In medicine, triage is a process by which care providers such as medical professionals and those with first aid knowledge determine the order of priority for providing treatment to injured individuals and/or inform the rationing of limited supplies so that they go to those who can most benefit from it. Triage is usually relied upon when there are more injured individuals than available care providers, or when there are more injured individuals than supplies to treat them.
Emergency tourniquets are cuff-like devices designed to stop severe traumatic bleeding before or during transport to a care facility. They are wrapped around the limb, proximal to the site of trauma, and tightened until all blood vessels underneath are occluded. The design and construction of emergency tourniquets allows quick application by first aid responders or the injured persons themselves. Correct use of tourniquet devices has been shown to save lives under austere conditions with comparatively low risk of injury. In field trials, prompt application of emergency tourniquets before the patient goes into shock are associated with higher survival rates than any other scenario where tourniquets were used later or not at all.
Battlefield medicine, also called field surgery and later combat casualty care, is the treatment of wounded combatants and non-combatants in or near an area of combat. Civilian medicine has been greatly advanced by procedures that were first developed to treat the wounds inflicted during combat. With the advent of advanced procedures and medical technology, even polytrauma can be survivable in modern wars. Battlefield medicine is a category of military medicine.
Major trauma is any injury that has the potential to cause prolonged disability or death. There are many causes of major trauma, blunt and penetrating, including falls, motor vehicle collisions, stabbing wounds, and gunshot wounds. Depending on the severity of injury, quickness of management, and transportation to an appropriate medical facility may be necessary to prevent loss of life or limb. The initial assessment is critical, and involves a physical evaluation and also may include the use of imaging tools to determine the types of injuries accurately and to formulate a course of treatment.
The Expert Field Medical Badge (EFMB) is a United States Army special skills badge first created on June 18, 1965. This badge is the non-combat equivalent of the Combat Medical Badge (CMB) and is awarded to U.S. military personnel and North Atlantic Treaty Organization (NATO) military personnel who successfully complete a set of qualification tests, including both written and performance portions. The EFMB is known for its adherence to its testing standards and, as such, requires strict attention to detail from candidates in order to receive a "GO" on its combat testing lanes. The pass rate for FY 2017 was 7%, making the EFMB one of the most difficult and prestigious Army special skill badges to earn.
Casualty evacuation, also known as CASEVAC or by the callsign Dustoff or colloquially Dust Off, is a military term for the emergency patient evacuation of casualties from a combat zone. Casevac can be done by both ground and air. "DUSTOFF" is the callsign specific to U.S. Army Air Ambulance units. CASEVACs by air today are almost exclusively done by helicopter, a practice begun on a small scale toward the end of World War II; before that, STOL aircraft, such as the Fieseler Fi 156 or Piper J-3 were used.
A combat medic is responsible for providing emergency medical treatment at a point of wounding in a combat or training environment, as well as primary care and health protection and evacuation from a point of injury or illness. Additionally, medics may also be responsible for the creation, oversight, and execution of long-term patient care plans in consultation with or in the absence of a readily available doctor or advanced practice provider. Combat medics may be used in hospitals and clinics, where they have the opportunity to work in additional roles, such as operating medical and laboratory equipment and performing and assisting with procedures.
Advanced trauma life support (ATLS) is a training program for medical providers in the management of acute trauma cases, developed by the American College of Surgeons. Similar programs exist for immediate care providers such as paramedics. The program has been adopted worldwide in over 60 countries, sometimes under the name of Early Management of Severe Trauma, especially outside North America. Its goal is to teach a simplified and standardized approach to trauma patients. Originally designed for emergency situations where only one doctor and one nurse are present, ATLS is now widely accepted as the standard of care for initial assessment and treatment in trauma centers. The premise of the ATLS program is to treat the greatest threat to life first. It also advocates that the lack of a definitive diagnosis and a detailed history should not slow the application of indicated treatment for life-threatening injury, with the most time-critical interventions performed early.
ABC and its variations are initialism mnemonics for essential steps used by both medical professionals and lay persons when dealing with a patient. In its original form it stands for Airway, Breathing, and Circulation. The protocol was originally developed as a memory aid for rescuers performing cardiopulmonary resuscitation, and the most widely known use of the initialism is in the care of the unconscious or unresponsive patient, although it is also used as a reminder of the priorities for assessment and treatment of patients in many acute medical and trauma situations, from first-aid to hospital medical treatment. Airway, breathing, and circulation are all vital for life, and each is required, in that order, for the next to be effective: a viable Airway is necessary for Breathing to provide oxygenated blood for Circulation. Since its development, the mnemonic has been extended and modified to fit the different areas in which it is used, with different versions changing the meaning of letters or adding other letters.
