Observations from the Korean War for Modern Military Medicine.

This paper reviews developments in military medicine during the Korean War and places them in the evolution of military medical lessons from the Second World War and the subsequent development of military medicine through the Vietnam War to the present day. The analysis is structured according to the '10 Instruments of Military Healthcare.' Whilst there were incremental developments in military medicine in all these areas, several innovations are specifically attributed to the Korean War. The introduction of helicopters to the battlefield led to the establishment of dedicated medical evacuation helicopters crewed with medical personnel and the evolution into the DUSTOFF system during the Vietnam War. Helicopter evacuation was the primary medical evacuation system in the wars in Iraq and Afghanistan. The establishment of the Mobile Army Surgical Hospital during the Korean War were founded upon the US Auxiliary Surgical Groups or the UK Casualty Clearing Stations of World War II. The requirement for resuscitation and surgical teams close to the battlefield has endured through the development of mobile hospitals of varying sizes from Field Surgical Teams to the current 'modular' Hospital Centre and other international equivalents. There were many innovations in the clinical care of battle casualties covering wound shock, surgical techniques, preventive medicine, and acute psychiatric care that refreshed or advanced knowledge from the Second World War. These were enabled through the establishment of medical research programs that were managed within the theatre of operations. Further advances in all these clinical topics can be observed through the Vietnam War to the wars in Iraq and Afghanistan - all of which were underpinned by institutional directed research programs. Finally, collaboration between international military medical services and the development of Korean military medical services is a major theme of this review. This 'military-tomilitary' and 'civil-military' medical engagement was also a major activity during the Vietnam War and more recently in Iraq and Afghanistan. Overall, the topics and themes in military medicine that were important during the Korean War can be considered to be part of trajectory of innovation in military medicine have been replicated in many subsequent wars. The paper also highlights some 'lessons' from World War II that had to be relearned in the Korean War, and some observations from the Korean War that had to be relearned in subsequent wars.

El origen del aerotransporte sanitario en España. Una historia olvidada de la Medicina de Urgencias / Earliest air ambulance flights in Spain: a forgotten part of the history of emergency medicine

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Helicopter medical evacuation in the Korean War: Did it matter?

BACKGROUND: Because of M*A*S*H and other popular portrayals, helicopter evacuation of casualties has been closely linked to the Korean War. We sought to investigate their role in military medicine during this conflict. METHODS: This study incorporated a thorough review of the original source documents dating to the Korean War that are housed in the National Archives, the Military History Institute, and other repositories. RESULTS: Medical evacuation helicopters entered the war late, after the United Nations forces had suffered the majority of their casualties. There were relatively few helicopters in the country, and a combination of mechanical and personnel issues kept many grounded. Technological constraints limited their efficacy. Military policy forbade rescues from the front lines, and interhospital transfers comprised a significant percentage of their missions. CONCLUSION: Helicopters did not appreciably decrease the average time from wounding to surgical care, nor did they evacuate a statistically significant number of casualties, and ultimately, they had minimal effect on military medicine. However, the war did provide helicopters the opportunity to prove themselves conceptually, leading to their widespread usage in Vietnam, in later conflicts, and ultimately in civilian health care systems.

Reseña histórica sobre los nuevos vehículos aéreos no tripulados para uso sanitario / History of the new unmanned aerial vehicles in health care

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Respuesta del Editor: Reseña histórica sobre los nuevos vehículos aéreos no tripulados para uso sanitario / Editor’s reply: History of the new unmanned aerial vehicles in health care

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[To the 70th anniversary of the 39th separate medical troop (Airmobile) of Air Force].

On December, 18th, 2014 it is 70 years from the date of creation 39 separate medical troop (aeromobile) of the Air force. The history of troop goes to the Great Patriotic War, when it was organized the 234th separate health battalion, The battalion has passed a fighting way as a part of 106 Guards shooting division from Hungary up to Austria. In the postwar period military personnels of the troop took the active participation in medical maintenance of soldiers-commandos in many local confrontations with the participation of Soviet, and after the Russian Army. During its lifetime the troop was repeatedly reorganized and now it is modern military treatment-and-prophylactic institution, it has in staff 100 beds and does all types of qualified (with elements special-purpose) medical aid to the wounded and sick, carries out the supply to the division of the medical supplies.

El comienzo del transporte aéreo sanitario en España. De la campaña del norte de África (1909-27) al Servicio de Búsqueda y Salvamento (1955) / The beginning of air medical transportation in Spain. From the North African campaign (1909-27) to the Search and Rescue Service (1955)

El transporte aéreo sanitario comenzó en España con la evacuación de heridos en la guerra que manteníamos en el norte de África (1909-1927). Su desarrollo se realizó en el ámbito de la aviación militar debido al ambiente bélico reinante a mediados del siglo pasado. El interés científico en su desarrollo se vio interrumpido por la contienda civil española. En esta se realizaron traslados de heridos en las dos zonas beligerantes que sirvieron de experiencia, sobre todo para los alemanes, para la segunda guerra mundial. Después de la guerra civil, el gobierno estableció sus primeros acuerdos internacionales con la firma de convenios para realizar labores de salvamento en el Mediterráneo occidental, siendo aceptado por ambos bandos enfrentados en la segunda guerra mundial. Con la apertura internacional de España en los años 50 se firman los acuerdos con Estados Unidos que incluyen nuevo material en el campo del salvamento y traslado de enfermos (AU)

