{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,8]],"date-time":"2026-11-08T04:21:43Z","timestamp":1794111703765,"version":"4.8.0"},"reference-count":59,"publisher":"Oxford University Press (OUP)","issue":"1-2","license":[{"start":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T00:00:00Z","timestamp":1693353600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,23]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:p>The ongoing war in Ukraine presents unique challenges to prehospital medical care for wounded combatants and civilians. The purpose of this article is to identify, describe, and address gaps in prehospital care, casualty evacuation, and medical evacuation throughout Ukraine to share lessons for other providers. Observations and experiences of medical personnel were collected and analyzed, focusing on pain management, antibiotic use, patient assessment, mass casualty triage, blood loss, hypothermia, transport immobilization, and clinical governance. Gaps identified include limited access to pain management, lack of antibiotic guidance, inadequate patient assessment and triage, access to damage control resuscitation and blood, challenged transport immobilization practices, and challenges with clinical governance for both local and foreign providers. Improved prehospital care and casualty and medical evacuation in Ukraine are required, through increased use of empiric pain management, focused antibiotic guidance, enhanced patient assessment and triage in the form of training, access to prehospital blood, and better transport immobilization practices. A robust and active lessons learned program, trauma data capture, and quality improvement process is needed to reduce preventable morbidity and mortality in the war zone. The recommendations presented in this article serve as a starting point for improvements in prehospital care in Ukraine with potential to change prehospital training for the NATO alliance and other organizations operating in similar areas of conflict.<\/jats:p>\n               <jats:p>Graphical Abstract<\/jats:p>","DOI":"10.1093\/milmed\/usad253","type":"journal-article","created":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T20:44:55Z","timestamp":1693428295000},"page":"17-29","source":"Crossref","is-referenced-by-count":76,"title":["Prehospital Lessons From the War in\u00a0Ukraine: Damage Control Resuscitation and\u00a0Surgery Experiences From Point of Injury to Role 2"],"prefix":"10.1093","volume":"189","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6877-8298","authenticated-orcid":false,"given":"John","family":"Quinn","sequence":"first","affiliation":[{"name":"Prague Center for Global Health , Prague 120 00, Czech Republic"},{"name":"East Surrey Emergency Department , Redhill RH1 5RH, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2952-1670","authenticated-orcid":false,"given":"Serhii I","family":"Panasenko","sequence":"additional","affiliation":[{"name":"Department of Surgery No 3, Poltava State Medical University , Poltava 36039, Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yaroslav","family":"Leshchenko","sequence":"additional","affiliation":[{"name":"Armed Forces of Ukraine , 02000, Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8892-4061","authenticated-orcid":false,"given":"Konstantyn","family":"Gumeniuk","sequence":"additional","affiliation":[{"name":"Ukrainian Armed Forces (UKR), Headquarters of Medical Forces of Military Forces , Kyiv 03168, Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4383-3040","authenticated-orcid":false,"given":"Anna","family":"Onderkov\u00e1","sequence":"additional","affiliation":[{"name":"Department of Oncology, Division of Surgery, University College London Hospital , London NW1 2BU, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-1814-1020","authenticated-orcid":false,"given":"David","family":"Stewart","sequence":"additional","affiliation":[{"name":"Emergency & Deployed Medicine San Diego, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A J","family":"Gimpelson","sequence":"additional","affiliation":[{"name":"New England Health Solutions, Manchester , NH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mykola","family":"Buriachyk","sequence":"additional","affiliation":[{"name":"Shupyk National Healthcare University of Ukraine , Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Martinez","sequence":"additional","affiliation":[{"name":"Unconventional Medicine LLC Miami , Miami, FL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracey A","family":"Parnell","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of British Columbia , Vancouver, BC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonid","family":"Brain","sequence":"additional","affiliation":[{"name":"NewYork-Presbyterian Brooklyn Methodist Hospital Emergency Department"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke","family":"Sciulli","sequence":"additional","affiliation":[{"name":"Auton Lab, Carnegie Mellon University , Pittsburgh, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John B","family":"Holcomb","sequence":"additional","affiliation":[{"name":"Prague Center for Global Health , Prague 120 00, Czech Republic"},{"name":"Emergency & Deployed Medicine San Diego, California, USA"},{"name":"Department of Surgery, Division of Trauma and Acute Care Surgery, University of Alabama at Birmingham , Birmingham, AL"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,8,30]]},"reference":[{"key":"2024012918212673400_R1","article-title":"Ukraine\u2019s war is like World War I, not World War II. 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