The deficiency of a adequate number of medics and drug stores, as well as an highly prolonged evacuation are a immense problem for the Ukrainian army. utilizing our neighbors' war experiences, we must guarantee that the military medical services are well trained as shortly as possible.
Missions in Iraq and Afghanistan have definitely changed military medicine. Stories about the improvement of the battlefield rescue in the Polish Army have been starting in the same place for respective years. The soldiers then gained fresh skills and knowledge, which they frequently faced with practice. They understood the importance of self-help in the field and helping an injured colleague. The medical evacuation chain worked well, alleged golden hr rules were followed, regarding the time in which the victim should go to the field hospital. But it is time to separate these stories with a thick line and take a step forward. There has been a full-scale war going on beyond our east border for over 2 years, in which, contrary to all conventions, medical services are on the front, and the cross painted on ambulances is treated by Russians as a shield. The war, during which there is no evacuation of victims by air, while respective twelve soldiers are killed daily, and respective 100 are injured. Therefore, according to our doctors and rescuers, we should look at the problems which the war in Ukraine exposes in Poland as shortly as possible. We must do everything we can to guarantee that the scripts from the Ukrainian front never happen again.
The fact that in military wellness care – at all level of wellness – must be invested, besides the management of the national defence department knows. The reorganisation has already begun and is 1 of the priorities of the Minister of National Defence. At the end of May, Deputy Prime Minister, Head of the MON Władysław Kosiniak-Kamish announced that the Military Medical Academy will be restored in Łódź. The university was dissolved 2 decades ago and then trained military doctors for years within the limits of the MON in the alleged Military-Lekarski College at the Medical University of Łódź. Today, the head of the defence department says "stop" to temporary solutions. – Building a component of medical troops, building the highest level of security, we must remember that the personnel that are needed to carry out these activities, their training and preparation are the most crucial thing. We request doctors, nurses, paramedics, that is very well trained and prepared personnel, who will supply help," said Władysław Kosiniak-Kamysz. This year the bill on the establishment of a fresh university is to be sent to the Sejm. “We hope that Parliament will accept it and we will be able to recreate it, and actually build the best training centre for both doctors and officers of the Polish Army, soldiers who will join the service in the Polish Army,” said the minister.
Last bell
Experts point out that wellness problems, including this military one, revealed coronavirus pandemic in 2020. The avalanche-growing number of patients with COVID-19 caused the country to run out of medics. A remediation for the ailments of the national wellness strategy was to be medical in uniform. The decision to mention military paramedics to work in hospitals, including temporary and covid ones, although right, did not bring the expected results, due to the fact that the hands to work were inactive not enough. It was so rapidly decided that soldiers who had completed qualified first aid (kpp) courses would besides join the fight against the pandemic. The military supported medical personnel in infirmary emergency wards, emergency chambers, but most of all they gained the authority to execute coronavirus tests. – Further challenges came faster than expected. any military medics were directed towards the east wall of the country to safe the functioning of the Military Task Force Podlasie. And again, we found that staff shortages among military medics are visible on practically all level – said Colonel Anita Podlasin, deputy commander of the Military Medical Training Centre in Łódź. Why does the army face specified problems? There are at least a fewer reasons, but the most common point is the deficiency of opportunities to combine professional practice with military service, and, above all, lower than in civilian earnings.
Personnel shortages among doctors may be worrying, especially erstwhile we realize that this is 1 of the major problems facing the Ukrainian army. Many doctors died in the first months of full-scale conflict. The restoration of trained personnel during wartime is highly hard and time consuming. "The situation in Ukraine is mercilessly revealing problems that we as a country could collide with in the event of the outbreak of war. The deficiency of medical personnel is just 1 example. Others include problems with the evacuation of wounded. The time for it to be carried out calculated before the war for a maximum of 30 minutes, present due to the threat on the battlefield drags up to respective hours. There is no anticipation to usage rescue helicopters, sanitary transports are under attack, medical equipment and medicines are missing – according to military doctors and rescuers. They besides point out that standardized procedures and training introduced years ago in NATO does not work in the different situations that happen in Ukraine. – It is time to redefine any assumptions and adapt to the requirements of the modern battlefield – noted Colonel Podlasin.
Similarly, Dr. Beata Zysiak-Christ, a medical lifeguard and an assistant prof. at the Faculty of safety Sciences of the Academy of Land Forces is of the opinion. "The experience of Ukrainian soldiers, medics and civilians active in war activities shows how many fresh solutions will should be introduced to training programmes in another countries, including us. We request to be prepared for a fresh kind of conflict," she points out. Referring to the conclusions of the war in Ukraine, he adds: "We know that an experienced paramedic can easy execute certain life-saving procedures, which are usually reserved only for doctors. This includes, for example, pleural drainage or blood transfusion straight from the donor. Our wellness services, based on these experiences, should prepare well for emergency situations. If we do not do so rapidly and there is an armed conflict in our territory, it may be besides late to learn in this area.
