Satava R M
Yale University School of Medicine, New Haven, CT 06510, USA.
Ann Acad Med Singap. 1997 Jan;26(1):118-20.
For decades, warfighters have been putting in place a sophisticated "digital battlefield", an electronic communication and information system to support advanced technology. Medicine is now in a position to leverage these technologies to produce a fundamental revolution, and the keystone is the digital physician. Today nearly all information about a patient can be acquired electronically, and with the new technologies of teleoperation and telesurgery we can provide remote treatment and even surgery through telemedicine. The following framework for military medicine will leverage upon the current electronic battlefield. A personnel status monitor (PSM) will have a global positioning locator to tell the position of each soldier and a suite of vital signs sensors. When a soldier is wounded, the medic will instantly know the location of the soldier, and how serious is the casualty. This will permit the medic to locate the most critically wounded soldier. Once stabilised, he will be placed in a critical care pod, a fully automated intensive care unit in a stretcher, which will monitor his vital signs, administer fluids and medications and provide environmental protection. If immediate surgery is needed, a remote telepresence surgery vehicle will come to the wounded soldier, the medic will place him in the vehicle, and a surgeon will operate remotely using telepresence surgery from a distant Mobile Advance Surgical Hospital (MASH) to the combat zone. Also, the expertise from any specialist will be available from the rear echelons as far back as the home country. For education and training in combat casualty care, virtual reality simulators are being implemented. This same scenario can be utilised in civilian health care, especially in providing care to patients in remote areas who do not currently have access to simple, let alone sophisticated, health care.
几十年来，作战人员一直在构建一个复杂的“数字战场”，即一个支持先进技术的电子通信和信息系统。医学现在有能力利用这些技术引发一场根本性的革命，而关键在于数字医生。如今，几乎所有关于患者的信息都可以通过电子方式获取，借助远程操作和远程手术等新技术，我们能够通过远程医疗提供远程治疗甚至手术。以下军事医学框架将利用当前的电子战场。人员状态监测器（PSM）将配备全球定位定位器以告知每名士兵的位置以及一套生命体征传感器。当一名士兵受伤时，医护兵将立即知晓该士兵的位置以及伤势的严重程度。这将使医护兵能够找到伤势最严重的士兵。一旦伤势稳定，他将被安置在重症护理舱中，这是一种担架式的全自动重症监护单元，它将监测其生命体征、给予液体和药物并提供环境保护。如果需要立即进行手术，一辆远程临场手术车将前往受伤士兵处，医护兵将其安置在车内，外科医生将从遥远的移动前进外科医院（MASH）通过远程临场手术在作战区域进行远程操作。此外，来自任何专科医生的专业知识都可以从后方梯队直至本国获取。为了进行战斗伤员护理的教育和培训，正在采用虚拟现实模拟器。同样的方案可用于民用医疗保健，特别是为目前无法获得简单医疗保健更不用说复杂医疗保健的偏远地区患者提供护理。
