TRAUMA JOURNAL
Historically, many of the lessons learned in assisting wounded in the military field have found application in the civilian trauma (ATLS protocols, PHTLS, etc.). The experiences of combat medics in World War II, Korea and Vietnam, along with their growing understanding of the on-site assistance, rapid evacuation, transport and final treatment of those injured in combat, are the basis on care which is based tactical combat casualties. While SWAT teams began to appear in the 1960's, it was recognized that the medical support of some kind would be necessary for units in high-risk missions. The model proposed model was based on medical military combat, suggesting it was part of the tactical unit. More specifically, these technicians were a medical team of special operations. Some of the policemen and paramedics who were tactical units often were veterans of Vietnam. It is important to mention that for best performance of a tactical medical team in a public security force, it is necessary to integrate the staff who are trained in three areas: as a provider of medical services, be a police officer, and be official of techniques special intervention (SWAT type techniques). Recently, medi-cal services civil emergency has been called to assist in numerous school shootings, mall shootings and other acts of terrorism that have tactical factors similar to those found in combat. The threat of receiving hostile fire, having to attend multiple injuries has covered, and prolonged evacuation times have come into play. Fighting in the border cities, and some other places in our country are examples that illustrate that even in urban settings, starting treatment, and transport of injured may require tactics and training outside the parameters of the proto-cols standard of medical services emergencies. The adoption of the guidelines apply-able tactical care of combat casualties in tactical programs for Emergency Medical Services and the application of these principles to the tactical operations-tion of the Corps and State Security Forces can be a better continuity-ing tactics and additional lives saved when the wounded are produced during the course of these operations.
Unfortunately this is the situation faced by prehospital services, the paramedics will have to manage both tactical medical protocols for medical care (use of tourniquet combat pneumothorax management, use of gauze combat) and techniques for the extraction of casualties under fire, injured etc transport. "NAR will have to ply the use of rigid stretchers canvas military style stretchers use of tactics, we must train them in skills now Tactica Medicine. In hospitals, emergency physicians will have to know how to handle war wounds such as traumatic amputations, treatment of patients with burns and shrapnel wounds (explosions explosive devices), gunshot wounds of high-speed fire, replacement of liquids, and not to standard ATLS, but Tactica Medicine protocols (especially in hospitals where no bank blood count) will have to think about putting into practice triage of combat, it is urgent to prepare to cope.
Each day more victims for gunshot wounds, are becoming increasingly common among patients admitted to hospitals with wounds of war, every day patients admitted with injuries exsanguinating multiple gunshot to the emergency room, shootings occur more everyday, it is urgent that we be able to handle such situations, this is the reality that we are facing. Lt.
. Cor. Retired Hernandez Luis Alfredo Perez Bold Tactics Instructor of Medicine
43 2009, 12 (2): 43
