Military Review

The Golden Hour of the Wounded Soldier

81
The Golden Hour of the Wounded Soldier


How does Israeli field medicine work

In military medicine, there is a key concept of the “golden hour” to assist the wounded on the battlefield: if full medical assistance is provided within the first hour after being wounded, it will save the lives of 90% of injured soldiers. The delay of death is similar - the delay in providing assistance for only two hours leads to the fact that the number of survivors after injury quickly falls to 10%.

The military medical service of the Israeli army is rightfully considered one of the most advanced. She recently improved the system for saving the lives of the wounded on the battlefield, reducing the “golden hour” to 43 minutes, which led to a marked increase in the number of saved lives. So, if during the Doomsday War in 1973, up to 35% of wounded soldiers died, then during Operation “Enduring Rock” in July-August of this year, the irretrievable loss among the wounded did not exceed 6%.

Doctor on the battlefield

Israel believes that the problem of the “golden hour” can be solved only as a result of a radical change in the entire multi-level structure of care for the wounded. Everything is important here: individual first-aid kits, dressing facilities, medical equipment, time and methods for evacuating the wounded.

However, the experience and knowledge of the military physician, who is able to assist in the first minutes after being wounded, is crucial in saving the lives of the wounded, and therefore the military doctor must go into battle with the soldiers. When a doctor who knows what to do is two minutes from the wounded, it changes the course of events.

In the framework of the traditional scheme in which military doctors work in the armies of most countries of the world, paramedics and orderlies usually provide first aid on the battlefield, and then a lot of time is spent on evacuating the wounded to the rear. The injured die or go to hospital in a state where medicine is already powerless. This is because with most combat wounds very quickly, in just 5 — 10 minutes, a serious and deadly complication develops — shock. It leads to respiratory failure and cardiac activity. Another danger is blood loss: in cases of severe arterial bleeding, a person can bleed out in 10 — 15 minutes.


During the exercise. Photo: Israel Defense Forces


In Israel, these problems are solved in many ways, but the key solution is to provide highly qualified medical assistance right on the battlefield. The military doctors are directly in the combat formations of the fighting units and come to the rescue already in the first minutes after being wounded.

A military doctor on the battlefield can do a lot. A military doctor, captain Alexei Kalganov, tells us twice that he won awards for courage shown in saving the lives of the wounded on the battlefield. In peacetime, Aleksey Kalganov is a leading orthopedic surgeon in an Israeli hospital, and during the fighting he, like other Israeli doctors, is drafted into the army.

“We covered our special forces, who fought. Four soldiers were seriously injured. One bullet landed in the mouth. I looked - all airways are ruined. I thought he was dead, but the pulse was still palpable. I quickly inserted a tube into the throat, pumped blood from the lungs, and we evacuated it along with other wounded people. In truth, I had no doubt that he was not a tenant, and he not only survived, but almost completely recovered. All decided some seconds. He was just lucky that he was not just a doctor, but a surgeon. ”

Major Pavel Kataev, a military doctor, was assigned to an infantry battalion that fought in Gaza during Operation Cast Lead in January 2009. “That night we were in a building next to a house that was accidentally hit by two of our tank projectile. Naturally, as soon as the radio reported on the multitude of casualties, we rushed there and arrived even before the dust settled from the explosion. The picture was as follows: all the commanders were wounded, there was no one to command the military, the soldiers were shooting in all directions from all windows and miraculously did not hit us.

In the first few minutes, it was harder to command both soldiers and provide medical assistance. Many soldiers lie, a lot of blood, moans, screams, shooting. The first thing I did was to stop the fire, carefully lower all the wounded down and take positions in the guard, guarding the building and not shooting without any reason. All this happened for maybe no more than a minute, but it seemed like an eternity. There were more than 20 victims, three killed, which we could no longer help, eight seriously wounded, among them Ben Spitzer, who had both hands torn off and legs crushed. We immediately began doing surgical and resuscitation procedures to save their lives. Then I contacted the head of the medical service of the Southern Military District, reported to him about the condition of the wounded, specifying which specialists, such as microsurgeons, should be urgently prepared in hospitals to receive the wounded, since every minute can be decisive.


Photo: Yoav Lemmer / AFP


As soon as they let me go home after the end of the fighting, I first went to the hospital, went to the intensive care unit to Beni, saw that they had sewn his hands (unfortunately, only one got accustomed, I had to amputate the second one) that the legs are in place, and sighed with relief. "

A military doctor on the battlefield risks his life on a par with soldiers and officers of combat units. Military doctor captain of the reserve Igor Rotshtein was urgently mobilized on July 24 of the year 2006. He was seconded to the 13 Battalion of the Givati ​​Infantry Brigade, in which he entered Lebanon. Rothstein was an experienced military doctor: for five years he served as a battalion doctor in the Southern Military District, took part in hostilities. After demobilization in 2004, he worked as a surgeon at Poria Hospital in Tiberias.

On the night of August 4 2006, in the area of ​​the village of Markabe in southern Lebanon, Rotstein died in battle, saving the life of a wounded soldier. A torn shell wounded a soldier. The doctor hurried to help the wounded man, and the next shell covered them both.

Evacuation of the wounded under fire

An important reserve for the precious minutes of the “golden hour” is the use of modern transport for the quickest possible evacuation of the wounded from the battlefield to inpatient hospitals. Israeli experience shows that the most effective means of evacuation are helicopters and tank bullets - “Merkava” tanks, equipped with mobile first-aid posts and equipped with additional armament. Such armored ambulances showed themselves particularly well in rescuing the wounded under enemy fire. Thus, during the war in Lebanon in the 2006 year, the Israeli Air Force helicopters performed about 120 evacuation flights, approximately half of them - on the enemy territory, where the evacuation took place under enemy fire. On these sorties, they removed a number of wounded to 360.

