Seeing future battlefield graded rescue from epidemic prevention and control
introduction
In the "epidemic" operation to combat the new crown pneumonia epidemic, the military and ground health service forces innovated to establish a hierarchical treatment system consisting of "square cabin hospitals, designated hospitals, and critically ill hospitals". Patients were classified, classified, and shunted, which effectively improved the cure rate. This graded rescue mode originates from the practice of war and continues to develop in battlefield health support operations. In the future, hierarchical rescue will take the stage of informatization warfare in a more flexible and efficient organizational form, providing strong support for maintaining, improving, and regenerating combat effectiveness.
Improve combat-based rescue grading
The treatment of the wounded and sick is the central task of health support during wartime. It has a bearing on the lives of officers and soldiers, is related to the morale of the army, and affects the outcome of the battle. Hierarchical treatment is the basic organizational form of health support in wartime, and it is developed from "local treatment" and "simple evacuation". In the cold weapon era, the wounded are usually treated locally and with the team. In the age of firearms, the wounded are usually transferred to a relatively stable environment for centralized treatment. In the Franco-Prussian war, the Prussian army sent the wounded to the rear hospital after a brief treatment in the battlefield, and implemented staged treatment. Starting from the First World War, in the face of the problem of treating the wounded in large numbers, countries around the world consciously organized the treatment and evacuation of the wounded in accordance with the "ladder". After extensive military practice, our army basically formed a "three-zone, seven-level" graded rescue mode during the Korean War. In fact, grading treatment is to divide the treatment activities into phases, stages, and continuous implementation when there are a large number of wounded and sick and the treatment environment is unstable, effectively breaking the objective between the emergence of a large number of wounded and sick and the lack of battlefield medical care and limited beds. Contradictions, improve the quality and level of health care support. In this "epidemic" operation, the military and local medical institutions separated the treatment process of patients with new coronary pneumonia from time and distance through grading, classification, treatment and evacuation. Improved treatment effect. In the future battlefield, with the reform of combat styles, changes in combat composition, the growth of support needs, and the advancement of technology and equipment, the organizational form of hierarchical treatment will continue to improve.
In the future information warfare, the basic strategy to improve the efficiency and effectiveness of the treatment of the wounded and the sick is to simplify the medical treatment ladder, to advance the excellent treatment technology, to accelerate the evacuation speed, and to build a "frontier stable injury, three-dimensional evacuation, stepped treatment, and strengthened forward" Graded treatment model. In each treatment ladder, the first-level treatment is to gain time and lay the foundation for the next-level treatment. The next-level treatment inherits and improves the previous level, but the treatment classification is not static and needs to be adjusted flexibly based on actual combat. To this end, it is necessary to change the approach led by a certain service, establish an organizational form that is more applicable to the characteristics of each service, uniformly deploy, deploy rescue and evacuation forces, and implement unified treatment and evacuation of the wounded and sick of the three armed services; Under the basic principle of zoning and classification, try to simplify the rescue ladder, and deploy high-quality forces such as field medical clinics and specialized surgical teams forward; change the method of gradual evacuation To expand the three-dimensional evacuation methods, use health trains, sanitary aircraft, ambulance helicopters, hospital ships and other platforms to establish treatment grading, evacuate wounded patients, and effectively improve the efficiency of treatment and evacuation.
Create "Four Links" for Medical Service Rescue
To win the fight against epidemic prevention and control, rescue technology is the foundation. The state has issued multiple versions of the diagnosis and treatment plan, and the military and local governments have also introduced various unique diagnosis and treatment measures to provide scientific, safe, and effective disease treatment technology for patients with new coronary pneumonia. Battlefield medical treatment technology is the housekeeping skill of the army's health service to ensure a win. There is a significant difference between the treatment of war trauma and wartime disease and the general clinical injury and treatment. The injury mechanism and treatment measures have unique rules of firearm injury. According to statistics, the treatment of an ordinary casualty during war involves an average of 16 specialties, and complex casualties may involve more than 50 specialties. In the future information warfare, to rob comrades of life with "death", it is necessary to build a complete and efficient health service rescue link to maximize the rate of injury and disease healing.
Technology determines tactics, tactical traction technology. The health service technology chain depends not only on the advancement of technology itself, but also on the service skills for scientific use of these technologies. In the future battlefield, we should focus on the rescue of the most difficult points in health service and build the "four chains." The first is the battle wound treatment chain. Should follow the rules of battle injury rescue, focus on the basic process from first aid to rehabilitation, aim at the primary to advanced technical systems, and create a "battle first aid, emergency treatment, early treatment, specialist treatment, rehabilitation" technology link. At the same time, in view of the decline in the proportion of gun injuries in modern wars, the increase in explosive injuries, burns, impact injuries, compound injuries, and seawater immersion injuries, the new concept of weapon injuries is gradually emerging, focusing on the development of military specialty medicine, strengthening emergency medicine, orthopedics, Special treatments for the treatment of war trauma in the brain, burns, severe illness, and anaesthesia, as well as the prevention and treatment of high-tech weapon injuries, have improved the technical level of medical institutions. Followed by the disease prevention and control chain. Focusing on the occurrence and development of diseases, we will build a technical link of "epidemiological investigation, disease surveillance and early warning, health education, health supervision, and emergency health treatment". The third is the nuclear biochemical rescue chain. Strengthen the military's leading position in nuclear and biochemical emergency medical rescue, strengthen the special service support capabilities of submarines and air crews, and create a nuclear, biochemical medical rescue link of "detection, inspection, elimination, prevention, rescue, delivery, and treatment". The last is the indispensable chain of health service organizations. We should focus on the organization of mass casualty treatment, and create a service link of the health service force "organization, carrying, delivery, deployment, perception, allegation, treatment, transfer, guidance, supply, supplement, and maintenance."
