Combat Care: Gun-Totin’ Doctors
ARMED DOCTORS: Traditionally, medical personnel did not carry weapons and wore a distinguishing red cross, to denote their protection as noncombatants under the Geneva Convention. This practice continued into World War II. However, the enemies faced by professional armies in more recent conflicts are often insurgents who either do not recognize the Geneva Convention, or do not care, and readily engage all personnel, irrespective of noncombatant status.
TCCC: Previously, military guidelines for trauma management mirrored tactics used in the civilian sector. Initiated by the elements of the Special Operations Command, the new strategies outlined in 1996 were collectively referred to as Tactical Combat Casualty Care . The techniques taught in TCCC are being widely used on the battlefield and are in general working well. HEMORRHAGE CONTROL: Hemorrhage is the leading cause of preventable death on the battlefield.
1. 90% of combat fatalities occur forward of medical care.
2. Half of these casualties bleed to death, 1/5 from extremity.
3. Trauma . Although bleeding is a main cause of death, the vast majority of wounds do not have life-threatening bleeding.
THE HASTY TOURNIQUET: A tourniquet is a constricting or compressing device used to control venous and arterial circulation to an extremity for a period of time. Putting a great deal of pressure on the affected blood vessel, it collapses it causing the bleeding to stop. Very quickly it was realized that this technique was ineffective due to human nature. Many war fighters would identify a gunshot wound and place the tourniquet 2-4inches above the wound only to find that they missed the entry wound. Eventually the choice was made to ensure that tourniquets should only be placed above the joint, allowing the pressure to be placed against a single bone. This allowed tourniquets to become extremely effective despite the abuse that is placed on them in a field scenario.
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