Tactical Medicine Research Articles

Current aspects of the organization of first aid to military personnel of the NATO bloc (using the example of the Bundeswehr army)

The study examines the most pressing issues of the organization of first aid to military personnel in the countries of the NATO bloc (using the example of the Bundeswehr army). It has been established that the system of first aid to the wounded and injured is based on the principles of “tactical medicine”, including the possession by military personnel of algorithms for providing assistance in the “red” and “yellow” combat zones, as well as methods of evacuation to the stage of medical care. It is emphasized that in order to quickly and effectively carry out self- and mutual assistance activities on the battlefield, NATO military personnel have appropriate training in the use of a standard individual first aid kit. It is shown that the Bundeswehr army has successfully implemented a training program consisting of two consecutive and logically related medical training courses: an initial training cycle (course “A”) and a special medical training course (course “B”). Only military personnel who have successfully completed both training courses are allowed to provide first aid in combat and emergency situations. It was revealed that within the framework of initial military training, students master a set of measures for phased first aid to the wounded and injured in accordance with the “C–A–B–C–D–E” scheme. The subsequent course of special medical training is aimed at training military personnel in emergency resuscitation measures in conditions as close as possible to combat. The purpose of the study was to analyze the literature data devoted to the study of the peculiarities of the existing system of first aid to the wounded and injured in the armies of NATO countries, including in the aspect of the organization of the training process for servicemen. The research methodology included the analysis of scientific publications selected from domestic and foreign databases, such as e-Library and PubMed. The methods of content analysis, synthesis, method of historical comparison, and bibliographic research method were used.

Active armed offender: A novel clinical practice guideline for pre-hospital care in Ireland

Incidents involving pre-hospital clinicians responding, or being caught in, active situations of those armed with knives and guns are rising in Ireland. These high-profile and high-stress situations require prior planning to minimise loss of life and maintain the safety of paramedic staff. Better situational awareness has been identified by veteran paramedics involved in active armed offender incidents as a key priority in preventing assault of staff. This novel proposed Clinical Practice Guideline (CPG) for the Pre Hospital Emergency Council (PHEC) Ireland is based on existing similar guidelines in Australia. This CPG combines pre-hospital emergency guidelines with established tactical medicine principles from the military and police services worldwide. This CPG seeks to minimise harm to clinicians as well as inform them of appropriate clinical priorities while operating in an unsafe situation

Tactical Medicine – a Challenge of the Times! Medical University – the Main Provider of First Aid in the Region or a Free Listener?

The article presents the results of the activities of the consortium "First Aid and Digital Health of the Population" and Amur State Medical Academy, as a higher educational institution — a leader and provider of effective education in first aid programs.

Some aspects of tactical medicine in service and combat activities of police officers under the conditions of the legal regime of martial state: problem issues in critical situations and combat conditions

The article highlights the problematic issues of tactical training of law enforcement officers in today’s conditions, considers the actual problems and challenges that law enforcement officers may face during the performance of official duties and the provision of first aid in combat conditions and emergency situations. The issue of the interaction of the National Police of Ukraine with other rescue services at the scene for the effective provision of first aid was considered. It is noted that the interaction of the police and other rescue services at the scene of the event in the conditions of martial law requires a special approach and careful planning. It is necessary to ensure a clear coordination of actions, an appropriate level of protection for the personnel of the rescue services, and to take into account the peculiarities of work in the conditions of hostilities. Effective interaction between different services will minimize the consequences of emergency situations and ensure the safety of the population in the conditions of martial law. The article highlights the algorithm of actions for providing assistance to injured persons by police officers under fire, considers the key issues of training law enforcement officers to provide effective first aid in conditions of martial law or extreme situations in general. The authors of the article emphasize the importance of unified training programs for police officers in tactical medicine, which should include both theoretical knowledge and practical skills. Special attention is paid to ensuring a high level of readiness of police officers for quick and effective response to emergency situations and saving lives in the conditions of an aggravated conflict. Service situations in which police officers may find themselves are often accompanied by conflicts and their escalation, up to “fire contact” with the offender. Therefore, for the training of police officers, the section of tactical medicine is the most relevant, which teaches the basic skills of providing self- and mutual aid in combat conditions, which are primarily aimed at eliminating the preventive causes of death, taking into account the threat from combat operations or an active shooter. Unfortunately, there are infamous cases of the death of police officers while performing law enforcement tasks, which indicates the need for mandatory integration of first aid standards into their training and operations in various tactical situations. In addition, it is important to note that training police officers in tactical medicine will not only help them provide effective care to victims, but will also increase their level of safety while performing their duties. Therefore, unified training programs for police officers in tactical medicine should be an integral part of the training of law enforcement officers.

