BATLS/BARTS/BBTLS training for Swedish Armed Forces medical personnel--a ten year retrospective study.

OBJECTIVE: The British BATLS/BARTS concept was introduced in Sweden in 1998. Perceived changes within the student group, regarding purposes for taking the course and previous trauma training were the subject of the study. METHODS: Records from all Swedish courses during 1998-2007 were examined and analyzed. RESULTS: In all, 61 courses with a total of 1254 students were conducted. Among the participants were 295 doctors, 764 nurses, 176 medical orderlies and 19 belonging to other categories. The course has by time become a pre-mission course. Also, a large number of the students now have previous (often civilian) trauma life support training. CONCLUSION: When the British BATLS/BARTS concept was introduced in Sweden ten years ago, the general level of trauma training among medical personnel was inadequate for the wartime needs of the Armed Forces. Today, the majority of individuals selected for international service already have previous trauma life support training. This has led to the courses now being aimed mainly at improving their knowledge of the tactical medical skills particular to the environment in which they will serve.

[Reduced but better health care for armed forces]. / Försvarsmaktens sjukvård bantas, men blir bättre.

The Swedish Armed Forces are presently undergoing the most extensive reorganization and downscaling in their history. In a new set of objectives for the Swedish Armed Forces Medical Service laid down by the Surgeon General, the aim is to provide combat casualty care with a quality on par with that of the civilian, peace-time health care system. This will be achieved by establishing advanced trauma care by specialist physicians and nurses closer to the point of injury, using armoured medical evacuation vehicles, and by introducing new treatment modalities such as intraosseous infusion using hyperoncotic solutions.

Adapting the Swedish Armed Forces medical services to meet new challenges.

The land battle today is different from that of 20 years ago. It now occurs over vast areas, the fluid battlefield. Tanks have undergone important changes (cross-country capability, improved armor, and more lethal weapons). The combat units contain armored personnel carriers, providing protection for the soldier. The weapon effects on armored vehicle personnel are well studied and include ballistic, blast, thermal, and toxic injury. However, casualty statistics for armored units are not extensively reported. The public acceptance of casualties, especially in peacekeeping operations, today is much lower than in the past. A study by the Swedish Armed Forces has identified the need for a new organizational structure. Casualties will be picked up on the battlefield by armored medical evacuation vehicles and transported directly to the battalion aid station. The training level of all medical personnel must be increased, using battlefield-related trauma courses and making better use of existing resources in the form of qualified medical practitioners.

Training for wartime anesthesia in Sweden.

Sweden has been spared from wars and similar disasters for almost two centuries, and over the years the population and politicians have been lulled into the belief that "it'll never happen". This has affected the ability of the medical system to respond adequately to the enormous demands that a war would make upon us. The geographical and political situation and the basic facts about Swedish health care are briefly sketched. After a review of the history of anesthesia in war, current medical planning for war or similar disaster situations in Sweden is outlined and its weaknesses mentioned. A program is presented that aims at improving the situation in anesthesia manpower, postgraduate training and equipment. The expanded role of the already highly skilled and independent Swedish corps of nurse anesthetists (RNA's) is outlined, especially in the field of regional anesthesia. Standardized methods for anesthesia in war also are presented. The aim is to make optimal use of existing resources and enable patients to be transferred immediately postoperatively to understaffed wards.