Grasping the "two keys" of hierarchical treatment in wartime
As of March 18, the army's support to the Hubei medical team has accumulatively treated 6,698 patients, and over 4,000 were cured and discharged. Army and ground health service forces seized the two key points of epidemic prevention and control. On the one hand, they set up a square cabin hospital to treat mild patients, isolate the source of the disease, treat them symptomatically, and reduce the infection rate. In critically ill patients, the mortality rate is minimized. Gradual treatment during wartime must also grasp the "bull nose", of which first aid and deterministic treatment are the two most important links. Data show that in the conventional weapons war, 40% of the dead died immediately after being wounded and could not be cured, 25% died within 5 minutes, the chance of treatment was slim, the remaining 35%, 15% died within 30 minutes, and 20% died. After 30 minutes. It can be seen that first aid on the battlefield is crucial and is the first key to reducing deaths and improving the rate of healing. High-quality first aid can effectively extend the life of the wounded, but the real solution to the problem lies in the definitive treatment of the complete elimination of the causes and complications of the injury. This is the second key and a fundamental measure to maintain the life of the wounded and restore combat effectiveness.
By grasping the two key links of first aid and deterministic treatment, we can choke the throat of "death" and save more comrades' lives. Strengthening the first-aid capability is inseparable from actual combat training. It is necessary to strengthen the training of self-rescue and mutual rescue of medical officers and soldiers, and to strengthen the foundation of front-line rescue capabilities. It is necessary to improve emergency response capabilities, and strive to strengthen the front-line to ensure that first-aid has sufficient strength and conditions. If possible, the rescue organization will be deployed forward; the advantages of unmanned intelligent means shall also be fully utilized to develop health service technology and equipment suitable for the front line of fire and enemy fire zones. Strengthening deterministic treatment capabilities requires military medical institutions to practice their internal skills, consolidate strong specialized technologies through job training and skill competition, and integrate high-tech means such as artificial intelligence, sensing technology, and robotics to gradually make medical security more intelligent. In addition, deterministic treatment should also establish a holistic concept, combining local treatment with overall function, combining surgical treatment with medical treatment, combining physiological repair with psychological rehabilitation, and obtaining comprehensive treatment and nursing measures to ensure injury and illness Recover as soon as possible.
Adhere to the dialectical unity of classification and limitation
Time is life, and humans suffering from trauma have limited natural survival time. On the battlefield, the timing of intervention in medical treatment measures is crucial. Timely and effective measures can save lives. Poor timing can lead to the end of life. In the prevention and control of this epidemic, military and field health service units treated patients with new coronary pneumonia in accordance with the principles of "receivable and receivable", "early detection, early reporting, early isolation, and early treatment", ensuring the patient's timeliness of treatment. There is a dialectical and unified relationship between hierarchical treatment and time-limited treatment, which is both mutually restrictive and complementary. On the one hand, there is a contradiction between grading and timeliness. The aging treatment requires that the wounded be given deterministic treatment in the shortest time to minimize the death rate. The tiered treatment requires the treatment forces to be deployed in stages. The treatment measures are implemented in stages. Separating the treatment process from time and space will objectively affect the timeliness of treatment. On the other hand, grading and aging are unified, grading restricts aging, and aging provides a basic time limit standard for determining the grading, the allocation of power, the grasp of the evacuation distance, and the use of transportation means.
Adhering to the dialectical unity of grading and time effectiveness is to guide grading treatment with time-effect treatment, and organically combine grading and time-effect treatment, so as to coordinate and optimize the organizational form and guarantee method of the treatment of the wounded and the sick, and strive to achieve grading and time-effect Complement each other and complement each other. In terms of organizational effectiveness, the experience of the joint epidemic prevention and control mechanism can be used for reference, allowing the health service command to be deeply integrated into the combat command chain, relying on "one network" and "one picture" to achieve efficient health service organization and command. In terms of operational capabilities, focusing on actual combat requires the establishment of combat composition of health service forces, reconstruction of the proportion structure of personnel, scientific allocation and optimization of military personnel and civilian personnel, and the improvement of operation speed. In terms of mobility, in accordance with the concept of systematization and integration, rationally equip sanitary equipment and equipment, improve availability, reliability and safety, and gradually realize the modularization, on-boardization and informationization of sanitary equipment and equipment. Relying on actual combat drills and non-war military operations, we beat all-round health-care forces, specializing in refining rapid response, rapid mobility, rapid deployment, and rapid treatment, and comprehensively improving the health-care support capabilities.
(Yang Zhuoyi Author Unit: Joint Service School of National Defense University)