Actual issues of improvement of types of official training of police officers

In the article, the authors provided a description of the types of service training, namely functional training, general training, tactical training, fire training, physical training. It was concluded that in order to improve the professional training of police officers, it is urgent to implement the measures of structural revision of its varieties, as well as qualitative updating of its content, taking into account the modern challenges that exist in police activity, the development of the National Police at the current stage of state formation. Taking into account the content of training on functional training, it has been proven that it would be more correct to talk about “functional and legal training”, which is proposed to be defined as a set of measures aimed at the acquisition and improvement of police knowledge, abilities and skills in the field of regulatory and legal support of official activities, features of police activity, taking into account the specifics of the functional duties of police officers, necessary for the successful performance of their official duties. It was emphasized the need to improve the name of the “life safety” component of general training, replacing it with the name “policeman’s personal safety and life safety”. The expediency of mastering tactical medicine by police officers was determined, which was proposed to be added to the component of pre-medical training. The need to include issues of improving the tactics of driving a company car in tactical training has been proven; effective use of the main varieties of special equipment, technical devices, technical means and specialized software, in particular, the tactics of using UAVs; tactics of police actions under the influence of sources of ionizing radiation. The position of scientists regarding the need to form a new model of physical training within the framework of service training of police officers with the implementation of NATO standards is supported, for which the following measures are proposed: studying the positive experience of the Armed Forces of Ukraine in terms of developing methodological recommendations for individual physical training of servicemen according to NATO standards; review of standards for physical training; creation of a typical program of physical training within the framework of official training of police officers. The need to introduce a new type of training in the system of police officer training – “general military training” – has been proven.

Terrorist attacks in Türkiye: An analysis of counter-terrorism medicine

Aim: The objective of this research was to perform a counter-terrorism medicine analysis of terrorist attacks in Türkiye. Methods: This study is a retrospective cross-sectional research. The study population consisted of terrorist incidents that occurred in Türkiye, as provided by the START Global Terrorism Database for the period from 1970 to 2020. Various characteristics of terror attacks in Türkiye were analyzed and presented in tabular form. Results: Over the past 51 years, there have been a total of 4,485 terrorist incidents, with 91.2% reaching their intended targets as orchestrated by terrorist organizations in Türkiye. Of these incidents, 2,767 had detrimental economic impacts. Additionally, 17,570 individuals experienced adverse medical effects. Among the 81 provinces in Turkey, Istanbul witnessed the highest number of terrorist incidents and suffered the most significant medical consequences. Conclusion: Türkiye has been significantly impacted by terrorist incidents over the past fifty years especially within the last decade, particularly in metropolitan provinces like Istanbul. These events have negatively affected both the health and economic well-being of many individuals. In response, while the country has implemented various security measures and preparedness strategies to mitigate such incidents, there is also a critical need to improve the readiness of healthcare services to effectively handle the potential consequences of terrorist attacks. This includes advancing anti-terror medicine and tactical medicine capabilities, as well as strengthening mass casualty management systems. Such improvements will ensure a more effective and coordinated response to large-scale emergencies, ultimately saving lives and reducing the long-term impacts on society.

