Military medicine

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Military medical exercise by the US armed forces

The Military Medicine , aptly as a military medicine called, is a medical specialty that deals with the prevention, detection and treatment of diseases and injuries in military occupied areas. It is based on the knowledge and methods of general human medicine with a specific focus on militarily particularly relevant aspects. In addition to surgery (as war surgery ), internal medicine and orthopedics , this also includes toxicology , microbiology and hygiene , radiation protection from nuclear medicine and special aspects of pharmacy ( military pharmacy ).

tasks

Military medicine tasks are for example

  • Criteria and methods suitable for selecting staff ( screening )
  • Prevention and treatment of diseases typical in war zones, e.g. vaccinations , behavioral training, operational resources, etc.
  • dealing with a mass seizure of patients
  • the diagnosis and therapy of injuries caused by weapons or ordnance or by military operations or other typical injuries
  • the treatment of mission-related psychiatric illnesses and psychological trauma,
  • Determination of procedures from first aid to transport to the final care of the injured or sick.

The special challenges of military medicine include deployments on site under field conditions or in improvised facilities such as tent hospitals. A job in the field of military medicine requires special training or experience that cannot be acquired in the civil health system. The transfer of relevant knowledge therefore takes place within the framework of the military medical service .

The aim of every military medical treatment is that this corresponds as far as possible to the medical-professional standard of "best medical practice", both in terms of the result and the quality of the implementation.

The medical society in the field of military medicine in Germany is the German Society for Military Medicine and Military Pharmacy , the Austrian equivalent is the Austrian Society for Military Medicine and Military Pharmacy .

Emergency military care

In the armed forces and combat zones, the primary supply is very limited and depends on logistical and military-tactical restrictions. Care has been standardized and accelerated more and more in the past decades, so that mortality has fallen significantly. In the foreground are gunshot and explosion injuries, in the wars in Iraq and Afghanistan above all by so-called unconventional explosive and incendiary devices (in English "IED" - called improvised explosive device ). Accordingly, hemostasis , circulatory stabilization and the application of tourniquets are paramount. The faster evacuation and lowering of mortality increased the risk of amputations in these wars . The US Army has a five-tier system of care for the seriously injured that has reduced the time it takes to move from injury to the United States to an average of 3-4 days:

  • Level I: Care on site and in combat, by other soldiers and paramedics, especially for hemostasis, intravenous fluid administration and primary first aid.
  • Level II: the first medical facility as a Forward Surgical Facility that can already carry out ATLS- guided trauma care, first surgical interventions for hemostasis and rapid stabilization as part of the so-called Damage Control Surgery and intubation. This is followed by rapid relocation largely by helicopter.
  • Level III: In the Combat Support Hospital , further evaluation and stabilization can take place, as well as initial definitive surgical interventions and intensive care monitoring, but with very limited capacities, so that the patient can often be transferred to specially equipped aircraft and by specialized Criticals before the final stabilization of the patient Care Air Transport Teams (CCAT) can take place.
  • Level IV: in these trauma centers of maximum care, complete first aid can finally take place, with all the possibilities of trauma surgery, neuro, thoracic, abdominal and vascular surgery, intensive medical stabilization and radiologically invasive measures. As a rule, relocation to the United States only takes place after adequate stabilization. One example in Germany is the Landstuhl Regional Medical Center , which was a Level IV center until May 2014.
  • Level V: These maximum care trauma centers are found exclusively in the United States. The best known is the Walter Reed National Military Medical Center in Bethesda, Maryland, or the San Antonio Military Medical Center in Fort Sam Houston , Texas. This is where non-urgent, reconstructive and secondary interventions take place, followed by rehabilitation and aids .

See also

Historical literature

  • J. Ulr. Bilguer : Surgical perceptions, which mostly during the war that lasted from 1756 to 1763 in which Königl. Prussia. Field hospitals recorded by various surgeons. Wever, Berlin 1763 (also: Hermannsche Buchhandlung, Frankfurt am Main 1768).
  • Friedrich von Esmarch : Manual of the war surgical technique. Rümpler, Hanover 1877 ( online ).
  • Franz Hermann Frölich:
    • History of the military medicine of the Germans in antiquity and the Middle Ages. In: German Archive for the History of Medicine and Medical Geography 3, (Leipzig) 1880, pp. 222–256.
    • About the beginnings of military medicine in the Middle Ages. ibid. 5, 1882, pp. 75-80.
    • Military medic. Brief description of the entire military medical system. Braunschweig 1887 (= Wreden's collection of short medical textbooks , 13).
    • History of the royal. Saxon Medical Corps , (Leipzig) 1888 ( online )
  • Otto Karl Schjerning et al; The gunshot wounds. [Advances in the field of X-rays. Supplementary Volume 7]. Hamburg, Gräfe & Sillem, 1913, 2nd edition.

Individual evidence

  1. ↑ Nicolai Guleke : War surgery and war surgeons through the ages. Gustav Fischer, Jena 1945
  2. ^ Ralf Vollmuth : War surgery. In: Werner E. Gerabek , Bernhard D. Haage, Gundolf Keil , Wolfgang Wegner (eds.): Enzyklopädie Medizingeschichte. De Gruyter, Berlin / New York 2005, ISBN 3-11-015714-4 , pp. 807-809.
  3. ↑ Robert L. Sheridan, Peter R. Shumaker, David R. King, Cameron D. Wright, Kamal MF Itani, Leopoldo C. Cancio: Case 15-2014: A man in the military who was injured by an improvised explosive device in Afghanistan New England Journal of Medicine 2014, Volume 370, Issue 20 of May 15, 2014, pages 1931–1940, [DOI: 10.1056 / NEJMcpc13100008]

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