New Reality
The Military Center for Medical Education in Łódź goes 1 step further and proposes that advanced medical procedures be taught not only by paramedics, but besides by soldiers without medical education. specified training has been carried out in Łódź for 2 years by Ukrainian soldiers. They are trained there as part of the EU Military Assistance Mission (EUMAM) EU Military Assistance Mission (EU Military Assistance Mission), based on a proprietary programme developed by WCKMed. Since the beginning of the war, nearly 400 Ukrainians participated in specified training in Lodz. – The starting point was for us to establish a course for medics of the battlefield, which was accepted in Ukraine just before the outbreak of the war. It was developed thematically and long – lasting 22 weeks – comparable to those experienced by NATO peculiar forces in the United States. Unfortunately, under war conditions, impossible to carry out. We were asked to build an first training program on this foundation. And yes, 22 weeks had to be shortened to... 25 days – says Colonel Podlasin.
Created in WCKMeda, the course for Ukrainians was included in the training directive of the Ukrainian Ministry of Defence and accepted by the European community. The second was not easy, especially since its program included content reserved for medical personnel only. “We had to decision distant from the NATO standardization and respond to the needs of soldiers fighting at the front. Although Ukrainians deficiency qualified medical staff, they inactive gotta save lives of the injured," says deputy commander of WCKMed.
The course created in Łódź centre focuses on learning applicable skills and patterns of treatment with the patient, and most importantly, it is designed for soldiers without medical education. “People with military experience, frontal experience, as well as people who have just begun to service in the military come to us. They are combined with deficiency of medical education and large motivation to learn – says Colonel Podlasin. They learn self-help and peer support in the field of combat, under fire and in a comparatively safe zone. Instructors pay peculiar attention to the treatment of massive hemorrhages, airway obstruction and to the provision of chest injuries. – This phase of the course is very akin to the CLS (Compat Lifesaver) training, which is for combat field rescuers. However, we have expanded it to include issues related to the usage of improvised measures. We teach Ukrainians how to make a tourniquet or how to evacuate utilizing casevac vehicles [casualty evacuation] - explained WCKMed trainers.
In the next phase of the course, Ukrainians learn procedures of alleged pre-hospital medicine, or non-battlefield injuries. War isn't just injuries and injuries to the body. You request to know how to deal with a patient with acute coronary syndrome, stroke or abrupt cardiac arrest. Moreover, mobilization in Ukraine includes soldiers whose wellness condition frequently leaves much to be desired. Ukrainians asked us to transfer cognition about basic wellness care, so that their physicians knew how to aid soldiers who, after weeks spent in trenches, conflict with various types of advanced respiratory tract infections, describe the instructors of the Łódź Centre. Ukrainians besides learn drug- and fluid therapy and how to deal with a patient who has suffered from flute attacks, cluster guns or white phosphorus. The staff of WKCMed admits that the reception of the course is very affirmative in Ukraine, it besides enjoys large interest. For this reason, training on a higher, teacher level was besides launched in Łódź recently. Trainers are trained in WCKMeda by soldiers of the Canadian Army.
Enter a higher level
According to the course prepared for the Ukrainian army, could Polish soldiers besides be trained? Medicalians from Łódź opt for this solution. “We request to multiply as shortly as possible the number of people who could save lives in war conditions and support qualified medical personnel. Let us learn from the mistakes of our neighbours to avoid them in the future at home," says Colonel Podlasin. In her opinion, soldiers who have completed qualified first aid courses should be directed at this kind of training.
Modern battlefields besides place higher demands on paramedics themselves. Due to the hard evacuation and reaching hospitals, the injured stay under the care of the paramedics for respective hours or more. Reports from the front are not optimistic here: the stabilization points are filled with injured people organized in the groundlands, trenches or ruins of buildings. With limited staff and hard access to medicines, medical cognition is crucial to survival. News from the front shows that rescuers should have at least simple skills in intensive care, surgery, pain treatment, as well as ability to manage the squad and skillfully delegate tasks. It is besides fundamental to measure the condition of the injured and to separate the injured accordingly. That's another subject we're not ready for yet. NATO begins to talk about ethical problems, due to the fact that the rule of reversed triage must be applied. This means that aid is given first to the injured, i.e. those who have a chance to last a lasting twelve hours of evacuation," explains deputy commander WCKMed. That's not all. Rescuers must learn to operate in secret, evacuate under cover of night, usage customized means of transport – trucks, buses and off-road cars.
Unfortunately, the subject of extended Field Care (PFC) and procedures in the field of alleged harm control resuscitation (a kind of rescue, the most urgent, advanced activities undertaken by medics) in our army is inactive in need. Paramedics are not trained in this area, and medical training in ground troops is inactive based on evacuations of chopper victims. It is different in peculiar troops, where doctors have very good substantive preparation in this area. Moreover, specialists besides make abilities and build a mobile surgical squad in their structures. 1 was already established in the GROM Military Unit, the another is building another peculiar unit. The primary task of this kind of division is to aid injured soldiers who require advanced medical care, including surgical interventions. SOSTs are prepared to operate anywhere in the world, wherever peculiar operations are carried out.