In English

The use of wound dressings is gaining more and more popularity, especially in the field of tactical and military medicine. Developing wound dressings capable of facilitating wound treatment and reducing healing time is one of the challenges of modern science. So, sodium alginate (Alg) is a good candidate for the development of wound dressings due to its bio- and hemocompatibility and biodegradability. However, Alg has its shortcomings, which can be dispatched by modification. The purpose of this work was to investigate the effect of Alg modification on the kinetics of ethonium release from crosslinked with Ca2+ ions samples. For this purpose, a method of Alg modifying with octane-1-amine was developed without the use of organic solvents and with the use of 1-ethyl-3-(3-dimethyl aminopropyl) carbodiimide hydrochloride (EDCl) as an initiator. The optimal parameters of alginate modification process were defined as 60 °С temperature and 24 hours duration. Physicochemical methods confirmed the success of the modification. Films based on the alginate modified with octane-1-amine (AlgM) were obtained using a calcium chloride solution as a crosslinker. The kinetics of swelling was studied and we found that the degree of swelling of the sample based on AlgM after 10 minutes is twice as large (α = 0.71) as for Alg (α = 0.37), which indicates a faster release of drugs. It has been found that the kinetics of release of ethonium depends not only on the kinetics of swelling but also on the chemical nature of the drug. The ethonium was immobilised in alginate films as a model of bactericidal drug. The kinetics of ethonium release was studied at different pH values corresponding to the pH of healthy skin (5.5), open wounds (7.2) and inflamed wounds (8.2). It was found that the release of ethonium from the sample based on AlgM is more pH-sensitive and prolonged, compared to the sample based on Alg. This effect is explained by the appearance of an additional mechanism of retention of ethonium by AlgM due to hydrophobic-hydrophobic interactions in the films. The prolonged release properties observed in the drug-loaded samples make them promising candidates for the development of targeted drug delivery systems and wound dressings, which are particularly relevant for the treatment of chronic and burn wounds. Future research will focus on optimizing the crosslinking method and exploring potential applications of modified alginate-based materials in biomedical sciences.

The content and structure of the educational discipline "Military-patriotic education" for the preparation of applicants for the specialty 017 "Physical culture and sports"

The full-scale war in Ukraine determined the educational strategy of the state regarding the organization and implementation of military-patriotic education and military-patriotic training of youth. The article presents the content and elements of the structure of the educational discipline "Military-patriotic education" for the preparation of applicants for the "Physical culture and sports" specialty. Research methods used: analysis of educational and methodological literature; study of scientific publications on the subject of research; systematization and generalization of information; study of regulatory documentation regarding the organization of the educational process in institutions of higher education.
 The training course contains three credits, 2 content modules: the basics of military and patriotic education; physical and military training. The goal of the educational discipline is to form the affirmation of national identity, patriotic consciousness, a sense of loyalty and love for Ukraine, readiness to fulfill the civic and constitutional duty to protect national interests, territorial integrity and independence of Ukraine based on real heroic examples of Ukrainians.
 The educational course includes the following topics: structure and content of military-patriotic education; history of the Ukrainian army and military service; state symbols of Ukraine; military and patriotic games; general physical training; fire training; topographic preparation; tactical training; tactical medicine.
 During the study, relevant competences are formed. The system of values, which Ukraine demonstrates by its own example and the highest price of Ukrainian Heroes, is assimilated; the formation of patriotic values, education of respect and dignity, features of the Ukrainian mentality; acquisition of skills and abilities in military applied training.

Self-Described Training Needs of Special Operations Forces Medics and the Birth of the TACMED Division.