The helicopters were equipped with the necessary medical equipment, military doctors and paramedics who provided qualified medical assistance directly on board the helicopters were included in the crews. The evacuation of the wounded by air from the battlefield to the hospital lasted an average of about 3,5 hours. In one flight, an average 4,5 soldier was evacuated. During the evacuation by air, not a single wounded soldier died.

During the war in Lebanon in July 2006, the military doctor captain Marina Kaminskaya was the head of the medical service of the tank battalion, in which she entered Lebanon on the first day of the war and took part in the battles for the settlements of Kanatra, Maroun ar-Rush and the city of Bint Jubail . Kaminsky fought on the tank bulanse. On it, she was in the thick of the fighting for Bint Jubail, a key location for the concentration of the Hezbollah terrorist group in southern Lebanon on July 24 on July 2006. To evacuate the wounded tankers and infantrymen from the battlefield, the command sent her tank bulans. The car was covered by two conventional tanks, one - directly, and the second - on the nearest approaches.


During the exercise. Photo: Israel Defense Forces


At the height of the battle, the wounded began to enter the tank bulan. Among them was an officer who was seriously injured - a bullet of an enemy sniper hit him in the face. Kaminskaya, right on the battlefield, gave him first aid and took him to the tank bulanse to the helipad, from where the wounded were taken by helicopter to the hospital in Haifa.

During the battle, a tank was shot down, covering it with a tank-bulance. Of the four crew members of the wrecked tank, the tank platoon commander was killed, two tankers were slightly injured. The battalion commander’s tank, which came to the rescue of the crew, was blown up by a land mine containing approximately 300 kilograms of explosives. Of the seven people in the tank — the crew members and officers of the battalion headquarters — the sergeant, the driver were killed, and the rest were injured.

Kaminskaya, despite the enemy's fire, provided all the wounded with medical assistance and successfully evacuated them in her tank bulan. In total, she saved the lives of more than 25 wounded soldiers during the fighting.

New technologies save the wounded on the battlefield

Any war is a kind of testing ground not only for new weapons, but also for the newest technologies to save the lives of the wounded. Operation "Enduring Rock" was no exception.

It is estimated that up to 80% of the wounded are killed due to blood loss. In the course of Operation Enduring Rock, the troops successfully tested a whole range of new technologies and medical devices, which made it possible to significantly increase the number of lives saved.

As the only way to stop the bleeding was used overlay harness. Now the Israeli army has abandoned the traditional rubber harnesses: now in the backpack of each soldier there is a “turnstile”, which is a 96-centimeter nylon sleeve with a harness inside, equipped with a handle. The handle is part of a device consisting of locks and velcro, using which a soldier can stop the bleeding by himself, even if he is wounded in the arm. Soldiers are taught to use the "turnstile" even on the course of a young fighter.

In cases when the “turnstile” is not suitable, for example, when amputation is high or a wound to the stomach, hemostatic dressing devices containing components that promote blood clotting and intended to stop external bleeding of varying intensity, including damage to large vessels, began to be used in the Israeli army. .


During the exercise. Photo: Israel Defense Forces


In addition to using these new hemostatic agents in the bag of every military medic, there are now ampoules of hexacaprone on the battlefield, accelerating the process of stopping bleeding.

With a large blood loss, military doctors directly in the battlefield inject a solution of blood plasma powder. The advantage of this technology is that, unlike portions of donor blood that require cooling or freezing, blood plasma powder can be taken with you on the battlefield. A package of plasma powder and a bottle of liquid is all that is needed to prepare a solution.

During the battles in Gaza, a new tool, such as a kind of zipper, reliably tightening open wounds, has been tested, but its use requires a fairly high qualification of military doctors.

A common cause of the death of the wounded is pain shock. Now all military paramedics have automatic syringes for injecting morphine, as well as a new tool - "aktik", based on fentanyl, a hundred times stronger than morphine. This medicine is placed under the tongue, and the pain disappears for at least an hour. The advantages of "aktika" include the fact that it not only alleviates the suffering of the wounded, but also does not lead to a drop in pressure, and this is one of the problems in using morphine and its derivatives.

Among the other medical innovations used to save the life of the wounded during the “golden hour”, Israeli military doctors are armed with a portable ultrasound scanner to detect internal bleeding in the field, an oxygen saturation meter to check the condition of the wounded, and a carbon dioxide detector to test the effectiveness of artificial respiration and fentatil lollipop to soothe sharp pains in a minute.
Author:
Originator:
http://rusplt.ru/world/zolotoy-chas-ranenogo-soldata-12907.html
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  1. Serbor
    Serbor 20 September 2014 08: 50
    +30
    Unconditional achievement of the Israeli military physicians. This experience needs to be studied and adopted. The mechanism and structure of military operations has changed. In the conditions of network-centric conflicts, I think, the maximum approximation of qualified medical care to the wounded is justified. Specialized, of course, should already be in the hospital. At the same time, with large-scale military operations along the entire line and depth of the front, such tactics are not justified - there will be huge losses among doctors. It takes a maximum of 2 years to prepare an experienced fighter. It takes 8-10 years to prepare a highly qualified surgeon. Feel the difference? Therefore, in large-scale hostilities, it is necessary to use the experience of the Second World War, which proved that a quick and correctly carried out staged evacuation allows you to return up to 70% of the wounded. In the current conditions, in the presence of ambulance helicopters, these indicators can be improved to 75-80% no more. Anything more than a fairy tale doesn’t.
    1. sso-xnumx
      sso-xnumx 20 September 2014 13: 14
      +4
      Do not compare the nature of the combat trauma of the Second World War and modern weapons. Everything has changed, both the weapons and the damage they inflicted. They have become heavier and more extensive. Unfortunately, the "field furniture reforms" put an end to work to improve the modern and promising system of organizing medical support for troops in combat conditions.
      And the current officials from the HLMU are not very concerned about this. There are enough current problems.
      1. Lopatov
        Lopatov 20 September 2014 13: 54
        +1
        Quote: sso-250659
        Do not compare the nature of the battle trauma of the Second World War and modern weapons. Everything has changed

        Yah ???
        1. sso-xnumx
          sso-xnumx 20 September 2014 15: 16
          +6
          Well yes! Believe the military doctor ...
          1. Bayonet
            Bayonet 21 September 2014 13: 13
            +1
            Quote: sso-250659
            Well yes! Believe the military doctor ...

