Vuckov S, Hebrang A, Tomljanović Z, Depolo A
Department of Surgery, University Hospital Center Rijeka, University of Rijeka, Croatia.
Mil Med. 1998 Feb;163(2):110-6.
The aim of this report is to present the various aspects of the reorganization of the health service in the Croatian province of Lika during the first year, 1991-1992, of the war in Croatia. In the former Socialist Republic of Yugoslavia, the health service was completely in the hands of the state, and Croatia was not able to transform it in the first year of its independence. The paper documents the personnel, supplies, and equipment that the health service of Lika had at its disposal in the first year of the war, the division of the health service into the stationary and front-line medical corps, and the evacuation protocols developed to transfer surgical patients to the rear-area hospital. The response of the health service allowed for rapid and successful patient treatment, emphasized by the fact that the usual time elapsed between wounding and delivery of the patient to the operating table was less than 30 minutes. All surgeries, with the exception of those involving severe craniocerebral injuries, were performed in the war hospitals of Lika. After stabilization of their postoperative condition, generally within 30 minutes, patients were evacuated to the rear-area hospital in Rijeka, with artificial respiration. The distance by road from the war hospitals in Otocac and Gospić to the reararea hospital in Rijeka was 120 and 170 km, respectively. Collectively, the results of our work demonstrate that a nonmilitary health service can be transformed successfully and efficiently into a war medical service. Yet, we believe that this is possible only under the extreme conditions of a defensive war.
本报告旨在介绍克罗地亚利卡省在1991 - 1992年克罗地亚战争第一年期间卫生服务重组的各个方面。在前南斯拉夫社会主义共和国，卫生服务完全由国家掌控，克罗地亚在独立的第一年无法对其进行变革。本文记录了利卡省卫生服务在战争第一年所拥有的人员、物资和设备，卫生服务分为固定医疗队和前线医疗队的情况，以及为将外科患者转移至后方医院而制定的疏散方案。卫生服务的响应使得患者能够得到快速且成功的治疗，受伤至患者被送上手术台的通常时间不到30分钟这一事实就突出了这一点。除了涉及严重颅脑损伤的手术外，所有手术均在利卡省的战地医院进行。术后病情稳定后，一般在30分钟内，患者通过人工呼吸被疏散至里耶卡的后方医院。从奥托克和戈斯皮奇的战地医院到里耶卡后方医院的公路距离分别为120公里和170公里。总体而言，我们的工作成果表明，非军事卫生服务能够成功且高效地转变为战时医疗服务。然而，我们认为这只有在防御性战争的极端条件下才有可能。
