Evidence-based medicine in NATO member countries and in Ukraine: The role of data collection and analysis
From the presentation by Ricardo Flores-Artola during the Second International Conference on Tactical Medicine, held in Ukraine.
In the USA there exists a register of pre-hospital medicine – a database and analysis of injuries, from which one can ascertain the type of treatment given to an injured patient and whether it was appropriate.
To document statistics about injuries obtained on the field of battle is most challenging. The job of the medic is to save a life and to ensure personal safety. The last thing on his/her mind is to document the case.
In the USA, the reporting format in respect of injuries has been simplified, so that the medic is not distracted from his primary aim.
Every first-aid kit contains a simplified form, such that a soldier is able to note details about his own trauma injury. Later, the card is attached to the history of the illness and the information will be uploaded to the register.
Why do we need such information? The gathered information will enable an improvement of the system to heal trauma injuries, ensure better communication and determine certain tendencies, which can be avoided in the future.
This also allows for the improvement of knowledge and to review the effectiveness of our current equipment and methods. The gathering of data is most important because it allows us to better prepare soldiers for service.
The best that we can do is to concentrate on our combatants rather than our medics. Each soldier must be given the basic instruments and skills in first aid.
In 2009 the US Defence Council implemented a memorandum, in which it was noted that TCCC preparation must be given to all officers, soldiers and to all medical personnel.
Often, the first to be killed is the medic. We have taught every ranger and provided equipment. This allowed them to undertake quite difficult operations. The number of deaths has reduced significantly.
Many of the rangers would have died if they had waited for a medic to put on a tourniquet.
I am personally very proud that I train others to save themselves. In most cases, by the time I got to an injured person, they had already applied the tourniquet to themselves and utilised other equipment.
They did this to save themselves. I only completed documents, provided pain relief, because I had better equipment, and escorted them to the next station.
P.S. A week following the presentation by Ricardo Flores-Artoli we met with the Deputy Director of the main military hospital in Kyiv, Oleksandr Lashyn.
The military hospital currently retains information about the injured in paper format. The program for the collection of data electronically “E-Health”, is currently in development. It is not known when it will be ready for use, as its development is currently only being financed by private donations.