Tactical Medicine—The Israeli Revised Protocol

Abstract

Limited conflicts and the war against terrorism, in particular, have changed the emphasis in the present trend from preparing to cope with full-scale wars to the need to combat in limited conflicts. This shift has affected significantly medical units' preparations. Law enforcement organizations have come together with medical first responders in a combined new model. This model is supposed to be adopted and utilized in combat and evolved from the civilian model toward a modus operandi that combines the tactical and medical protocols into a single algorithm, the "Tactical Combat Casualty Care" (TCCC). This TCCC model is believed to enhance the mutual understanding and cooperation of tactical and medical forces in combat and especially amongst special military units. Utilizing the model will be achieved by the development of well-matched standard operating procedures and sharing drills. All these acts are hoped to improve safety of the participating units and hopefully also the medical outcomes.

Fixing the Wounded or Keeping Lead in the Air—Tactical Officers' Views of Emergency Care on the Battlefield

“…Therefore, nurses and doc tors need to have an adequate knowledge of the military environment, and officers need to have a deeper understand ing of the medical field; in other words, both groups should have an understanding of each other's knowledge, since they have different goals to be carried out through their actions. 8 Leading emergency care on the battlefield means empha sizing the relationship and importance of cooperation between military and medical judgment. Therefore, it is important to be aware that tactical decisions based on med ical judgment can be detrimental to military success, and vice versa.8 Hence, military judgment is what has to ulti mately be the valid and respected authority; however, it is of utmost importance that, if the situation allows, there is a dialog between the medics and the tactical officer to be able to take medical judgments into account and make the bestinformed decisions.…”

Militär akutsjukvård i fält : när den övade verkligheten blir verklig

“…officeren vill lösa sin uppgift att slutföra sitt uppdrag och medicinalpersonalen vill rädda liv, vilket kan skapa problem när man ska ta hand om den skadade (Waldman, Richman & Shapira, 2012).…”

“…Det innebär att ta hand om den skadade på bästa sätt, minimera ytterligare förluster och maximera möjligheten att lyckas med uppdraget. Det taktiska beslutet måste göras av chefer som svar på skadeutfallet på enheten, vilket är svårt och komplicerat och kräver scenariobaserad träning (Waldman et al, 2012).…”

“…TCCC har i olika versioner implementerats i andra länders försvarsmakter: Israel (Waldman et al, 2012), Storbritannien (Hawley, 1998), Kanada (Savage et al, 2011), Australien och Nya Zealand (Butler & Blackbourne, 2012 (Lundberg, 2009). Utformningen av TCCC i andra länder beror på respektive lands hälsolagstiftning som styr vilken kompetens som krävs för att utföra vissa medicinska åtgärder (White, 1990).…”