Every soldier is simply a lifeguard.
On the military map of Poland are places where the conclusions of the war in Ukraine are implemented in medical training on an ongoing basis. “Tactical medicine was, is and will always be very crucial to me”, said Colonel Krzysztof Sarnowski, commander of the 2nd Reconnaissance Regiment in Hrubieszów. “I think that all soldier should be a battlefield rescuer and have the skills essential to aid himself and his injured colleague. Missions taught us that these basic skills save lives, says the scout commander. He stresses that CLS courses will be passed by all his subordinates. In June in WCKMeda in Łódź, training at the teacher level will be the first group of scouts. Later CLS courses will be organized in Hrubieszów. – Reconnaissance troops must be mostly self-sufficient. We operate secretly, in tiny groups, frequently in an isolated environment. Soldiers are mostly on their own, so they must have basic cognition of the field of combat medicine, says Colonel Sarnowski.
Colonel Krzysztof Sarnowski is not isolated in his beliefs. More and more commanders realize the request for medical training. This is the case, among others, in the 15th Giant Mechanized Brigade. The soldiers of this unit have been intensively trained in tactical medicine for many years. – Already in 2019 we started Tactical Medical training in the brigade. On the first course we trained all paramedics, and in subsequent editions – besides soldiers without medical education. We taught them basic procedures for providing assistance in the field of combat, including how to decently find and halt haemorrhages, to irritate the airways and to supply chest wounds, and to relieve pleural displeasure," says Major Paweł Tomala, assistant commander of the 15 BZ for wellness care and at the same time a paramedic. He explains that CLS courses are presently being conducted in the Brigade. – This is simply a standardized course that looks the same regardless of where the training is, and his graduates receive the title of a battlefield rescuer. presently we have more than half a 1000 trained military men. That means there's at least 1 CLS postgraduate on each team. Ultimately, we want to train all our soldiers like this – says Major Tomala. The officer explains that 15 BZ in the field of medicine is besides trained with allies stationed in Poland as part of the NATO Battalion Combat Group.
The CLS course organized by allies was attended, among others, by Lieutenant Oskar Jędraszek of the 2nd Mechanized Battalion 15 BZ. “When I learned that specified a course was being organised, I volunteered myself due to the fact that I believe that both the commanders of the divisions and their subordinates request skills in the field of medicine.” In addition to CLS training, the 15th Brigade Mechanized jointly with the Battalion Combat Group organizes the “Mascal” exercises on average all six months. They are intended only for people with medical education. The Assistant Commander of the 15th BZ for wellness Care admits that there are more medical training in the brigade in fresh years and this is due to the deterioration of the safety situation in our part of Europe. – The war in Ukraine and the conclusions of this conflict changed our approach and way of seeing medical training. We are convinced that the skills in this area are needed by all soldier, not only medical paramedics – says Major Tomala and says: – During all tactical exercise and exercise, soldiers besides train from the rescue field. We usage not only equipment that is equipped with 15 BZ, i.e. e., medical evacuation vehicles. We practice utilizing field medical facilities and coordinate with hospitals in our region. We are trying to implement for training the conclusions of what is happening on the front beyond our east border. We practice procedures for prolonged care of the injured and in case of mass events, where we may have respective or respective twelve injured. Above all, however, we focus on developing the skills of soldiers in the field of self-help and medical assistance to a colleague.
Fifteen is besides active in innovative projects. At the end of May, the 15th Mechanized Brigade with the Academy of War Art and the Military Medical Institute conducted medical evacuation exercises utilizing drones. “Ukraine shows that we cannot always usage the WEM transport or the MEDEVAC chopper and that we request to look for alternate solutions, specified as unmanned ones”, said Major Tomala. In Orzysz, with the usage of bsp, evacuation of the victim (for now in this function of the phantoms), medical examination of the image from the air and transport of medical means was practiced.
Medicine of the battlefield is simply a very crucial component of training besides in the 1st Armored Brigade in Happy. The CLS courses organized there regularly are embedded in scenarios drawn from the war in Ukraine, so soldiers learn to aid injured in trenches. The same is actual in the 25th Air Cavalry Brigade, the 6th Air-Desant Brigade or in territorial defence troops.
CLS courses are a good foundation and the skills of field rescuers must be maintained at all times. However, the war in Ukraine shows that standard procedures are not enough. Medicalians agree – you gotta abandon the patterns and think outside the box. This is clearly seen in tactical training. Our soldiers, utilizing Ukrainian experience, returned to fighting training in trenchesThey learn urban fighting. Now it's time for medicine.
