EMERGENCY MEDICAL CARE FOR VICTIMS OF COMBAT TRAUMA: PRINCIPLES OF MEDICAL TRIAGE AND MEDICAL CARE

Abstract. The article discusses the guiding principles of tactical medical triage. There are significant differences between the provision of emergency medical care (EMC) to civilian casualties in peacetime and during hostilities or casualties who have received combat trauma. The features of combat trauma are as follows. Combat trauma is the result of the action of unique factors that include high energy and determine the high lethality of the factors of injury, multiple causes of injuries, the predominance of penetrating wounds, the preservation of the threat of re-injury in tactical conditions, a complex and harsh environment with limited resources and delayed evacuation, and, accordingly, the difficulty or impossibility of providing full assistance in the desired period of time. Tactical medicine specialists clearly identify three zones in the theater of military events in which EMC can be provided only to a certain extent. The red zone, or zone of active shelling, has the least opportunities for providing EMC. A place protected from active fire is called the yellow zone. Accordingly, specialists operating in the yellow zone have wider opportunities to provide EMС. Thus, the scope of assistance is expanded. The green zone or evacuation sector represents places that are adapted or equipped for receiving and sorting wounded victims, providing them with assistance, treatment and preparation for further evacuation. When conducting medical triage in tactical conditions, specialists distinguish urgent, delayed, minimal and expected categories of victims. Accordingly, representatives of the medical service determine the procedure and scope of providing the necessary EMС, monitor the correct functioning of triage, movement of victims, the scope and adequacy of EMС, and the evacuation procedure.