[Surgical care rendered to the wounded in the antiterrorist operations on the Northern Caucasus: premedical and initial medical care in the combat zone (Report II)]

The analysis of organization and contents of the first aid, premedical and initial medical care rendered to the wounded in the armed conflicts on the Northern Caucasus (1994-1996, 1999-2002) was conducted. It was established that the first aid was rendered to the most casualties who needed it (65% in the first conflict and 79% in the second conflict). The mean terms of rendering the first aid in the second conflict as compared with the conflict of 1994-1996 were decreased from 29 +/- 2 min to 18 +/- min. The role of premedical care was minimal in both conflicts: it was rendered to 3% casualties only. The premedical care was rendered in those cases when the first aid appeared to be ineffective, had obvious defects or in the delay of further evacuation of the wounded. The initial medical care became the central type or pre-hospital care in the combat zone. It was rendered to 56% casualties in the first conflict and to 59% in the second conflict. The mean terms of initial medical care rendered in the second armed conflict were 1.5 +/- 0.2 h. They have considerably decreased as compare with the first conflict (2.5 +/- 0.4 h). The introduction of the physicians with initial surgery and intensive care training in the staffs of regimental medical companies was resulted in significant improvement of initial medical care quality. It provided the adequate preparedness of the wounded for aeromedical evacuation to multipurpose military hospitals of the first level.