Training needs of Special Operations Forces (SOF) medics were surveyed and new training initiatives have been created to meet their needs. SOF medics perform an array of medical procedures in austere environments with minimal supervision. Medical skills decay over time after initial training and the perceived training needs of active SOF medics were unclear. To fill this gap, active SOF medics (n=57) completed a survey that included confidence ratings and indications of whether additional training would make them more proficient in 70 medical knowledge and procedural skills, assembled into categories by a panel of experts (airway, trauma, neuro, differential diagnosis, administrative, infection, critical care, environmental, other). Data were analyzed with analysis of variance (ANOVA) and nonparametric statistics at P<.05. Confidence was highest in the trauma, administrative, and airway categories, and lowest in the infection, differential diagnosis, and neuro categories (P<.05 or less). Categories indicating the greatest need for additional training were environmental and critical care, while those indicating lowest need were the airway and trauma categories (P=.05). Additional training was endorsed by >75% of participants in each category. SOF medics also wanted additional training in all areas, preferably hands-on with live patients in realistic scenarios, taught by experienced medics. Findings highlight the training needs of SOF medics and demonstrate the value of bottom-up feedback toward optimizing sustainment training. Based on present findings, two TACMED (Tactical Medicine) Divisions at the SOF Echelon III level were created to meet the sustainment training needs of SOF medics.

Training of Emergency Medical Specialists in Contemporary Realities

Relevance. In accordance with Federal Law No. 323-FZ [17], emergency medical assistance, including emergency specialized medical care, is provided in emergency form outside a medical organization, as well as on outpatient and inpatient basis. An ambulance is an emergency medical service that travels to those whose lives and health are in danger. Emergency medical assistance, including emergency specialized medical care, is provided in case of diseases, accidents, injuries, poisonings and other conditions requiring urgent medical intervention. The reasons for calling an ambulance in an emergency form are sudden acute diseases (conditions) and (or) sudden exacerbations of chronic diseases without obvious signs of a threat to life, requiring urgent medical intervention. In the training of doctors, including in postgraduate education, these factors are taken into account.Aim of the study. Improvement of the quality of theoretical and practical training of emergency medical specialists, as well as clinical residents and practical doctors of various specialties, taking into account issues of emergency and military medicine.Material and methods. A review of official documents of the Ministry of Healthcare of the Russian Federation and the literature on postgraduate education of doctors with subsequent primary specialized accreditation for 2018-2022 was carried out. The literature on modern approaches to the provision of emergency medical care to victims was studied, taking into account the specifics of military (tactical) medicine for 2020–2022.Conclusion. The training of emergency medical professionals, taking into account the realities of the present, should include issues of tactical medicine and be practice-oriented using simulation equipment. It is necessary to know and be able to work with modern means of protection and medical care available in the troops; be prepared to work in medical institutions of various levels with the mass flow of injured and wounded.

Тактическая медицина в российской армии в XX – начале XXI в.

Исследовательская работа освещает развитие отечественной военно-полевой медицины в области доврачебной медицинской помощи и эвакуации раненых военнослужащих российской армии на протяжении последнего столетия. В период XX – начале ХХI века произошла трансформация санитарной доврачебной помощи в тактическую медицину. Подчеркивается значение действий современного тактического медика в условиях иррегулярной войны и взаимопомощь сослуживцев при эвакуации раненых. Знание и навыки действий в рамках тактической медицины являются важным фактором сохранения жизни военнослужащих во время военных действий. The article highlights the development of domestic military field medicine in the field of pre-hospital medical care and evacuation of wounded soldiers of the Russian army over the past century. The importance of the modern tactical medicine in irregular warfare and the mutual assistance of comrades-in-arms in evacuating the wounded is emphasized. The author concludes that in the period of the 20th and early 21st centuries there was a transformation of sanitary pre-hospital care into tactical medicine. The knowledge and skills of tactical medicine are an important factor in preserving the lives of military personnel during military operations.

Wound packing trainee construction

Haemorrhage is one of the main causes of death in injuries in both civilian and military conditions. Controlling bleeding is the most important task facing the rescuer when helping a casualty. There are many ways to control bleeding, but these methods are often misused. Most of the methods described have their roots in battlefield medicine developed on the basis of experience from armed conflicts. Currently, there is a clear trend towards adapting tactical medicine solutions for civil rescues because they are effective and simple. Increased awareness among civilian rescuers and regular training will hopefully lead to more effective help for injured people. The authors' work focused on the construction of an effective trainer to mimic a hip wound and a practical examination of how training affects the time to stop bleeding using the wound packing technique.

