The term “médecine de l’avant” (in french) (”forward medicine” in literal translation in English) designates medical procedures performed outside the hospital, before arriving at the field hospital: either on the battlefield, or in a refuge near the battlefield, hospital..etc
The main characteristics are:
a high level of stress on the part of the workers
lack of diagnosis (other than with the help of the five senses)
an austere environment, very limited means (impossibility of having bulky or fragile equipment).
The treatment of the injured has two components:
a medical aspect: saving the life of the injured person, then allowing his recovery.
a logistical aspect: put him out of danger by taking him out of the combat zone to bring him to the initial care structure, then evacuate him to more efficient structures.
Killed in action (KIA): people who died before arriving at a care facility.
Penetrating brain trauma : these cases have little chance of survival even with prompt surgery.
combination of several causes : mainly brain trauma and hemorrhage;
respiratory system injury
pneumothorax under tension
Died of wounds (DoW): people who died in a care structure.
sepsis and multi-visceral failure
hypovolemic shock : mainly due to hemorrhage of the liver and / or small pelvis, with or without coagulopathy.
instantaneous death : death within seconds or minutes of injury; these are usually injuries to the brain, spinal cord, heart and major vessels
early death : death within minutes or hours of injury; it is generally respiratory distress, uncontrolled bleeding, and extradural or subdural hematoma;
late death : within hours, days, or even weeks after injury; it is usually death from sepsis and multi-organ failure.