            Modern small-caliber bullets - 5.45, 5.56, cause more severe damage than the old 7.62, 7.92 or 9 mm.
    2. siberalt
      siberalt 20 September 2014 18: 17
      +5
      We would have such a territory as in Israel and it would be possible to make "golden 10 minutes". laughing
      1. Aaron Zawi
        Aaron Zawi 20 September 2014 18: 26
        +5
        Quote: siberalt
        We would have such a territory as in Israel and it would be possible to make "golden 10 minutes". laughing

        Well, 10 minutes are "golden" precisely because at that time they determine the severity of the wound and provide the maximum possible assistance before evacuation. During the VLV, the wounded were taken out by helicopters from the river. Flying to Haifa. It is quite under 100 km. Do not work doctors on the spot, no evacuation would help.
      2. Bayonet
        Bayonet 21 September 2014 13: 09
        +5
        Quote: siberalt
        We would have such a territory as in Israel and we could make "golden 10 minutes"

        We should appreciate our soldiers like that, and the territory has nothing to do with it!
    3. The comment was deleted.
    4. tasha
      tasha 20 September 2014 19: 42
      +4
      Dear Serbor
      I agree with you almost completely. But! I would like to note that in addition to a quick and proper evacuation, i.e. In order to deliver the wounded to the point of providing qualified (!) medical care, in my opinion, it is still necessary to create primary treatment facilities available to the same fighter of secondary training (I already wrote about syringe tubes and the effect of their introduction). Just as an example, aerosols (foams with different effects).
    5. Bayonet
      Bayonet 21 September 2014 13: 07
      +1
      Quote: Serbor
      Unconditional achievement of the Israeli military physicians. This experience needs to be studied and adopted.

      And some evil creatures are minus the article!
  2. Serbor
    Serbor 20 September 2014 08: 59
    +8
    War is a cruel thing. During the Second World War, such wounded, as described by the author, were not evacuated at all, because the evacuation of such an almost hopeless wounded (90-95% death during transportation) will take the lives of 4-5 severe, but more easily wounded, who are not evacuated on time. In this regard, there was a system of primary medical triage of the wounded. Lungs - for surgical treatment and evacuation in the 3rd stage, medium, if possible, and evacuation in the 2nd stage, heavy - immediate evacuation after stopping bleeding and against the background of anti-shock measures. The hopeless - in a separate tent, pain relief ... and that's it. Nevertheless, they managed to survive even in the "death tent", which amazed the military doctors.
    1. Stas57
      Stas57 21 September 2014 17: 32
      +1
      In this regard, there was a system of primary medical sorting of the wounded. Lungs - for surgical treatment and evacuation in the 3 line, medium if possible and evacuation in the 2 line, heavy - immediate evacuation after stopping the bleeding and against the backdrop of anti-shock measures.

      Thanks Pirogov N. And, sorting is his brainchild
  3. aszzz888
    aszzz888 20 September 2014 09: 04
    +10
    It is what it is. They do not throw the wounded like dill.
  4. saag
    saag 20 September 2014 09: 16
    +3
    "... Now all military paramedics have automatic syringes."

    the first-aid kit is getting closer and closer to reality
  5. Deniska999
    Deniska999 20 September 2014 09: 18
    +7
    We must use the experience of Israeli military doctors.
    1. padonok.71
      padonok.71 20 September 2014 10: 26
      +1
      If we discard the technical component, then the Israelis adopted our experience (and did it right). Reread the names of Israeli military doctors, funny, don’t you?
      And we need not "adopt" but remember, of course, with an amendment to modern technology.
      1. Dan4eG
        Dan4eG 20 September 2014 10: 34
        +4
        If we discard the technical component, then it is the Israelis who have adopted our experience

        Details, please??
        Reread the names of Israeli military doctors

        I re-read and also looked at the source: “Russian Planet”, funny, don’t you?
        1. padonok.71
          padonok.71 20 September 2014 13: 29
          +2
          This is technology. Means of transport, medical assistance, communication, etc. and the structure itself (medical instructors in units, sorting the wounded, etc.) is very similar to the Red Army / SA, but of course in the realities of Israel.
          I haven’t read the Russian planet - I can’t say anything. Maybe funny.
          1. Dan4eG
            Dan4eG 20 September 2014 14: 16
            0
            Sanitary instructors in units

            Nope, there is a school of military doctors, where they tune in to courses from units!
            sorting of the wounded

