From the Israel Defense Forces, Medical Corps (A.B., I.S., E.G., R.N., S.G., J.C., N.F., T.B.), Tel Hasomer, Ramat Gan; The Azrieli Faculty of Medicine (A.B., I.S., E.G.), Bar-Ilan University, Safed, Israel; the Uniformed Services University of the Health Sciences (E.G.), Bethesda, Maryland; Department of General Surgery and Transplantation (R.N.), Sheba Medical Center, Tel Hashomer; Department of Surgery (S.G.), Rabin Medical Center, Petah Tikva, Israel; United States Army Institute of Surgical Research (B.A.); University of Texas at San Antonio (B.A.), San Antonio, Texas; and Department of Military Medicine (T.B.), Hebrew University, Jerusalem, Israel.
J Trauma Acute Care Surg. 2019 Jul;87(1S Suppl 1):S165-S171. doi: 10.1097/TA.0000000000002217.
The Israeli Defense Force Medical Corps (IDF-MC) is routinely collecting prehospital data to establish a prehospital registry. Since February 2013, Israel has been providing medical care to Syrian refugees. This unique humanitarian aid begins in prehospital settings and typically culminates in Israeli civilian hospitals. This report describes the accumulated experience of the IDF-MC to provide Syrian refugees with prehospital treatment.
Care provided by IDF-MC medical teams, including prehospital casualty care, is regularly documented and after-action reports are conducted. Records of casualties arriving at the Israeli-Syrian border from February 16, 2013, to December 31, 2017, were prospectively extracted from the IDF Trauma Registry. Patients who did not have a casualty card were excluded. The database included demographic information, injury signature and treatment given.
During the study period, 2,785 Syrian casualties were treated, of whom 2,339 were trauma victims. The most common mechanism of injury was penetrating (60.4%). Prehospital lifesaving interventions included 127 endotracheal intubations, 30 cricothyroidotomies, 55 chest decompressions, and 58 tourniquets for extremity hemorrhage control. Remote Damage Control Resuscitation included reconstituted freeze-dried plasma (n = 75) and tranexamic acid (n = 222 casualties) with no adverse effects.
The experience of the IDF-MC teams in caring for civilian casualties along a hostile international border is unique. In this capacity, the IDF-MC has demonstrated effectiveness in providing lifesaving and resuscitative interventions including tranexamic acid and freeze-dried plasma. In this experience, tourniquets have been effective in controlling hemorrhage when applied early and endotracheal intubation and cricothyroidotomy have provided effective airway options in select patients. Prehospital combat casualty care presents a significant challenge both in terms of providing adequate care and in terms of data collection and analysis. The experience described in this article is one example of effective, ongoing prehospital data gathering process. Efforts to provide medical relief to victims of the Syrian civil war continue to this day. While we hope for a better future, as long as these lessons continue to accumulate, it is our obligation to use them to support improvement of trauma care and hopefully save more lives.
Therapeutic, level III.
以色列国防军医疗团（IDF-MC）经常收集院前数据以建立院前登记册。自 2013 年 2 月以来，以色列一直在向叙利亚难民提供医疗服务。这种独特的人道主义援助始于院前环境，通常以以色列平民医院为终点。本报告描述了 IDF-MC 为叙利亚难民提供院前治疗的积累经验。
IDF-MC 医疗队提供的护理，包括院前伤员救治，定期记录并进行事后报告。从 2013 年 2 月 16 日至 2017 年 12 月 31 日，从 IDF 创伤登记处前瞻性提取抵达以色列-叙利亚边境的伤员记录。没有伤员卡的患者被排除在外。数据库包括人口统计学信息、损伤特征和给予的治疗。
在研究期间，共治疗了 2785 名叙利亚伤员，其中 2339 名是创伤受害者。最常见的损伤机制是穿透伤（60.4%）。院前救生干预措施包括 127 次气管插管、30 次环甲切开术、55 次胸部减压和 58 次四肢止血带控制出血。远程损伤控制复苏包括重组冻干血浆（n = 75）和氨甲环酸（n = 222 名伤员），没有不良反应。
IDF-MC 团队在敌对国际边境照顾平民伤员的经验是独特的。在此过程中，IDF-MC 已证明在提供救生和复苏干预措施方面的有效性，包括氨甲环酸和冻干血浆。在这种情况下，止血带在早期应用时可有效控制出血，气管插管和环甲切开术在某些患者中提供了有效的气道选择。院前战场伤员救治在提供充分护理以及数据收集和分析方面都带来了重大挑战。本文所述的经验是有效进行院前数据收集过程的一个例子。向叙利亚内战受害者提供医疗救援的努力仍在继续。虽然我们希望有一个更美好的未来，但只要这些经验继续积累，我们就有责任利用它们来支持创伤护理的改善，并希望挽救更多生命。
治疗，III 级。