IMPLEMENTATION OF EDUCATIONAL HUB AT IVANO-FRANKIVSK NATIONAL MEDICAL UNIVERSITY'S PROFESSIONAL MEDICAL COLLEGE

The development of technologies transforms, develops, and improves old and creates new forms of human life organization, optimizing and modernizing them. Technologies also influence transformational changes in education and require the joint efforts and collective work of all educators, which necessitates updating approaches to organizing educational processes, determining the renewal of the educational space, and developing a modern educational environment characterized by technological saturation. One of the elements of the information and digital learning environment is the so-called digital (virtual) educational hub. Digital educational hubs can support any educational field, including the «Health care» sector. Learning during the pandemic and war has prompted us to create an online platform for self-education or an Education Hub based on the university website.&#x0D; The target audience of the hub includes students of the specialized medical college of Ivano-Frankivsk National Medical University in the field of knowledge 22 «Health Care», specialties 223 «Nursing», 221 «Dentistry», 226 «Pharmacy»; students of the medical and dental faculties of IFNMU, and students of other medical educational institutions.&#x0D; The Educational hub consists of a homepage that provides general information about the Professional Medical College, Ivano-Frankivsk National Medical University, the goals of the hub, and more. The next page, «Nursing» is designed for students of specialty 223 «Nursing». Virtual learning blocks have been created for students, which contain videos and algorithms for various manipulations, test tasks, materials for preparation for the Krok M exam, tactical medicine guides, and more.&#x0D; From the «Nursing» page, one can navigate to the «Dentistry» page, designed for students of specialty 221 «Dentistry» and the «Pharmacy» page, designed for students of specialty 226 «Pharmacy».&#x0D; As part of the cooperation between the professional medical college of the Ivano-Frankivsk National Medical University and the Andrey Krupinsky Lviv Medical Academy before the war, various events took place. The war has had an impact on our lives...&#x0D; However, our cooperation continues. During times of unstable electricity and constant anxiety for the implementation of academic mobility, we have used the Educational Hub. In particular, professors Natalia Tsubanova, Oleksandra Palahitska, and Natalia Rudakova from the Andriy Krupinsky Lviv Medical Academy posted a series of educational materials on the Educational Hub. Associate Professor Oleksandr Bulbuk (professional medical college of the Ivano-Frankivsk National Medical University) shared his educational materials on dentistry. This ensured free access and the establishment of organized learning opportunities, allowing all interested students from both educational institutions to participate in the educational process regardless of their location and time.&#x0D; The Educational Hub of the Professional Medical College of Ivano-Frankivsk National Medical University is an element of the information and digital learning environment that modernizes and enhances it, providing the development of the educational process in the field of "Healthcare". Additionally, this educational platform enables academic mobility for all participants of the educational process.

APPLICATION OF DISTANCE LEARNING TECHNOLOGIES IN THE PROFESSIONAL TRAINING OF BORDER PROTECTION SPECIALISTS: THEORETICAL BASICS AND GENERALIZATION OF EXPERIENCE

The article presents a review of scientific sources and publications aimed at determining the theoretical foundations of using distance learning technologies in the training of border guard specialists. It is found that these technologies have proven to be effective in the context of improving and enhancing the quality of professional training of border guards. The application of distance learning technologies in the professional training of border guard specialists is an important and necessary element in the modern world. The main theoretical foundations that justify the use of distance learning technologies in the professional training of border guard specialists in the European Union include such aspects as learning effectiveness, cost-effectiveness, wide access to training, modernity of technology, mobility and flexibility, interactivity and cooperation, and relevance of knowledge. It is found that among a fairly wide range of studies carried out in previous years, the authors focus on the use of distance learning technologies for the purpose of training and retraining of officers and junior personal of border agencies of Ukraine and other countries, to improve their qualifications in the retraining system, to update the knowledge of border protection specialists on regulatory and legal aspects in the field of border protection, to improve their communication skills (including foreign language skills). The role of distance learning technologies in developing the leadership skills of border guard specialists, improving their tactical medicine skills, etc. is also important. The use of distance learning technologies in the professional training of border guard specialists in the European Union is an important element of responding to the challenges of the modern world. Distance learning allows to ensure the quality of professional training of border guard specialists effectively and ensure that their knowledge and skills meet modern requirements and standards. However, despite the attention of scholars to this problem, there are currently only a few publications that present the experience of using distance learning technologies in the professional training of border guard specialists in the European Union.