            But is it somewhere else?
            1. padonok.71
              padonok.71 20 September 2014 20: 54
              0
              About medical instructors - at least name the Unterfeldmedgers, the essence is one.
              Sorting - it happens in another way. Read the memoirs of the German infantrymen from the first, the beginning of the second MV.
              1. Dan4eG
                Dan4eG 21 September 2014 11: 00
                0
                Well, I didn’t know that you liked the SS rank more !!
                And if you also read about the Crusades, then generally tryndets !!
                1. padonok.71
                  padonok.71 21 September 2014 12: 17
                  -2
                  Where did such conclusions come from about my preferences for rank? By the way, such a title / position neither in the SS, nor in the Wehrmacht / Luftwaffe / Kriegsmarin / Panzerwaffe (etc.), nor when it was not. I made it up. I just think in German (first language), although Russich is both parents and spiritually.
                  And what did the crusaders offend you?
                  And you know that, as a council, you do not project your complexes (ss, crusaders) onto others, in this case me. I already see your next koment with accusations of fascism and I hasten to disappoint you - no, I'm not a fascist. Although of course, like any normal person, I will not put in one row an unemployed Negro from the United States and a surgeon (it does not matter by nationality, even a Jew).
      2. Aaron Zawi
        Aaron Zawi 20 September 2014 11: 08
        +7
        Quote: padonok.71
        If we discard the technical component, then the Israelis adopted our experience (and did it right). Reread the names of Israeli military doctors, funny, don’t you?
        And we need not "adopt" but remember, of course, with an amendment to modern technology.

        You are not quite right. Since the 19 century, Israel has had a large number of immigrants from Russia and, therefore, many carriers of Russian surnames. And the medical care system here was built of course, taking into account international experience and its own, unfortunately quite extensive.
        1. padonok.71
          padonok.71 20 September 2014 13: 18
          +1
          Wrong in what? The fact that the original system of medical care was lapped up with the Red Army? And not only Jews but also Bosches, Americans and many others. Or is it that Israel rose largely thanks to the "Jews" of the Soviet Union?
          And by the way, Israel, as a state, was formed in November 1948, again mainly thanks to the USSR and to Stalin personally (how sad it is for you). And no matter how not in the 19th century, do not ascribe a century to your history, otherwise you will be like the Chinese, who have a moon-like age-mate to Neanderthals.
          1. Aaron Zawi
            Aaron Zawi 20 September 2014 14: 07
            +5
            Israel was reborn in May 1948 as an independent state. But agree not from scratch. From scratch it is impossible to build a state that is attacked by 7 states on the first day of independence.
            The AOI medical service, like other troops, did not appear from scratch, but on the basis of Jewish armed forces directly from Israel and several thousand Jewish veterans who fought in the Allied armies. Well, my own extensive experience. What's wrong?
            1. padonok.71
              padonok.71 20 September 2014 17: 06
              0
              Quote: Aron Zaavi
              In Israel since the 19 century

              That's what it is.
              1. Aaron Zawi
                Aaron Zawi 20 September 2014 23: 15
                0
                Quote: padonok.71
                Quote: Aron Zaavi
                In Israel since the 19 century

                That's what it is.

                If I would write in Eretz Yisrael (Land of Israel), it would be less clear.
                1. padonok.71
                  padonok.71 21 September 2014 08: 56
                  -2
                  What about Eretz Yisrael? You have never owned this land. Someone always drove you there. Egyptians, Babylonians, Romans, Mamiluks, Ottomans, Crusaders, English mandate. They wouldn’t recall, they wouldn’t disgrace.
                  So far, I'm tired of the "greatness" (egotism and pride) of God's chosen ones.
                  1. padonok.71
                    padonok.71 21 September 2014 17: 23
                    +1
                    Come on, come on minuses, there’s nothing to say.
      3. sso-xnumx
        sso-xnumx 20 September 2014 13: 07
        +3
        All right! The development of armored medical vehicles for the Russian Armed Forces began in the early 90's. Twentieth century. In the first Chechen one of the 2 experimental vehicles, on the BTR-80 chassis, underwent military tests in the area of ​​the database. When moving in a convoy along a serpentine road on a slippery road, the carrier lost control and fell into the gorge. It was evaluated as necessary and meets the requirements for use in combat conditions.
    2. Lopatov
      Lopatov 20 September 2014 11: 28
      +3
      The military doctors themselves are definitely better. Since the Second World War. The highest percentage returned to duty.

      But with organizational-staffing and technical issues, we have major problems
    3. tasha
      tasha 20 September 2014 19: 45
      0
      Deniska999
      It depends on what. Please read the very first comment from Sarbor, everything is clearly written there.
  6. runway
    runway 20 September 2014 10: 06
    +4
    The correct approach to saving a soldier's life is that there are no “hopeless” wounded today. 6% losses, but you need to strive to reduce the percentage of deaths of soldiers. When a soldier sees that the country takes care of him, and in the event of his serious injury, he will not leave him to die on the battlefield, but uses tanks and aircraft to save him, then he will act much more confidently.
    Only for the damage that Serdyukov inflicted on our military medicine with his (?) Reforms, he had to rot forever on a bunk. But what to talk about, if even for the death of conscripts during the "disposal of ammunition by detonation", he was awarded a new state position ...
  7. Observer2014
    Observer2014 20 September 2014 10: 19
    +7
    Unconditional achievement of the Israeli military physicians. These are the sizes of ISRAEL without offense!
    1. padonok.71
      padonok.71 20 September 2014 10: 33
      +5
      Took off the tongue. Absolutely right. There is no need for mobile deployable hospitals, normal hospitals with normal operating rooms / laboratories / household services are within walking distance.
      1. Lopatov
        Lopatov 20 September 2014 11: 12
        +13
        From Grozny to Vladikavkaz is also not very far. But at an o'clock I did not hear that fit. At first, waiting for the helicopter. Then the flight, then the path from the helipad on the Shalkh on the outskirts of the city to the hospital through traffic-laden streets.