Air medical transportation began in Spain with the evacuation of casualties during the North African campaign (1909-1927). Its development was carried out in the environment of the military aviation due to the atmosphere of war in the middle of the last century. The scientific interest in its development was interrupted by the Spanish civil war. During this war casualty evacuations took place on both sides and were a useful experience, mainly for the Germans during the Second World War. After the civil war the government established its first international agreements in order to perform rescue activities in the Western Mediterranean, which were accepted by both sides in the Second World War. With the opening up of Spain in the fifties agreements were signed with the United States including new equipment for the rescue and evacuation of patients (AU)

Aspectos históricos do transporte aeromédico e da medicina aeroespacial - revisão / Historical aspects of aeromedical transportand aerospace medicine – review

A história do transporte aeromédico e da Medicina Aeroespacial consiste em agradável viagem ao passado, com grandes perspectivas. Este trabalho descreve como a Medicina militar e as guerras trouxeram conhecimentos sobre a fisiologia humana, contribuindo para o desenvolvimento de várias áreas médicas. A viagem inicia-se na mitologia grega, com Dédalus e Ícaro, passando pelos balões inicialmente sem direção, depois seus dirigíveis, até chegar às máquinas voadoras mais pesadas que o ar. O homem experimentou ambiente hostil que lhe era desconhecido; a baixa pressão atmosférica, a hipóxia e a hipotermia eram apenas o começo. Paul Bert, médico fisiologista e pai da Medicina Aeroespacial, já realizava estudos em câmara hipobárica, mesmo com toda limitação tecnológica da época. Nascia nova era, em que o homem começava a entender e a dominar as alterações fisiológicas da altitude.A concepção de transporte aeromédico foi introduzida durante as guerras napoleônicas e sedimentada na Guerra Franco-Prussiana (1871), quando 160 feridos foram transportados da Paris sediada, em balões de ar quente. A grande evolução nos cuidados pré-hospitalares e no modelo de remoção de pacientes ocorreu durante as Guerras do Vietnã e da Coreia,palco de estrutura que serviu de molde para os sistemas de atendimento ao trauma da atualidade. As guerras continuam a assolar a humanidade, levando vidas e trazendo sofrimento e dor aos que ficam. Paradoxalmente, é a mesma guerra que fornece condições de pesquisae desenvolvimento de inventos e tecnologia, as quais propulsionaram a conquista de novos universos. O caminho é literal. Vai da imaginação da mitologia grega em possibilitar ao homem voar, até a da atualidade, que faz sonhar em conquistar o espaço, com a mesma personalidade desbravadora que dos antecessores. Aqui o céu não é o limite.

The history of aeromedical transport and Aerospace Medicine consists in a pleasant journey to the past, with great prospects. This article describes how military medicine and wars advanced our understanding of human physiology, contributing to the development of various medical s. The journey begins in Greek mythology, with Daedalus and Icarus, moving on to balloons, then on to airships, until we reach heavier than air flying machines. Man experienced a hostile environment unknown to him, low atmospheric pressure, hypoxia and hypothermia were just the beginning.Paul Bert, medical physiologist and father of Aerospace Medicine, already performed studies in hypobaric chambers, even with all the technological limitations of his time. A new era was born, in which man began to understand and master the physiological changes of altitude. The concept of aeromedical transport was introduced during the Napoleonic wars and consolidated in the Franco-Prussian War (1871), when 160 wounded men were transported from sieged Paris on hot air balloons. A great evolution in pre-hospital care and patient evacuation strategies occurred during thewars in Vietnam and Korea, stages that served as a templates for the structures of trauma care today. Wars continue to ravage humanity, taking lives and bringing pain and suffering to those who remain. Paradoxically,it is the same war that provides conditions for research and development of inventions and technology, which propelled the conquering of new worlds. The path is literal. It goes from the ingenuity of Greek mythologythat enabled man to fly, to today, making us dream of conquering space, with the same adventurous personality of our predecessors. Here, the sky is not the limit.

Long-range critical care evacuation and reoperative surgery.

Long-range critical care aeromedical evacuation has significantly contributed to the unprecedented survival during recent military operations. With advances in critical care, patients with increased injury severity and overall complexity are routinely evacuated while resuscitation is ongoing. Additional specialty teams now provide advanced pulmonary rescue therapies for the most critically ill patients. As part of the continuum of trauma care, an overseas fixed facility provides follow-on emergency surgical critical care to optimize patient outcomes before final evacuation to the continental United States.

Military medical advances resulting from the conflict in Korea, Part I: Systems advances that enhanced patient survival.

The Korean War started several years after the World War II had ended and no recognition of the threat or preparation was made for this possibility. The military and its medical service had been downsized after World War II and had to quickly ramp up to meet the surprise attack. The war provided the laboratory for trials and experimentation with the new technological developments of the era. The Korean conflict led to numerous advances in medical systems and patient care. The Mobile Army Surgical Hospital came of age, and was instrumental in saving many lives. Helicopters saw their first regular use as flying ambulances to take the injured to definitive care in a timely fashion. The national blood banking program was rapidly geared up and new techniques such as plastic bags for collection and delivery resulted. Body armor was developed that would allow mobility while offering protection and was widely used for the first time. Each of these systems improvements saved the lives of soldiers in combat and were soon to be used in the civilian sector to save and improve lives around the world.