Medical evacuation

A medical evacuation is a system of measures for the evacuation of the affected patients and from the field or from the hearth of mass destruction and their delivery at health facilities and in the institutions that provide them with medical care and treatment.
Medical evacuation is the most important element medical-evacuation support of the army (see Medical-evacuation support) and assistance to the population in the system of medical services of civil defence (see). In peacetime medical evacuation used during natural disasters and other catastrophes, accompanied by a large number of victims. The main reason that causes the need to produce medical evacuation, are usually extremely limited possibilities for affected patients and directly on the location of the injury or disease during their mass appearance. Undoubtedly, in the interests of the affected ill treatment on the location of the injury or illness would be the most appropriate. They quickly would provide much needed rest and treated them from beginning to end disease the same doctor. However, the difficulties in creating the necessary conditions in place for the organization of treatment at the appropriate level, inability to concentrate here the necessary forces and means, and in some cases military danger and the associated risk of repeated defeat suffered inevitably require medical evacuation.
Thus, medical evacuation is a measure of the forced - not only indifferent to the health evacuated, but dangerous, because it is connected with the disturbance of the peace, division of medical services. At the same time it is necessary. In this regard, the medical service is obliged to limit medical evacuation, rationally combined with treatment and to evacuate the most gentle ways and means.
In the conditions of modern war medical evacuation is the most important means of ensuring the timely provision of qualified and specialized medical assistance to the affected and the sick. It provides fast delivery of all the affected patients and in those stages of medical evacuation (see above), which are the most rationally for medical reasons and in accordance with the circumstances should be sequentially first medical, professional and specialized care and hospital treatment. However, under favorable conditions it is expedient to carry out medical evacuation, bypassing some of the stages of medical evacuation, directly in the institutions which are intended to provide in full specialized assistance (evacuation on purpose).
In conditions of the acting army medical evacuation begins with the collection, removal and disposal of affected from the battlefield and home mass lesions (see the Removal and removal of diseased). The collection impressed on the battlefield is the responsibility of the assistant battalion. Removal of the affected battalions organizes a senior doctor of the regiment. Further evacuation is carried out by order of the responsible medical chiefs. The principle of evacuation, at which higher medical Director sends their transport to the stages lower level health service, called evacuation "on himself"; he does not exclude the responsibility and child health chiefs for the removal of the diseased and the sick.
For evacuation uses a special transports (see) and vehicles designed to transport. The latter is used mainly along the way when you return it after unloading in the rear (back-haul transportation).
The section from the battlefield to the RAP for export affected may apply special conveyors and small ambulance with high cross-country capacity, in the area between RAP and Meds - car transports. Evacuation from Meds, as a rule, is carried out Autocentrum, and also by air transport. The increasing value for evacuation acquire the helicopters.
For medical evacuation inside the hospital databases and beyond them is used avtosolitony transport, specially equipped railway and water and sanitation and transport aviation. Undoubtedly, in the future sanitary aviation, and transport planes will be along with motor vehicles and railway transport one of the main means of evacuation of the affected and the sick.
In the system of MGO at occurrence of nuclear hearth of great importance for the timely collection affected in specially intended for this purpose places and their subsequent removal and export to the OPM. These tasks are performed San. brigades together with rescue units. Export is organized transport OPM and attached tools. The evacuation of the peace operation in the hospital database is organized by the medical Department operational Department. On this site you can apply various kinds of motor transport, under appropriate conditions - railway and water transport, as well as helicopters.
Medical evacuation is closely connected with aviatransportnoe medical sorting (see Sorting medical). Only by carefully conducted aviatransportnoe medical sorting it is possible to rationally organize medical evacuation. From issues such as the establishment of indications and contraindications for the evacuation, the choice of the mode of transport, defining the order of evacuation and destination, depends the fate of the affected and the sick.
For the transportation of serious importance should be given appropriate training evacuees, which is mostly relied on the medical staff (pre-shipment inspection, checking the availability of medical documentation, fix bandages and immobilization, the introduction of painkillers and other). Should provide nutrition, hydration and care evacuated in transit. Using back-haul transportation, you must prepare it for transportation amazed and sick - to warm, to establish possible potresaiuwii fixtures, put a soft rug, etc., All these measures should ensure that transported the most favorable conditions in transit.