        Just distance gives few bonuses, if there is no desire and opportunities to use this advantage.
        1. padonok.71
          padonok.71 20 September 2014 13: 02
          +5
          And we have the whole country is it the Caucasus? Have you been to the east, north? And so with Art. Batagov to Vladik was dragged for two days, personally.
          1. Lopatov
            Lopatov 20 September 2014 14: 13
            +3
            Quote: padonok.71
            And we have the whole country is it the Caucasus? Have you been to the east, north?

            Is there a war going on there?

            Tell me, without search engines, how many security officials died and were wounded in the Caucasus over the past August? "Everything is fine, beautiful marquise" (c)? If something happens again, decide that the war began with the explosions in Moscow?

            Quote: padonok.71
            And so with Art. Batagov to Vladik was dragged for two days, personally.

            If you go from the direction of Alkhakhzurov, there is a T-shaped intersection. Nalevo-in Art. Atagi, to the right to Pionerskoe. The men from Pionerskoye went for a drive, left in the evening to be in Ingushetia before the stop wheels, and in the morning they stood in the convoy on Shalkhi to go back. Having had time to go shopping and hang out in saunas. And you mean some two days ...
            1. padonok.71
              padonok.71 20 September 2014 17: 10
              +2
              Bet you bet?
              Quote: Spade
              The men from Pionerskoye went for a drive, left in the evening to be in Ingushetia before the stop wheels, and in the morning they stood in the convoy on Shalkhi to go back. Having had time to go shopping and hang out in saunas. And you mean some two days ...
              95g. Divorced the way out, backache of the thigh, with damage to the artery, fracture of the tibia - laugh at it.
      2. sso-xnumx
        sso-xnumx 20 September 2014 13: 01
        +5
        Minus one!
        Quote: padonok.71
        padonok.71
        right! All of Israel from south to north in a day, not particularly in a hurry to drive through. And almost in the north, settlements are almost at every step, and compare our distances.
        1. padonok.71
          padonok.71 20 September 2014 14: 00
          +4
          Thank you, dear man! Minusillers probably in Russia have never been.
      3. tasha
        tasha 20 September 2014 19: 49
        +2
        Well, the article says that highly qualified doctors are right on the battlefield, which cannot be welcomed.
    2. Dan4eG
      Dan4eG 20 September 2014 10: 38
      +5
      And what was sent to the WWII from the front to Moscow directly, or were there field hospitals ??? Who prevents the organization of a hospital 100-200 km from the front or the place of military operations? And prepare it in advance!
      1. Lopatov
        Lopatov 20 September 2014 11: 36
        +3
        Field hospitals are still worse than hospitals, do not try to bring them as close as possible.
        1. Dan4eG
          Dan4eG 20 September 2014 14: 18
          +2
          Field hospitals are worse than hospitals

          but I didn’t say it, but for an urgent operation in the name of salvation, that’s it! after that it is possible to transport to a hospital for 1000 miles!
  8. TECHNOLOGY
    TECHNOLOGY 20 September 2014 10: 35
    +6
    Israel's medicine is one of the best in the world. Our "doctors" need to learn. I mean civilian polyclinics and hospitals.
  9. svp67
    svp67 20 September 2014 11: 03
    +7
    It is necessary that our specialists very well study the experience of foreign warring armies. And everything that is "sensible" must be adopted and adopted "into service"
  10. givargi
    givargi 20 September 2014 11: 09
    +11
    Ya reanimatolog v Amerike. Boevaya medicina v zapadnyx armiax konechno ochen effektivna. No vsio eto dostupno iz za xoroshevo finansirovania medicini. Rossiiskie vrachi ne tupye, no u nix netu sverxsovremmennyx texnologii i preparatov. Finansy reshaiut vsio ...
  11. Ordinary stock
    Ordinary stock 20 September 2014 12: 09
    +3
    It is necessary to immediately introduce everything described into the Russian army. People are the most valuable capital of the state. Do not spare money to save them.
    1. sso-xnumx
      sso-xnumx 20 September 2014 13: 20
      +1
      To my deep regret, burying a Russian soldier is cheaper than curing and returning to service. After 1995, it was estimated that the cost of a full cycle of medical care for one soldier is 20-25 million, at prices of that time. And bury 90 thousand.
      1. TOR2
        TOR2 20 September 2014 20: 44
        +5
        Yes you are right. In addition, many people, both at the top and bottom, simply do not want to understand that today's mobilization and human resources will seriously differ from those of the 40s of the last century. And this is a serious problem for our state.
  12. Icebreaker
    Icebreaker 20 September 2014 12: 23
    +9
    Quote: givargi
    Ya reanimatolog v Amerike. Boevaya medicina v zapadnyx armiax konechno ochen effektivna. No vsio eto dostupno iz za xoroshevo finansirovania medicini. Rossiiskie vrachi ne tupye, no u nix netu sverxsovremmennyx texnologii i preparatov. Finansy reshaiut vsio ...

    As a person directly related to medicine (though not military), I sign with two hands good
    Our doctors are no worse, or maybe better, Jewish and American (it’s not without reason that many are leaving negative ), but about equipment, facilities, etc. etc. - it’s bad with us ... Recently, of course, it has begun to straighten out, but this is due to the merit of certain individual leaders who can knock out money for some organization ... I hope that it will increase and improve in the near future.
    1. sso-xnumx
      sso-xnumx 20 September 2014 13: 21
      0
      Quote: Icebreaker
      I hope to soon and generally increase and improve.

