Journal of the Royal Army Medical Corps
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The deployment of British Contingent (BRITCON) to United Nations Force in Rwanda (UNAMIR) on Operation GABRIEL in 1994, proved to be a successful deployment on humanitarian operations. Many of the lessons have been successfully incorporated into training, equipment and organisational structures since the deployment. Others require further work to develop and assimilate. ⋯ Implications for future humanitarian operations include a co-operative approach to pre-deployment training with the Non-Governmental Organisation (NGO) community. This will help to promote understanding between the 2 arms of the humanitarian effort and will exploit the strengths of both sides. Equally, the military medical services have to be fully aware of mission definition and its centrality to planning, execution and audit of performance.
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With the development of British Army doctrine it is necessary to review the concepts underlying medical support to the modern battlefield. In particular, the provision of timely and balanced resuscitation to the high intensity battle is an issue requiring an understanding of both the tactical and the clinical demands. The wholesale application of civilian techniques and approaches to trauma management is not possible given the austerity of the battlefield clinical environment. ⋯ Specifically, the introduction of a triad approach to trauma management is offered. The triad comprises readily available Battlefield Advanced Trauma Life Support (BATLS) skills, Surgical Resuscitation deployed forward and the provision of Field Intensive Care. Such an approach would marry together the clinically ideal with the tactically.
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There is a requirement for a basic approach to the provision of analgesia on the battlefield using the morphine autojet. Assuming there is cardiorespiratory stability and no contraindications to opioid therapy, morphine can be administered intramuscularly to a serviceman in pain on a 2 hourly basis provided that there are no adverse effects on the respiratory rate and degree of sedation. This proven simple approach in civilian practice has the potential to be incorporated into Battlefield Advanced Trauma Life Support (BATLS) and Combat Training Regimens (CTR).
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Medical Support Troop Bravo (MST Bravo) provides third line medical support for the United Kingdom Battle Group currently deployed on operation Grapple 2 in Bosnia Herzegovina. Standing operating procedures for the initial assessment and resuscitation of all casualties are based on the protocols taught on Advanced Trauma Life Support (ATLS) and Battlefield Advanced Trauma Life Support (BATLS) courses. ⋯ This has led to an appraisal of CBA removal and the identification of a drill for rapid, safe and reliable means of undressing without jeopardy to the integrity of the spine. The method is described.