New horizons for medics

Just in case.

– The thought for these studies was born for at least a fewer reasons, but the most crucial thing is that we gotta prepare for threats that may yet come. safety conditions in our part of the planet have late worsened, after all, there is simply a war behind our east border. All this makes us, as physicians, request to pay more attention to training and developing our skills besides in the field of tactical medicine and extended care - says Marcin Gałkiewicz, coordinator of postgraduate studies in field medicine at the ŚUM. – We observe the conflict in Ukraine and we see that the border between civilian and military medicine is beginning to blur. Medical personnel, including this civilian one, are getting closer to the front line. So it seems reasonable to teach doctors, nurses, or paramedics in uncomfortable conditions, under force of fire and time. Especially due to the fact that – as the experience of our east neighbours shows – it is the doctors who have been the mark of attacks since the beginning of the war.

Editorial: Magdalena Kowalski-Sendek. Photos: Paweł Sobkowicz, Aleksander Kruk, Commandos Military Unit, Silesian Medical University. Installation: Paweł Sobkowicz

It is crucial to remember that caring for the victim in hard conditions is simply a real challenge and it is hard to compare it to working in the ER or hospitals in Poland, where we adhere to the time standards concerning the provision of assistance or evacuation - added the university coordinator. At the same time, the lecturer emphasizes that cognition of the field of combat medicine can be useful not only during warfare, as is the case in Ukraine, but besides during various types of disasters – ecological or construction – or terrorist incidents. A word, wherever a lifeguard will be forced to look after the injured (or injured) for a long time.

WUM lecturers point out that the creation of postgraduate studies is besides a kind of consequence of the introduction of a medical field for medical rescue years ago, regardless of the university. - We're going a step further and we're proposing not a subject block, but a full college. We prepared 3 semesters of intensive learning, as much as 366 hours of classes – most of them practical. After graduation, listeners will gain not only fresh competences and skills, but besides the global certificate of NAEMT - emphasised Marcin Gałkiewicz. NAEMT is short for the National Association of Emergency Medical Techniques. It is an global organization of medical rescue, supervises and certified, among others, courses in field medicine worldwide.

JWK indicates direction

The program of postgraduate studies was prepared in cooperation with the Commandos Military Unit from Lublin. - JWK has been working with the Silesian Medical University for 3 years, and has supported applicable training of medical rescue students of this university for 2 years. Now we are active in the organization of postgraduate studies. We have co-created the program, utilizing the experience of specialist training, which we have been conducting for our medical operators in Lublin for 3 years - says Grzegorz, Petty Officer JWK, experienced paramedic.

Let us halt at these specialist trainings. In early 2023, the Commandos Military Unit prepared a multi-level training plan for its operators. It assumes that all soldiers are inactive undergoing the CLS (Compat Lifesaver) course during basic training. Then, those who, in combat teams, include doctors' jobs, go to specialist training, or a fewer weeks of medical classes conducted on and outside the unit. In their function as observers, they practice in infirmary emergency wards, they besides have classes in the department. The next phase of learning is six months of specialist training organised by JWK.

The basis for specified a commando training program in Ljubljana is the belief that rescuers from the unit must have comprehensive knowledge, going far beyond military procedures. "Due to the nature of our service and scope of action, we anticipate rescuers to have universal capabilities. They request to know how to operate during fast evacuation, or within a fewer days, or even 2 months of isolation - noted the officer from JWK.

Civil and military rescuers stress that the conflict in Ukraine has set completely fresh standards of medical care and exposed many weaknesses of the system. We draw conclusions from what is happening in Ukraine. We see that there are no standards for fast evacuation of the victim. In fact, in many respects the conflict in Ukraine resembles planet War II. Learning extended medical care becomes mandatory for doctors present - said representatives of the WUM and JWK. They supplement that physicians request to know how to deal with both field-specific injuries (e.g. chest shots, massive haemorrhages) and pneumonia, infection or infection, including in paediatric and geriatric patients. A wide scope of competences and cognition are essential for the patient to experience evacuation and specialist care at the infirmary or at the stabilization point.

Change the way you think

Let's go back to postgraduate studies organized by the WUM. According to JWK recommendations, listeners will learn about the physiology of man in the conditions of the battlefield, including how chronic fatigue affects our body. They learn the basics of psychology in crisis situations, due to the fact that – as Ukraine shows again – war experiences can origin PTSD. The listeners will learn, among others, about various techniques of coping with stress or how not to panic erstwhile you gotta spend a fewer days in a dark area underground. They will besides learn how the victim or fellow workers admit the symptoms of a suicid crisis. peculiar attention will be paid by lecturers to cognition of intensive therapy, including pharmacotherapy in tactical medicine, patient ventilation techniques, laboratory diagnostics in extended patient care or ultrasound applications.

– We'll besides be conducting field surgery classes, practicing in the event of chest injuries, securing airways in combat conditions, sewing wounds. Our students will practice utilizing animal or cadaver elements, i.e. fragments of corpses - says Marcin Gałkiewicz. Listeners will learn and practice nursing procedures, gain cognition of physiotherapy, about nutrition in prolonged patient care, and even about dentistry. The university besides provides for classes related to the planning of medical safety in tactical and countering hypothermia activities. The program includes classes on, for example, sight and proceeding harm in the battlefield, as well as trauma orthopaedics, protection against weapons of mass destruction, treatment with the trauma patient, and what for military medics is an absolute basis, and so the examination of the patient according to the MARCH protocol (a shorthand from Massive bleeding – massive hemorrhages, Airways – airways, Respiratorys – breathing and chest injuries, Circulation – circulation and haemorrhage, Head injury/Hypothermia – head injury and hypothermia).

The JWK commandos declare that they will oversee the course of the class, and will actively engage in educating listeners during the last 3rd semester. At that time, applicable classes with navigation and endurance elements will be organized in the area. Those who have acquired cognition will usage it during more or little complex medical exercises. "The conclusions of armed conflicts in Iraq, Afghanistan, Ukraine or Israel and Africa show that preparing medical personnel for isolation or prolonged evacuation requires a change in thinking, predicting threats, appropriate planning of procedures and the usage of medical equipment. The function of the unit will be to divide all cognition and prepare applicable exercises in the scope of extended medical care - says Grzegorz from JWK.