      Is not a fact...
  13. Majordok
    Majordok 20 September 2014 12: 27
    +7
    In a combined arms battle, the presence of doctors in the zone of fire contact is impractical, only in a local special operation. The effect of the golden hour will be if the fighters are trained to provide medical first self and mutual assistance. To which, unfortunately, little attention is paid. In the Great Patriotic War, 74% of the wounded survived thanks to the high experience of military medicine, which "Taburetkin" destroyed, a huge reduction in beds and military doctors.
    1. padonok.71
      padonok.71 20 September 2014 13: 43
      +7
      Gold words! At the forefront, the doctor has absolutely nothing to do. He simply will not be able to provide any serious help (no conditions - the battle is on!). To be at the forefront is the task of the paramedic. It must not be cured, it must be delivered (and not allowed to die during delivery) before sorting. And at the sorting, the doctor is already entering the case. And deducing an expensive and very long trained specialist is at least stupid.
  14. Death Nik1
    Death Nik1 20 September 2014 12: 39
    +7
    In fact, the main invention of Israeli medicine is the creation of a system of interaction between infantry, the Air Force, and honey. troops, doctors as part of special. groups and civilian hospitals.
    This system does not require financial investments, but only requires an understanding of the interaction between all the links in the chain of evacuation of the wounded. In the army, after all, how:
    The Air Force has its own connection; the infantry has its own; connections, connections are often just as special. In case of injuries, while through the headquarters of the infantry they will contact the headquarters of the Air Force, and they, in turn, will find a helicopter free from combat missions a lot of time will pass. So it turns out that it’s faster to take the wounded away by car. However, when driving a car, shaking acts in the most harmful way (any military doctor will confirm this), and if the soldier is seriously injured, the driver of the medical military transport (and this is either an armored car or an armored personnel carrier) is in a hurry, the shaking is even more (they’re not being transported on asphalt but across the field), as a result, they bring a corpse. It turns out a vicious circle, and the Israeli system helps break it

    There are also field medical sangbats in Israel, but they are only demolished in case of large-scale military operations such as the first Lebanon war. By the way, in the last operation, such a field hospital was deployed for Palestinians on the border of the Gaza Strip.
    1. TOR2
      TOR2 20 September 2014 21: 23
      +2
      Quote: Smert Nik1
      However, when driving a car, shaking acts in the most harmful way (any military doctor will confirm it), and if the soldier is seriously injured, the driver of the medical military transport (and this is either an armored car or an armored personnel carrier) is in a hurry, the shaking is even more (they’re not being transported on asphalt but across the field), as a result, they bring a corpse. It turns out a vicious circle, and the Israeli system helps break it

      It depends on the intensity of the fighting. In cases where there is a high probability of a helicopter defeat, it will have to be carried by land transport. There are many technical solutions to minimize shaking. For this, of course, specialized transport will be required, moreover with good booking, maneuverability and of course speed.
    2. sso-xnumx
      sso-xnumx 21 September 2014 19: 05
      +1
      Quote: Smert Nik1
      but they grumble

      Sorry, correct. It will be right - deploy.
      As the OTMS instructor told us, "the bear is turning around in the apiary."
  15. Skuto
    Skuto 20 September 2014 13: 50
    +2
    However:
    During the battles in Gaza, a new tool, such as a kind of zipper, reliably tightening open wounds, has been tested, but its use requires a fairly high qualification of military doctors.

    And what I found: http://fakty.ua/51927-hirurgicheskij-shov-na-zastezhke-molnii-postradavshij-smoz
    het-nalozhit-sebe-samostoyatelno

    offensively.
    1. Aleksys2
      Aleksys2 20 September 2014 19: 18
      0
      Quote: Skuto
      offensively.

      Garbage, this method can only "sew up" a superficial cut, but for this there are already other technologies (as an example):
      1. BF-6 glue is used to treat microtrauma - abrasions, scratches, cuts and other minor skin lesions. The film is formed within 2 — 5 minutes after application of BF-6 and is firmly held on the skin for 2 — 3 days.
      2. Plaster strips for surgical sutures Omnistrip. It is used for atraumatic closure of small wounds and thin surgical incisions, as well as for joining wound edges and normalizing fresh postoperative scars.
      Etc.
  16. kirsa
    kirsa 20 September 2014 14: 03
    +4
    The successes of the Israelis are obvious, but as has been said more than once above, these are successes in the specific conditions of warfare (small "theater", small scale, small numbers, etc.). It is even impossible to imagine what will happen on a front with a length of, say, several thousand kilometers. No doctors, especially surgeons or resuscitators, can find enough. Even in peacetime there are not enough of them, and you generally get tired of looking for "handy" ones. No need to reinvent the wheel. The theoretical organization of the medical service has long been thought out to the smallest detail. You just need to fill it, and it will be so good that the Jews will be amazed.
  17. condrat13
    condrat13 20 September 2014 14: 17
    +5
    The experience of Soviet medicine in the Great Patriotic War of 1941-1945 - 35 volumes

    http://medpunkt.pro/biblio/books/opyt-sovetskoj-mediciny-v-velikoj-otechestvenno
    j-vojne /

    everything has already been said there. The rest is promotion and deepening in the light of the development of medical science and technology.
  18. Prikaz4ikov1992
    Prikaz4ikov1992 20 September 2014 20: 07
    +2
    Is there anyone from Israel? Do you have any special unloading for doctors? And just like with equipment for doctors and transport?
    1. Aaron Zawi
      Aaron Zawi 20 September 2014 20: 18
      +5
      Quote: Prikaz4ikov1992
      Is there anyone from Israel? Do you have any special unloading for doctors? And just like with equipment for doctors and transport?

