From the days of the Roman Legionnaire with his short sword and pilum to the modern-day infantryman with his assault rifle and grenades, man’s ability to tear the flesh and break the bones of his opponent has increased to new levels of grisly efficiency. Fortunately, for the soldier whose luck has run out and in the blink of an eye has been transformed from a combatant to a casualty, pre-hospital care of the injured has improved tremendously. Gone are the backward days when the field surgeon had more in common with an alchemist, protecting his “scientific secrets” of patient care from those who sought to understand the appropriateness of treating a gunshot wound with egg yolk, rose oil, and turpentine.
Along with technical advances in emergency medicine, patient care has entered new realms of delivery with the medical community’s growing acceptance of medical paraprofessionals. Without these paraprofessionals at the “scene” to initiate advanced emergency medical procedures, many of the newest procedures in emergency medicine would be limited in their effectiveness because patient transport time would spoil their effects.
Modern weapons of war are found in the hands of combatants in the most remote regions. However, as a rule, modern military medicine, with its mobile hospitals and rapid patient evacuation to definitive health care, fails to follow combatants into the fields of conflict. It is in just such a scenario—where physicians are not to be found, patient transport to a hospital is measured in days instead of minutes, resources are limited, and the environment is hostile— that the Pre-Hospital Care Provider (PHCP) is in his element.
The subject matter in this book covers advanced medical procedures set in a field setting. Should the PHCP find himself on an isolated battlefield or in the middle of some form of civil disaster, his ability to employ the procedures covered in this book in a timely and competent manner will have a positive impact upon his patients.
For the wounded soldier who sees his strength ebbing into the warm pool of liquid by his side and seeks relief from his pain by crushing the blades of grass in his hands, thoughts are of family never to be seen again and aid from whatever quarter he can find it. Ditch medicine—the difference between life and death—often starts with the thud of a pair of boots landing beside the soldier and a PHCP simply grasping his patient’s hand and peering into his ashen face.