incidentes con Víctimas en Masa Tipo de estudio: Guideline Límite: Humans País/Región como asunto: Europa Idioma: En Revista: Mil Med Año: 2024 Tipo del documento: Article País de afiliación: República Checa Pais de publicación: Reino Unido