      Of course, for machine gunners and signalmen. And what is your common standard? As for transport, in each deployed battalion there is a medical platoon on the M113 converted for ambulances. Now, as TBTDR is saturated, there is information about the creation of armored ambulances that will allow the wounded to be transported directly under fire. (It seems that during the last operation in Gaza, two such machines were tested, but this is more at the level of the OBS, I will not argue.)
  19. slavbag
    slavbag 20 September 2014 20: 29
    +5
    There is. Doctors have special unloading. There is equipment in special bags and boxes. Folding stretchers are carried by the soldiers themselves. Like cans of water. The specifics of our theater of operations. Ambulances: there are all kinds of them. There are 4 × 4 Nun Nun, Abir, Fords pickups, and all that are on wheels based on light trucks. On the Merkava caterpillar, heavy armored personnel carrier, M113. And helicopters.
  20. Roman_999
    Roman_999 20 September 2014 21: 01
    +5
    Quote: siberalt
    We would have such a territory as in Israel

    I don’t think we need the territory of Israel. The system of pre-medical and medical care can and should be done better here with us. It’s not bad to know the experience of military doctors in constantly warring countries.
    1. Aleksys2
      Aleksys2 21 September 2014 11: 35
      +2
      Quote: Roman_999
      The system of pre-medical and medical care can and should be done better here with us.

      This is how it is with us
      1. cosmos111
        cosmos111 21 September 2014 19: 32
        +2
        BM "Vodnik" is an excellent honey ... armored vehicle ... the rest are on the General Staff .....

        and, here’s how they have them .... we need a modern BM, with a fodder entrance and a honey block, to provide honey ... help, in the first minutes, after an injury ... up to intubation of the lungs and mechanical ventilation. ..

        honey ... armor ... "PATRIA AMV"


        1. Aleksys2
          Aleksys2 22 September 2014 00: 56
          +2
          Quote: cosmos111
          we need a modern BM

          No doubt, not one is needed. What is most interesting, there are developments, but as we have recently been led, they are not in the troops.
          What was in service:
          For the search, collection and evacuation of the wounded from the battlefield and from the centers of mass sanitary losses:
          1) Front edge conveyor LUAZ-967TPK - withdrawn from service.
          2) Crawler snow and swamp-going tractor-tractor GT-SM (GAZ-71)
          3) Crawler small-sized armored conveyor tractor GT-MU (GAZ-73)
          For transportation of the wounded in the army and army rear areas:
          1) AC-66, АС-66М1 and АС-66MP ambulances
          2) Sanitary vehicle UAZ-396295
          What was developed and tested:
          BMM-80 - Armored medical vehicle based on BTR-80 (GAZ-59039)
          In three trim levels:
          BMM-80-1 - search, collection and evacuation of the wounded from the battlefield and from the centers of mass sanitary losses;
          BMM-80-2 - medical center of the battalion;
          BMM-80-3 - dressing room with a medical team.
          A total of 2 such machines were produced. One was lost in the North Caucasus. I saw the rest during the exercises in Krasnoye Selo. My opinion about this car is mixed. On the one hand - as a conveyor it is better than a “loaf”, although there is bulletproof booking, on the other hand - as a dressing room it is not very convenient for a doctor taller than 170 cm to work in it - it is extremely difficult. Although the equipment allows you to carry out a full-fledged resuscitation allowance, you can also deploy a battalion medical center (the tent includes an 12 stretcher tent and the necessary kits)

          BMM-1 - Armored medical vehicle based on the BMP-1
          Exists only in a single copy. The machine is more convenient, you can work in it in full growth. It is possible to provide first aid with qualified items.

          BMM-1D based on BMD-3.
          In three options:
          1 - an armored front-line ambulance transporter - for tracing, collecting and evacuating the wounded from zero battle, as well as providing them with first aid;
          2 - armored medical platoon machine for the provision of first aid;
          3 - an armored dressing room - to provide first aid to the wounded according to vital indications.
          Himself "in the iron" did not see. They say good.

          BMM-1 and BMM-2 based on the all-terrain vehicle Vodnik (GAZ-3937)
          Very convenient conveyor.
          1. cosmos111
            cosmos111 22 September 2014 08: 37
            0
            Quote: Aleksys2
            BMM-1 and BMM-2 based on the all-terrain vehicle Vodnik (GAZ-3937)
            Very convenient conveyor.

            I agree ... a small upgrade of the GAZ-3937 and honey equipment, and there will be excellent honey ... armor ... of the leading edge !!!
  21. gameover_65
    gameover_65 20 September 2014 21: 02
    -4
    oh gentlemen, again super Jews)))
    the author, and you understand the essence:
    So, if during the Doomsday War in 1973 up to 35% of wounded soldiers died, then during Operation Enduring Rock in July - August of this year, irretrievable losses among the wounded did not exceed 6%.

    you are comparing the incomparable. this is one thing died, and the irretrievable loss is another.
    the punitive operation "Enduring Rock" and the fighting of the Doomsday War are two different things!

    That night we were in a building near the house, which mistakenly hit two of our tank shells. Naturally, as soon as the radio reported a lot of victims, we rushed there and arrived before the dust from the explosion had subsided. The picture was this: all the commanders were wounded, there was no one to command the military, the soldiers were shooting in all directions from all windows and miraculously did not hit us.

    it was probably super-shells that only hit commanders.
    your fighters lose their control if no one commands them? and they don’t even try to help the commanders, but stupidly scorch in all directions?

    article minus. what to learn then? we are in different situations. and how will their medicine work in a full-scale war? in punitive operations against partisans is good, but what if the war?
    although for them the war of the Palestinians is jerking.
    1. Aaron Zawi
      Aaron Zawi 21 September 2014 19: 48
      +1
      Quote: gameover_65
      oh gentlemen, again super Jews))).

      I honestly did not see any super in the article. Just a description of the changes in the AOI medical service based on experience.
  22. padonok.71
    padonok.71 20 September 2014 21: 59
    -5
    Quote: gameover_65
    and how will their medicine work in a full-scale war?

