France Katherine, Handford C
General Surgery, James Cook University Hospital, Middlesbrough, UK
Orthopaedics, Queen Elizabeth Hospital, Birmingham, UK.
BMJ Mil Health. 2021 Aug;167(4):275-279. doi: 10.1136/bmjmilitary-2020-001691. Epub 2021 Jan 20.
The positive impact of advances in military medicine and the influence these have had on civilian medical practice have been well documented throughout history: this review will be looking specifically between 2009 and 2020.
Review of innovations that have been implemented or have influenced civilian practice within the areas of trauma, disease outbreak management and civilian systems between 2009 and 2020. This review will also aim to explore the impact that working with or within the military can have on individuals within civilian healthcare systems and the future challenges we face to maintain skills.
Using a narrative approach to this review, we found that there have been numerous changes to trauma management within the UK, based on military practice and research during conflict, which have improved survival outcomes. In addition, the use of niche military skills as part of a coordinated response, during both internal and international disease outbreaks, are thought to have supported civilian systems enabling an efficient and prolonged response. Furthermore, adaptation of military concepts and their application to the NHS through consultant-led prehospital teams, centralisation of specialties in the form of major trauma centres and the introduction of guidelines to manage 'major incidents and mass casualty events' in 2018 have improved patient outcomes.
From 2009 to 2020, lessons learnt from the British and other nations' militaries have been integrated into UK practice and have likely contributed to improved outcomes in the management of major incidents both nationally and internationally.
军事医学进步所带来的积极影响及其对民用医疗实践的作用在历史上已有充分记载：本综述将特别关注2009年至2020年期间的情况。
回顾2009年至2020年期间在创伤、疾病爆发管理及民用医疗系统领域已实施或影响民用医疗实践的创新举措。本综述还旨在探讨在军事环境中工作或与军队合作对民用医疗系统中的个人可能产生的影响，以及我们在维持相关技能方面面临的未来挑战。
采用叙述性方法进行本综述，我们发现，基于冲突期间的军事实践与研究，英国的创伤管理发生了诸多变化，这些变化改善了生存结果。此外，在国内和国际疾病爆发期间，将小众军事技能作为协调应对措施的一部分加以运用，被认为对民用医疗系统起到了支持作用，使其能够做出高效且持久的应对。此外，通过由顾问主导的院前急救团队将军事理念进行调整并应用于国民医疗服务体系（NHS），以主要创伤中心的形式对专科进行集中管理，以及在2018年引入管理“重大事件和大规模伤亡事件”的指南，均改善了患者治疗效果。
从2009年到2020年，从英国及其他国家军队汲取的经验教训已融入英国的医疗实践中，并可能有助于在国内外重大事件的管理中取得更好的成果。
