Page 122 - JSOM Winter 2025

data, advanced life support interventions, and outcomes were Over the years and generations, military medics around the
collected. Each organ failure was then analyzed during a 7-day world have crystallized effective approaches, doctrines and
trauma course according to the Sequential Organ Failure As- SOPs.
sessment score.
As a result of this work, a piece of carbon with a servomotor,
Results: Of the 100 patients who met the inclusion criteria, which costs $600, flies in at the speed of 70km/h, with explo-
those with persistent MOF at day 4 (MOF group) represented sives attached to it hull. It completely ruins our plans.
22% of the total population (median Sequential Organ Failure
Assessment score 6.0 [IQR5.3–8.0]). Compared to those with- This eternal struggle between the shield and the sword . . .
out persistent MOF, these patients were more severely injured Will the ‘golden hour’ still exist in the future? Will it become
(median Military Injury Severity Score 38.0 [IQR 33.0–56.8] a relic of the past, a pleasant memory of a ‘comfortable war’?
vs. 26.5 [IQR 20.0–34.0], P<.001) by an explosive mechanism
(68.2%) and sustained more traumatic brain injury (40.9% Will the existing training programmes and their skill sets be
vs. 14.1%, P=.013). The MOF group also received signifi- sufficient to preserve the lives and health of the wounded
cantly more blood units (median 14.0 [IQR 8.3–24.8] vs. 6.0 effectively?
[IQR 0.0–12.0], P<.001) and massive transfusions (68.2% What will happen to the survival rate of soldiers in the condi-
vs. 32.1%, P=.002). Pulmonary and cardiovascular dysfunc- tions of modern warfare?
tion were the most frequently observed trauma outcomes. A
multivariable logistic regression model showed that MOF per- Drones have fundamentally changed logistics.
sistence at day 4 was significantly associated with severe inju- Drones have significantly complicated logistics.
ries (OR 1.5 [95% CI1–2.3], P=.042).
Drones have significantly developed logistics.
Conclusion: A high number of severe lesions significantly and Everyone can see everyone else on the battlefield. This is our
independently increased the risk of MOF persistence at day new format for waging war.
4 after combat-related trauma. These findings are particu-
larly relevant to current and anticipated large-scale combat Enemy drones study your activity, they record logistics chains
operations that will challenge battlefield casualty care and and direct their fire on those chains; they strike your evacua-
evacuation. tion vehicles and destroy your infrastructure in the rear.
Friendly drones provide you with information 24/7, search for
Newbies Study Tactics; Experts Study Logistics the wounded, study logistics routes, adjust evacuation routes,
Lt Serhii Rotchuk, 12th Special Forces Brigade Azov of the deliver supplies and transport the wounded . . .
National Guard of Ukraine
These are new challenges. These are new opportunities.
War is primarily about logistics. Military medicine is a special
logistics operation.
PMID: 41468399; DOI: 10.55460/SPHZ-ZAEZ
The fact that, during this operation, people apply pleural
drains to each other and inject themselves with Ketamine
amounts to secondary, auxiliary processes.

120 | JSOM Volume 25, Edition 4 / Winter 2025