    And they will not have such a war:
    1. Not with anyone. The region is like that. Like in football the third league.
    2. Not what. The country simply suffocates in the first week of the war. Economically. Food. Psychologically. And so on (add at will, everything will do).
    3. Global allies will simply not give (well, you understand who I mean wink ).
    PS: and so yes, tired
    Super Jews again
  23. dyremar 66
    dyremar 66 20 September 2014 22: 15
    +5
    Quote: Serbor
    War is a cruel thing. During the Second World War, such wounded, as described by the author, were not evacuated at all, because the evacuation of such an almost hopeless wounded (90-95% death during transportation) will take the lives of 4-5 severe, but more easily wounded, who are not evacuated on time. In this regard, there was a system of primary medical triage of the wounded. Lungs - for surgical treatment and evacuation in the 3rd stage, medium, if possible, and evacuation in the 2nd stage, heavy - immediate evacuation after stopping bleeding and against the background of anti-shock measures. The hopeless - in a separate tent, pain relief ... and that's it. Nevertheless, they managed to survive even in the "death tent", which amazed the military doctors.

    you are right for everything - I myself survived in such a tent under formidable in '96 - the non-flying weather three died in a day and a friend of mine came to me and put buprenorphine and for some reason cried quietly ... then the helicopter hankala Vladikov and Rostov ... when six months later we met and he talked about a tent for the hopeless I was in ah ... e ....
  24. gameover_65
    gameover_65 20 September 2014 22: 15
    -2
    let's not confuse war and punitive operations.

    http://www.youtube.com/watch?v=OhhjN_Sd2oI
  25. captain
    captain 20 September 2014 23: 09
    +11
    A good article, I was in Afghanistan and more than once convinced that we were evacuating the wounded late, although the helicopter pilots (thanks to them) were courageous people and landed at altitudes up to 3x km. There was a case when our aircraft struck the 781 orb (our infantry brought it in), in the second company almost everything was wounded, but it was easy, but I have two and one, as the medical officer said (he was lucky he was a medical assistant in civilian life), not a tenant if do not take out. I knitted with turntables and asked to sit down (the altitude was about 3x km 0, the pilots answered that they had no right to land, but then one still sat down and saved my scout (Sergeant Nosyrev), barely took off, or rather rolled into the abyss, they thought it would break, and he took off (it was the deputy commander of the Air Force of the 40 Army Pavel Aprelkin. The doctor in Kabul then Nosyrev said that he would have been brought to 40 minutes later and he would have been a cargo of 200. I think that there should be medical platoons in the battalions , which should include specially trained paramedics and VR ACHI.The vehicles must be equipped with armored vehicles and must have special medical helicopters with special equipment as part of medical battalions.
    1. sso-xnumx
      sso-xnumx 21 September 2014 09: 13
      +2
      As for the helicopters in the battalion, the search is over, but otherwise everything is right!
  26. Ols76
    Ols76 21 September 2014 04: 46
    +8
    Thanks to the author for an interesting article.
  27. Stas57
    Stas57 21 September 2014 13: 43
    +2
    and we go our own way, cheap show-offs of the tourniquet on the preklad, and then, when stepping on a mine, the machine turns out to be a few meters away from you, there’s nothing to even drag a limb, not to mention the fact that the tourniquet crack and crack.
    little thing that can cost a life
    1. Pazifist87
      Pazifist87 22 September 2014 16: 42
      0
      But the cheek does not scratch) And in winter the skin on the butt will not remain ...
  28. gameover_65
    gameover_65 21 September 2014 14: 09
    -2
    hey minus signers, what do you disagree with?
    at least one "God-chosen" would have spoken out for which he had slapped a minus to me.
    il maybe you died and irreparable loss is the same thing?
    Or can you believe that shells only hit commanders?
    il punitive operation, in your opinion, the same as war?
    strange you, by golly. people would say yes language does not turn.
    1. sso-xnumx
      sso-xnumx 21 September 2014 19: 12
      -2
      Forgive them, for they do not know what they are doing.
      moreover, the losses are divided into sanitary (wounded and sick) and irrevocable (dead from illnesses and wounds, and killed). A punitive operation or war is which way to look. And the fact that a shell or a bullet in general does not choose a victim. It all depends on the person who directed the weapon for a good deed or for evil.
      1. The comment was deleted.
  29. Mosen6Ish
    Mosen6Ish 21 September 2014 19: 47
    0
    Quote: Serbor
    The hopeless - in a separate tent, pain relief ... and that's it. Nevertheless, they managed to survive even in the "death tent", which amazed the military doctors.


    Now it became clear about what kind of "dead" my grandfather was telling ... the chances were near zero ...
  30. DmitryAndreenko
    DmitryAndreenko 22 September 2014 15: 10
    +1
    Quote: gameover_65

    strange you, by golly. people would say yes language does not turn.

    So nature, yours, such a beast, people do not count people for people, pah ...
    1. Pazifist87
      Pazifist87 22 September 2014 18: 46
      +1
      Some people, nationalism and anti-Semitism, are slightly brainwashed.
      And the article is very interesting. Thanks to the author.
  31. Vladislav_A
    Vladislav_A 22 September 2014 17: 48
    -1
    Great article, we need to learn from our experience.
  32. arslan23
    arslan23 24 September 2014 11: 18
    0
    Cool. Although the doctor does not envy. But still cool, 6 percent is an achievement with a capital letter. Where to get so many doctors for a major war? In Russia and Kazakhstan, there is a shortage of specialists in peacetime. And even in war, then. Every doctor is worth its weight in gold. Yeah ...
  33. vedruss
    vedruss 26 September 2014 12: 46
    0
    Yes, and we have a pretty good job. only piece by piece.