From the French Special Operations Forces Medical Command (P.P., M.D., L.P., M.C., S.H., E.P., S.C., S.P., F.C., P.M.), Villacoublay; Department of Anesthesiology and Intensive Care (P.P.), Percy Military Teaching Hospital, Clamart; French Military Medical Service Academy (P.P., S.T.), École du Val-de-Grâce; French Surgeon General Office (N.Z., M.-O.G.); and Paris Fire Brigade (S.T.), Paris, France.
J Trauma Acute Care Surg. 2024 Aug 1;97(2S Suppl 1):S67-S73. doi: 10.1097/TA.0000000000004336. Epub 2024 Apr 4.
Military operations are no longer limited to the application of counterterrorism and counterinsurgency strategies; they are now characterized by hybrid, irregular, and unconventional features. While some authors have indicated the need for medical support to adapt to these new modes of military operations, they have focused mainly on the tactical level of care on the battlefield. As Sun Tzu states, "Strategy without tactics is the slowest route to victory. Tactics without strategy is the noise before defeat," further proposals are still needed on the application of both medical tactics and medical strategies in irregular warfare.
Medical experts from the French Special Operations Forces (SOF) Medical Command have identified specific medical challenges that special operations face in the context of the current transformation of armed confrontations into irregular warfare.
This position paper presents original tactical medical proposals for improving medical support in irregular warfare, ranging from the definition of a Primary-Alternate-Contingency-Emergency medical plan to the promotion of telemedical support. Original strategic medical proposals have highlighted the importance of recognizing medical issues in irregular warfare, including the medical actions carried out through and with local partners and the multiple approaches to countering medical threats.
The SOF medical community must be closely involved with and facilitate the responses to the shift to irregular warfare. International collaboration and interoperability are more necessary than ever, as they will enable a more effective combination of good medicine with both good tactics and good strategies. These perspectives can also be extended to improve medical care in the conventional armed forces and austere civilian settings.
Therapeutic/Care Management; Level V.
军事行动不再局限于反恐和反叛乱战略的应用；现在的特点是混合、不规则和非常规。虽然一些作者指出需要医疗支持来适应这些新的军事行动模式，但他们主要关注的是战场上的战术护理水平。正如孙子所说：“没有战术的战略是最慢的胜利之路。没有战略的战术是失败前的噪音”，在非常规战争中应用医疗战术和医疗战略方面仍需要进一步的建议。
法国特种作战部队（SOF）医疗司令部的医学专家确定了特种作战部队在武装对抗向非常规战争转变的背景下面临的具体医疗挑战。
本立场文件提出了在非常规战争中改善医疗支持的原始战术医疗建议，从定义主要-备用-应急医疗计划到推广远程医疗支持。原始的战略医疗建议强调了认识非常规战争中的医疗问题的重要性，包括通过和与当地伙伴开展医疗行动以及对抗医疗威胁的多种方法。
SOF 医疗界必须密切参与并促进向非常规战争的转变。国际合作和互操作性比以往任何时候都更加必要，因为它们将使良好的医疗与良好的战术和战略更有效地结合在一起。这些观点也可以扩展到改善常规武装部队和艰苦的平民环境中的医疗护理。
治疗/护理管理；V 级。
