DeSoucy Erik Scott, Shackelford Stacy A, DuBose Joseph J, Zweben Seth, Rush Stephen C, Kotwal Russ S, Montgomery Harold R, Keenan Sean
J Spec Oper Med. 2017 Spring;17(1):121-129. doi: 10.55460/OAL4-CBRC.
Prolonged field care (PFC) is field medical care applied beyond doctrinal planning time-lines. As current and future medical operations must include deliberate and contingency planning for such events, data are lacking to support efforts. A case review was conducted to define the epidemiology, environment, and operational factors that affect PFC outcomes.
A survey distributed to US military medical providers solicited details of PFC encounters lasting more than 4 hours and included patient demographics, environmental descriptors, provider training, modes of transportation, injuries, mechanism of injury, vital signs, treatments, equipment and resources used, duration of PFC, and morbidity and mortality status on delivery to the next level of care. Descriptive statistics were used to analyze survey responses.
Surveys from 54 patients treated during 41 missions were analyzed. The PFC provider was on scene at time of injury or illness for 40.7% (22/54) of cases. The environment was described as remote or austere for 96.3% (52/54) of cases. Enemy activity or weather also contributed to need for PFC in 37.0% (20/54) of cases. Care was provided primarily outdoors (37.0%; 20/54) and in hardened nonmedical structures (37.0%; 20/54) with 42.6% (23/54) of cases managed in two or more locations or transport platforms. Teleconsultation was obtained in 14.8% (8/54) of cases. The prehospital time of care ranged from 4 to 120 hours (median 10 hours), and five (9.3%) patients died prior to transport to next level of care.
PFC in the prehospital setting is a vital area of military medicine about which data are sparse. This review was a novel initial analysis of recent US military PFC experiences, with descriptive findings that should prove helpful for future efforts to include defining unique skillsets and capabilities needed to effectively respond to a variety of PFC contingencies.
延长战地护理（PFC）是指超出既定计划时间线实施的战地医疗护理。由于当前和未来的军事行动必须包括针对此类事件的精心规划和应急规划，因此缺乏支持这些工作的数据。进行了一项病例回顾，以确定影响延长战地护理结果的流行病学、环境和操作因素。
向美国军事医疗人员发放的一份调查问卷，征集了持续时间超过4小时的延长战地护理情况的详细信息，包括患者人口统计学特征、环境描述、医疗人员培训情况、运输方式、损伤情况、损伤机制、生命体征、治疗方法、使用的设备和资源、延长战地护理的持续时间，以及转送至下一级护理时的发病率和死亡率状况。使用描述性统计分析调查回复。
分析了在41次任务期间治疗的54名患者的调查问卷。在40.7%（22/54）的病例中，延长战地护理医疗人员在受伤或患病时在现场。96.3%（52/54）的病例中，环境被描述为偏远或艰苦。37.0%（20/54）的病例中，敌方活动或天气也导致了对延长战地护理的需求。护理主要在户外（37.0%；20/54）和加固的非医疗建筑中（37.0%；20/54）提供，42.6%（23/54）的病例在两个或更多地点或运输平台进行管理。14.8%（8/54）的病例获得了远程会诊。院前护理时间为4至120小时（中位数为10小时），5名（9.3%）患者在转送至下一级护理之前死亡。
院前环境下的延长战地护理是军事医学中一个至关重要但数据稀少的领域。本综述是对美国军队近期延长战地护理经验的首次创新性分析，其描述性结果应有助于未来的工作，包括确定有效应对各种延长战地护理突发事件所需的独特技能和能力。
