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Review
. 2014 Dec;14(59):393-401.
doi: 10.15557/JoU.2014.0040. Epub 2014 Dec 30.

Application of ultrasound examination in tactical conditions illustrated with an example of the Field Hospital of the Polish Military Contingent in Afghanistan

Waldemar Machała  1 , Tomasz Wiśniewski  2 , Robert Brzozowski  3
Affiliations
Review

Application of ultrasound examination in tactical conditions illustrated with an example of the Field Hospital of the Polish Military Contingent in Afghanistan

Waldemar Machała et al. J Ultrason. 2014 Dec.

Abstract
in English, Polish

It is assumed that tactical medicine encompasses all therapeutic activities performed by a military medical service during military and humanitarian missions. Its scope is only apparently limited by the standards which, when referred to the NATO member countries, have been collected in the Joint Theater Trauma System - Clinical Practice Guidelines. The stage-structured character of medical assistance and treatment of the wounded, injured and sick patients assumes that the scope of therapeutic activities performed at each stage is limited only to essential actions. Consequently, more injured patients may be saved - those for whom life-saving activities are performed prior to their transfer to a higher level. The second level is represented by a field hospital. Its first structure is the trauma room in which a rescue team saves and qualifies the injured for further medical activities. Each injured patient undergoes an eFAST ultrasound examination which allows for a quick decision about a surgical treatment to be provided. Moreover, this technique is helpful in vascular cannulation. The authors present their own experiences with using an ultrasound examination during the work in the Field Hospital of the Polish Military Contingent in Afghanistan.

Za medycynę taktyczną przyjęto uznawać wszelkie czynności terapeutyczne wykonywane przez wojskową służbę zdrowia w czasie prowadzenia operacji militarnych i humanitarnych. Jej zakres jest tylko pozornie ograniczony przez standardy, które w odniesieniu do państw NATO zostały zgromadzone w Joint Theater Trauma System – Clinical Practice Guidelines. Etapowy charakter niesienia pomocy rannym, poszkodowanym i chorym oraz leczenia ich zakłada, że zakres terapii na każdym poziomie ogranicza się do wykonania niezbędnych czynności. Dzięki temu możliwe jest uratowanie większej liczby poszkodowanych, u których wykonano czynności niezbędne dla przeżycia do momentu przetransportowania na następny poziom. Drugi poziom reprezentowany jest przez szpital polowy. Jego pierwszą strukturę stanowi trauma room, w którym zespół urazowy ratuje i kwalifikuje rannego do dalszych czynności medycznych. Każdy ranny ma wykonywane badanie ultrasonograficzne o charakterze eFAST, dzięki czemu bez zbędnej zwłoki podejmowana jest decyzja o operacji. Ponadto technika ta służy pomocy w kaniulacji naczyń. Autorzy przedstawili doświadczenia własne z wykorzystania badania USG w pracy Szpitala Polowego Polskiego Kontyngentu Wojskowego w Afganistanie.

Keywords: combat medical procedures; eFAST examination; field hospital; tactical medicine.

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Figures

Fig. 1
Fig. 1
Medic performing an eFAST examination in the medical evacuation vehicle (MEV). Author: T. Wiśniewski
Fig. 2
Fig. 2
Medic performing an eFAST examination in the medical evacuation vehicle (MEV). Author: T. Wiśniewski
Fig. 3
Fig. 3
Trauma team during life-saving activities. Author: W. Machała
Fig. 4
Fig. 4
Trauma leader and anesthesiologist during life-saving activities conducted in the trauma room. Author: W. Machała
Fig. 5
Fig. 5
Trauma team during life-saving activities. The team leader is performing an eFAST examination. Author: W. Machała
Fig. 6
Fig. 6
Trauma room while aid is being provided to the injured. Author: W. Machała
Fig. 7
Fig. 7
Trauma room – trauma team during life-saving activities in a patient with a gunshot wound to the chest. Author: W. Machała
Fig. 8
Fig. 8
IScan during guide wire position verification in the RIJV. Author: T. Wiśniewski
Fig. 9
Fig. 9
Trauma room – preparation for eFAST examination in an injured patient who underwent needle thoracentesis. Author: W. Machała
Fig. 10
Fig. 10
Trauma room – preparation for a FAST examination in an injured patient during rescue thoracotomy. Author: W. Machała
Fig. 11
Fig. 11
EFAST in an injured patient in t he ICU. Author: T. Wiśniewski
See this image and copyright information in PMC

References

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