A medical evacuation is a system of measures ensuring the transportation of the wounded and sick, in need of treatment, from the areas of fighting troops (or of the centers of mass destruction that occurred in the rear of the troops) in medical institutions located both in the theatre of war on the greater or lesser distance from the front line)and beyond in the rear of the country. The
the medical evacuation is one of the most important elements of the system of medical support (see Medical-evacuation support). Medical evacuation can be carried out (massively) and in time of peace, if necessary, transportation of victims from the areas of natural disasters (earthquakes, floods and so on).
Medical evacuation should be viewed as an event of involuntary nature; it applies in all cases where the treatment of the wounded and sick in place is for some reason impossible or impractical for medical reasons. Most often need medical evacuation occurs when adverse conditions of combat conditions, especially when the discrepancy between the capacity of existing hospitals to the number of incoming wounded and sick, and if it is impossible to create the proper conditions for them more or less prolonged hospital treatment. Medical evacuation is often used when maneuvering the nature of the fighting troops, when you need to move them to medical facilities.
In the past, the evacuation of the wounded and sick a long time was cut off from the treatment process and was regarded primarily as a purely military activities, and not medical. Only the experience of the first world war 1914-1918 with its huge loss of lives and unprecedented up the volume evacuation led to radically reconsider this question. C. A. Oppel was proposed system of staging treatment, which included a combination of medical and evacuation. However, this system was implemented and has been further creative development only after the great October socialist revolution.
Medical evacuation is now regarded as the most important part of medical-evacuation support for the troops, is inextricably linked with the process of providing medical assistance to the wounded and sick and treatment; indissoluble connection and interdependence of emergency and remedial measures constitute the fundamental basis of the modern system of medical-evacuation support of the Armed Forces of the USSR. At the same time, medical evacuation is, along with therapeutic interventions (medical care, hospitalization, treatment and sorting (see Sorting medical) only a single element of a complex of medical-evacuation process and should be subject to the common idea of the organization of medical-evacuation support for the troops, adopted for the modern stage of development of the Armed Forces and military medicine.
In all cases, medical evacuation should be organized in such a way as to ensure (in this particular situation) best conditions for rendering medical aid to the wounded and sick and for their subsequent treatment. Of particular importance are: 1) the delivery of the wounded and sick on the stages of medical evacuation (see Step treatment) in terms of providing timely medical care; 2) the direction of the wounded and sick in strict accordance with medical indications specialized medical institutions (bypassing the intermediate stages of medical evacuation), intended for the provision of certain types of medical care, i.e. the application of the principle of evacuation on purpose; 3) preventing excessive overflow wounded and sick individual stages of medical evacuation, as it entails a sharp deterioration in the quality of medical care and hospital admission; 4) early casualities and the sick in hospitals, where they can be left for the systematic treatment.

From the point of view of purely medical transportation of the wounded and sick during the evacuation has a negative impact on evacuees and thereby harm them (N. I. Pirogov believed transportation of the wounded unconditional, but necessary evil). In this regard, the medical service of the Soviet Army envisages a number of measures for reducing the adverse impact of transport: the use of the most environmentally friendly modes of transport for the evacuation of seriously injured patients, used in treatment on the spot, etc., currently the evacuation of the wounded and sick in the Soviet Army is seen as an important medical function, designed to ensure the speedy delivery of health care and the subsequent treatment of the patients with the maximum reduction of the harmful impact of transport.
For medical evacuation used a variety of vehicle. The sick and the wounded could be evacuated to the General transport - freight, and sometimes even in the combat vehicles (for example, armored personnel carriers), transport aircraft, which are appropriately equipped to do this. But the most adapted for transportation of seriously injured patients (patients) specialized transports (see), which provides them with the most flexible conditions of evacuation. Currently, the most common types of sanitary transport, used on the battlefield, are different types of ambulances and sanitary aircraft (helicopters). For evacuation by rail are applied to the message of the military-sanitary trains (temporary and permanent), and on sea and river communications - sanitary and transport vessels.
Modern system of medical-evacuation support of the army, based on the principles of specialized treatment and evacuation on purpose and taking into account the complicated situation to health-care services, due to the possibility of wide use by the enemy rocket and nuclear weapons and other weapons of mass destruction as by troops of the army and rear parts of the country, greatly complicated the organization of medical evacuation. In some cases, a significant portion of the wounded and sick is delayed for treatment prior to final recovery (treatment on the spot) in medical institutions of hospital bases deployed on the battlefield. In this connection it is necessary to evacuees were distributed, respectively, medical indications for numerous specialized medical institutions mentioned hospital databases and delivered in these institutions directly, bypassing the intermediate stages of medical evacuation. As a result of this medical evacuation, starting with the health battalions and health-care units, acquired multithreaded nature, which in turn necessitates the creation of special bodies, contributing more clear it (medical distribution stations and points, sorting hospitals).
Medical evacuation is organized, as a rule, on the principle of "over", i.e. each medical Director (or a managing body) uses in his possession sanitary vehicle to remove the wounded from subordinated to him (the child) units of the medical service; for example, the head of the medical Department of the army sends transportation for evacuation of the wounded and sick of the divisions, divisional doctor of the regiments. This organization medical evacuation enables more efficient and rational use of transport means in accordance with the rapidly changing environment. However, depending on the conditions of medical evacuation can be organized "from itself", when, for example, regimental transport goes with the wounded to medical and sanitary battalion or a separate Megatrade.
The availability of modern means of medical transport, in particular air ambulance with a big radius of action, allows to carry out medical evacuation long distances, bypassing the separate links of medical-evacuation system. This makes it possible to more efficiently manage evacuation flows and their distribution between individual hospitals or hospital databases on the theatre of war to avoid overloading of the latter or to evacuate the wounded and the sick to be treated in the rear of the country, bypassing part of the hospital bases deployed on the ground and railway communications.
Complicated due to the specialization of the therapeutic process medical evacuation may be organized and carried out properly without careful sorting of each group evacuated the wounded and sick (see Sorting medical). Only provided that it is possible to distribute evacuated by specialized medical institutions in accordance with the need in certain types of medical care and treatment or to set the order of their transportation - transport, which should be evacuated this wounded or sick, place and order of evacuation, transport position (lying, sitting). The results of such an evacuation transport sort are recorded along with instructions about diagnosis of injury (disease) and the medical care received the wounded or sick, in medical-evacuation documents of the established form - primary health card and evacuation envelope that accompany evacuated to the final evacuation.
Medical evacuation is organized according to the plan of medical support. Planning medical evacuation is carried out after careful assessment of the military situation and is based on a preliminary calculation of possible losses, data on escape routes, areas of health posts and hospitals, as well as information about the resources of emergency vehicles. Based on these data the calculation of the needs of sanitary transport and decide on the distribution of emergency areas and order of work during combat operations (transactions).
Cm. Medical support of the Armed Forces.