The term military medicine has a number of potential connotations. It may mean:
Combat medics of the United States military may put themselves at greater risk than many other roles on the battlefield. In recent conflicts, the enemies faced by a professional army may not have respect for the laws of war and may actively target combat medics for the significant value they have in keeping the unit combat-effective. Since the non-combatant status granted to medics may not always be respected, modern combat medics carry weapons for personal defense and in most Western armies are virtually indistinguishable from regular infantrymen.
Peter Meong Rhee is an American surgeon, medical professor, and military veteran. During his 24 years in the United States Navy, Rhee served as a battlefield casualty physician in Afghanistan and Iraq.
68W is the Military Occupational Specialty (MOS) for the United States Army's Combat Medic. 68Ws are primarily responsible for providing emergency medical treatment at point of wounding on the battlefield, limited primary care, and health protection and evacuation from a point of injury or illness. 68Ws are certified as Emergency Medical Technicians (EMT) through the National Registry of Emergency Medical Technicians (NREMT). However, 68Ws often have a scope of practice much wider than that of civilian EMTs. This specialty is open to males and females with minimum line scores of 107 GT and 101 ST on the Armed Services Vocational Aptitude Battery (ASVAB).
The 274th Forward Surgical Team (Airborne)—part of the 274th Forward Resuscitative and Surgical Detachment (Airborne)—is an airborne forward surgical team of the United States Army providing Level II care far forward on the battlefield. It was first constituted in 1944 and served in Europe during World War II. More recently it has been involved in relief operations following natural disasters and has undertaken several recent deployments to Iraq and Afghanistan. The 274th Forward Surgical Team was part of both the initial entry forces of Operation Enduring Freedom in 2001 and Operation Iraqi Freedom in 2003. Currently the unit falls under the command of the 28th Combat Support Hospital and is based at Fort Bragg, North Carolina.
Tactical Emergency medical services (TEMS) is out-of-hospital care given in hostile situations by specially trained practitioners. Tactical support provided through TEMS can be applied in either the civilian world, generally with special law enforcement teams such as SWAT and SERT, as well as with military special operations teams. Tactical EMS providers are paramedics, nurses, and physicians who are trained to provide life-saving care and, sometimes, transport in situations such as tactical police operations, active shooters, bombings, and natural disasters. Tactical medical providers (TMPs) provide care in high risk situations where there is an increased likelihood for law enforcement, civilian, or suspect casualties. TEMS units are also deployed in situations where traditional EMS or firefighters cannot respond. TMPs are specially trained and authorized to perform live-saving medical procedures in austere and often times unconventional environments. TMPs are also expected to be competent in weapons safety and marksmanship, small unit tactics, waterborne operations, urban search and rescue, and HAZMAT. TMPs also serve to train their respective teams in complex medical procedures that may be performed in their absence. TEMS providers are sometimes sworn police officers cross trained as paramedics, paramedics that are operators trained and integrated into the SWAT Team, or medical providers trained in tactical EMS who are then integrated into law enforcement or military units.
QuikClot is a brand of hemostatic wound dressing that contains an agent that promotes blood clotting. The brand is owned by Teleflex. It is primarily used by militaries and law enforcement to treat hemorrhaging from trauma.
William 'Will' R. Smith, is an emergency physician and wilderness medicine consultant who lectures about integrating combat medicine into wilderness rescues around the world. He started Wilderness & Emergency Medicine Consulting, a company that helps people with pre-trip planning, online medical support, travel medicine in remote areas and provides expert witness testimony in court cases related to wilderness medicine. As medical director for the National Park Service, he oversaw the largest rescue event ever to occur in Grand Teton National Park. He lives in Jackson, Wyoming, where he is an emergency medicine physician at St. John’s Medical Center.
Homer Chin-nan Tien is a Canadian trauma surgeon and the president and CEO of Ornge, an air ambulance non-profit based on Ontario. He also holds the rank of colonel in the Canadian Forces Health Services, associate professorship at the University of Toronto, and was the former director of Trauma Services at Sunnybrook's Tory Regional Trauma Centre. He is the first to hold the Canadian Forces Major Sir Frederick Banting Term Chair in Military Trauma Research.
Prolonged field care refers to the specialized medical care provided to individuals who have sustained injuries or illnesses in situations where timely evacuation to a medical facility is delayed, challenging, or not feasible. This concept is applicable in various contexts, including military operations, wilderness emergencies, and disaster response scenarios. Definitions exhibit slight variation, but they convey the same fundamental meaning:
"Field medical care, applied beyond doctrinal planning time-lines"
"Field medical care that is applied beyond 'doctrinal planning time-lines' by a tactical medical practitioner in order to decrease patient mortality and morbidity."
"Prolonged care is provided to casualties if there is likely to be a delay in meeting medical planning timelines"