TacMed1: An Innovative Education Program in Tactical Medicine Education

TacMed1: An Innovative Education Program in Tactical Medicine Education

Применение саморасширяющейся полиуретановой пены для остановки продолжающегося внутрибрюшного кровотечения в условиях военных конфликтов и чрезвычайных ситуаций: из опыта проведения тактико-специальных учений

Summary. Investigation purpose – to evaluate the opportunity, efficiency and safety of usage of national polyurethane foam composition (PFC) during acute experiment taken in the frameworks of conducting of tactical-special exercises (TSE). Materials and methods of the investigation. Tactical-special military-medical exercises “Ochag” are conducted annually and directed to testing of advanced health care technologies which are perspective for saving solders life and health. For modeling of tactical conditions a time coordinate system of troop system of evacuation of injured was created – from the time of provision medical treatment on artificial battlefield on the frameworks of tactical medicine till the time of provision of primary medical-sanitary treatment in medical platoon and providing of surgery in the frameworks of tactical control of injures in surgical room deployed in a tent of medical company. Investigation results and their analysis. All animals survived till the end of the experiment, internal hemorrhaging was resolved. Till the 90th minute of experiment an appearance of small values of substances included in the developed foam was noticed in a series of blood analyzes. This way the first experience of this technology usage during medical treatment provision in tactical time range was got. For assess of this PFC a conducting of pre-clinical and clinical researches was planned.

Организация оказания помощи раненым офтальмологического профиля в современных вооруженных конфликтах: состояние и перспективы

The main feature of modern armed conflicts is the use of new weapons and, as a result, changes in the nature and structure of eye injuries. This feature, on the one hand, and the rapid progress of medical science, on the other hand, require a rapid response to the changing operational situation using the resources of modern ophthalmology in order to provide care to wounded and injured ophthalmic patients efficiently and rationally. There are some differences in approaches to pre-hospital self- and mutual aid to the wounded with ophtalmic injuries on the battlefield in different schools of military medical training and tactical medicine. Some use a binocular bandage, while others use a rigid eye shield. The complexity and variety of visual injuries require good practical skills and experience in order to perform high-quality surgical treatment of perforated corneal and scleral wounds in open eye trauma. This necessitates a thorough training of specialists with practical skills. The issue of medical supply of units providing specialized care at the stages of medical evacuation, which includes a military ophthalmologist, is particularly significant. The problem of reasonable and rational update of the ophthalmological equipment at the stages of medical evacuation requires active discussion. There is still the question of the use of effective protective equipment for the eye during combat operations, which, without limiting visual function, could prevent combat eye injuries, most often caused by small fragments and secondary wounding projectiles.

