TCCC στις Ελληνικές ΕΔ

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( ..) , MD, MA(Terr) ATLS (Advanced Trauma Life Support) American College of Surgeons (BATLS Battle Advanced Trauma Life Support). 4. ATLS(BATLS) . ( [para]medics) , , , , . , , , , Foley, , . ATLS . (good medical practice) / . . : 1. 2. 3. Tactical Combat Casualty Care (TCCC) ( SEAL) (USAF), (US Army), (US Army SF), (USMC) . TCCC (1999) PhTLS (Pre-Hospital Trauma Life Support) American College of Surgeons Committee on Trauma National Association of EMTs. ___________________________________________________________________________ www.soldier-21.yolasite.com

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H ( , Mogadishu, , 1993) (tactical medicine). . . . Peter Schoomaher : !. : 1. TCCC 2. 3. 4. TCCC (Care Under Fire) (Tactical Field Care) 5. . . . (-) . , . , TCCC , /. (killed in action) (died of wounds) :

shock

31% 25% 10% 9% 7% 5% 1% 12%

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O , . . , . . ( ): ( ) 60% 33% 6%

(care under fire) . 3 : 1. 2. 3. (CASEVAC) . H . . . [CASEVAC] ( ) , . ( ). : 1. 2. 3. 4. 5. 6. (-) , , , ,

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2: . . 2.500 . . ATLS, , , . . : . . , . . ( ). . , . . . , . Albert Sidney Johnston Shiloh 7 1862. Robert Lee. Dr. David Yandell . Johnston . . . ; Arishita (J Trauma 1989; 29:332-337), : ___________________________________________________________________________ www.soldier-21.yolasite.com

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1.4% . 5.5 . . , . . . . . 65 110 . . . (tactical field care) : [CPR] , . MEDEVAC. . , . . shock, . shock, 1000cc Hespan [max] . : ( 70 mm Hg). . (5mg) . , , , .

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, . .

H : , ( ) shock

CASEVAC MEDEVAC , . , . La Drang ( ), 11 . MEDEVAC , . , 229 . CASEVAC. , TCCC: CASEVAC ()

, . (scenario-based management plan). , , / ___________________________________________________________________________ www.soldier-21.yolasite.com

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. . , : . Mogadishu 3 1993 18 73 . , 15 (Combat Support Hospital). , : : / 16 Rangers 21 - / [, RPG] 30 : ; ; ; , ; ; ; : ; 30 ; (, ) ; ; ; , , , ___________________________________________________________________________ www.soldier-21.yolasite.com

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. . . [ / /]. , , ( ).. , . . (1) /- Quick Clot [sac 35gr] Chitosan Bandage (HemCon) SATS Special Operations Forces Tactical Tourniquet caps Asherman M 10mg/0.7mL + [ - ] [ chlorohexidine + cetrimide] [] Lester 500 mg tab tab 16mg cream Elocon cream 1:1000 - FASTJEKT

tab tab +

___________________________________________________________________________ www.soldier-21.yolasite.com

. - [84.5] LifeStraw Mark I [ + ] - CANA 10mg/2mL [-] (2) / A/A 100ml 2% inj 50 ml 15mg/1cc arcan 0.4mg/1mL QuikClot sac ANT 500 mg 500 mg 20 ml 250 ml 20 ml + tabl 500 ml tabl 5 ml tabl + pom Elocon cream Mizollen tabl 10ml tabl, 20mg/1cc 10%

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1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21

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. 1mg/1cc FastJekt 1:1000, 0.3ml EM & + MARK I (3/) tabl SHOCK Hespan 500cc 2gr inj IV tabl 1 2 3 4 5 6 7 8 9 10 11 12 13 14 1010, 2016 55 Hansaplast SAT System 55, 105 84.5, 154.5 Sorusal - Legius Chest Seal Asherman + 3-way * & 14 15 16 17 18 19 40 clips clips 71.5 (elly) [X2] vicril 2.0 3.0 [ ] 3.0 pds No 0 1 ( ) pds No 3.0 4.0 ( ) Descecter [x1] [ ] 5 cc, 21 G [, ] 8 Lister Metselbaung

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22 23 24 25 26 27 28 29 30 31 32

20 21 22 23 24 25 26 27 28

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. & 1 2 3 4 5 , / *

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* **

(1) ,(2) (3) PDA [software]

. . - , ( ) ( ) . (swine model) . STANAGs, ATLS BATLS, , 401 ( ) . , special forces medic (2 ) . 30.000 ; : ATLS / BATLS / 3. , ( ) ( ) . , 401 251 . ( , ). . . . , , .

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elite , . , .

[ ]: FastJekt H [] [. /], . Hespan shock , Hespan [hetastarch 6%] Ringers lactate. To , , . 1000cc Ringers lactate, 1 200cc . , Hespan . Hespan

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. 500cc Hespan 800cc 8 . : 4 Ringers lactate 4 500cc Hespan 450 gr. To Hespan 500cc . (Cefoxitin) . H (2gr IV) . Gram- . , . , .

QuikClot NSN: 6510-01-499-9285 [Part #: 0001] . ( : kevlar, ) ( Mogadishu, Shahikot, Anaconda 2002) (). ( ) ( ) . . ( Quikclot), FDA ( 2002). , . 50% . . . QuikClot

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. To , , .... (Hemosorb). . . Sorusal - Legius : GMP, FDA (510K), EN46002, ISO 9002, CE0483 . ( 4-6 ). Legius Betadine 2 . Legius Betadine 6 . . To . . SAT System NSN: 6515-01-500-2974 . . , . . (). . Chest Seal Asherman T (collapse) . (-) . , . Asherman ___________________________________________________________________________ www.soldier-21.yolasite.com

. , , . LifeStraw Personal

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. 31 , 29 mm, 160 . . 700 , , [, , , ]. [PuroTech Disinfection Resin PDR] . - 15 microns . 2 700 ( : 3 ). 50% (350 ).

$5 ( 100 ). To . ___________________________________________________________________________ www.soldier-21.yolasite.com

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Lifesaver . 100% . (680 ) (5.678 /) . : $229 (4.000L) $299 (6.000L) : $30 ( ).

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4 Pre-hospital Trauma Life Support (1999) 50% (Golden Hour). Ernest Lissabet 2 , . . , 100.000 , 450.000 11.000.000 . $100 . . . [WMD]. . . . LSTAT (Life Support for Trauma and Transport). T LSTAT , . 12.5 . : , , , , . . . [Internet] . . , ___________________________________________________________________________ www.soldier-21.yolasite.com

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[ / ]. , , ( ) . LSTAT -90 . (2) LSTAT. . . [ ] . SoleFresh NanoSilver 2.5 , 80% , 20% 0.3% nanosilver [25-250 nm]. , 50 . .

___________________________________________________________________________ www.soldier-21.yolasite.com

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