RESOURCE-BASED LEARNING OF TEACHERS OF THE SUBJECT "DEFENSE OF UKRAINE" IN THE CONTINUOUS TEACHER EDUCATION SYSTEM

Currently, in the conditions of the war, there are intensive searches for ways of functioning and development of continuous pedagogical education in Ukraine as the basis of national-patriotic, social, spiritual-cultural, intellectual development of society and the state. One of the effective ways to improve the quality of continuous pedagogical education is the transition to resource-oriented learning. In the article, the authors present a subsystem of resource-based learning of teachers of the subject "Defense of Ukraine" in the system of continuous pedagogical education, which is positioned as a set of three interrelated components: conceptual, didactic and effective. The conceptual component is represented by the goal of resource-based learning of teachers of the subject "Defense of Ukraine" in the system of continuous pedagogical education, and tasks that are reflected in the program of professional development of teachers of the subject "Defense of Ukraine" in the system of continuous pedagogical education. The didactic component is characterized by a number of components: classroom work (lectures, practical classes, trainings, seminars, master classes, etc.) during the organization of professional development courses for teachers of the subject "Defense of Ukraine"; extracurricular work (online training with lecturers, trainers of continuing education institutions); practice (attending classes organized and conducted by instructors of the Armed Forces of Ukraine on the basis of territorial recruitment and social support centers); methods of active learning from teachers of the subject "Defense of Ukraine"; active teaching methods at professional development courses from lecturers/trainers; consolidation of resources for the acquisition of military applied knowledge, skills and abilities. The effective component reflects the degree of formation of new military didactic knowledge in the teachers of the discipline "Defense of Ukraine", the system of knowledge by areas (military-historical, legal foundations of the defense of Ukraine; pre-conscription training; civil protection; pre-medical assistance, tactical medicine), military applied skills and skills for effective conducting of classes on the subject.

Организация занятий по основам тактической медицины с гражданами Оренбургской области, призванными на военную службу в рамках проведения частичной мобилизации

Summary. The aim of the study is to analyze practical training in the basics of tactical medicine with citizens called up for military service in the framework of partial mobilization. Materials and research methods. In the course of practical classes on the basics of tactical medicine were used: individual medical kits — AIM-3S, cloak tents, sanitary straps, improvised means. The exercises included training in: methods of applying a tourniquet for external bleeding; ways of immobilizing limbs if they are injured; performing anti-shock measures; applying bandages on a wound and the order of evacuation of wounded to a safe area. All practical exercises were conducted in the field conditions. Study results and their analysis. Classes with citizens called up for military service as part of partial mobilization were conducted on the training range of the training center responsible for manning the military unit of territorial defense. The servicemen learned necessary skills of first aid in self- and mutual aid modes in the red, yellow and green danger zones. Various methods of evacuating wounded to a safe zone were practiced. The training program was executed completely, learning goal was achieved.

Застосування протоколу “MARCH” на етапі надання долікарської допомоги в умовах надзвичайних ситуацій

Introduction. According to statistics, 90% of deaths on the battlefield occur at the pre-medical stage. However, some problems, such as bleeding from the extremities, severe pneumothorax, and airway problems, can be controlled in the prehospital setting. Of all the known protocols for these conditions, the last one used in the world today is the MARCH pre-medical protocol. The aim of the study is to assess the possibility of adapting the MARCH protocol for civilians in emergencies and hostilities. Materials and methods. A review of modern world and domestic literature on the algorithms of primary home care. Results and discussion. Three basic algorithms are used to provide primary care for the wounded: 1. The “MARCH” protocol is a sequence of actions during the provision of emergency home care to the wounded both on the battlefield and at the stage of evacuation. 2. CABCDE algorithm (Western European algorithm). 3. The Wheel-Bridge Algorithm, which is used to facilitate training in first aid for the wounded based on NATO standards. It fully reproduces the sequence of NATO’s protocol in Ukrainian only. These standards are designed for physicians who provide assistance on the battlefield, and they include stages with clear objectives, but these standards can be applied to civilians at the stage of primary care in non-life-threatening conditions, ie in places where no direct combat actions. This type of care corresponds to tactical medical care. Educating citizens in the basics of tactical medicine and implementing NATOstandard pre-medical tactical care algorithms is an important aspect of hostilities that will reduce civilian mortality and awareness of military emergencies. Conclusions. The issue of insufficient training of the population in the field of first aid in case of injuries and wounds is an urgent problem and needs to be addressed by improving the practical skills of the civilian population and by developing recommendations for a first aid kit for everyday wear. The MARCH algorithm can be easily and effortlessly adapted in Ukraine and is accessible to people without medical education, and its implementation among civilians will help improve the quality of pre-medical care and reduce mortality among the population in the area of hostilities or emergencies.