Management of the medical and evacuation system development of the armed forces of Ukraine according to NATO standards
DOI:
https://doi.org/10.34132/pard2023.20.08Keywords:
medical and evacuation support; Medical forces of the Armed Forces of Ukraine; NATO standards; unified medical space; phased planning and coordination; integration processes; levels of health careAbstract
The article focuses on the complex problem of organization and planning of medical and evacuation support of the Armed Forces of Ukraine in the conditions of the functioning of a unified medical space and integration processes. The purpose of the research is to generalize the organizational and management principles regarding the complex solution of tasks related to the organization and development of the medical and evacuation support system of the Armed Forces of Ukraine through interdepartmental interaction at different levels of management in accordance with NATO standards.
Among the main tasks of the functioning and development of the medical support system of the Armed Forces of Ukraine, which need to be solved, the transformation of the system of medical and evacuation support of the Armed Forces of Ukraine in accordance with international doctrines, guidelines and protocols aimed at the formation of a capable integrated system of its phased planning and coordination deserves special attention in cooperation and interaction with the relevant forces of NATO member states within the framework of strategic partnership. The need to solve the relevant tasks determines the need for consistent, purposeful development of the necessary capabilities at all levels of management of medical and evacuation support.
The solution of a complex of interdepartmental issues regarding the organization of a complete and capable system of medical and evacuation support of the Armed Forces of Ukraine involves determining the organizational principles of inter-subject interaction and coordination of different levels of management of medical and evacuation support in the context of the implementation of the Military Medical Doctrine of Ukraine in a unified medical space.
It has been established that integration into the unified medical space of Ukraine involves the construction of an integral system of medical and evacuation support for the troops in combination with the resource capabilities of the civilian health care system, and also determines the unity of views on the organization and procedure for the use of forces and means of medical services and ensures the resource capacity of civil health care institutions for medical and evacuation support of servicemen.
It has been proven the need for phased planning and inter-level coordination, as well as the importance of defining and clearly distinguishing the levels of management of medical and evacuation support and the necessary resources in accordance with Role/Echelon 1-4 medical support, which will provide the opportunity to integrate the military medical support system not only into a unified medical space of Ukraine, but also into the unified medical space of NATO member countries.
The formation of an effective system of medical and evacuation support in accordance with the standards of NATO member countries requires the development of a new, modern and resource-efficient concept of phased planning and coordination of medical and evacuation support in combat conditions (Phased Planning and Coordination of Medical Evacuation Support in Combat Conditions), which involves algorithmization processes (actions) at different levels of management and determination of appropriate work packages and resource modules for each stage of medical and evacuation support.
References
Allied Joint Publication-4.10, Allied Joint Doctrine For Medical Support. Retrieved from:https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/922182/doctrine_nato_med_spt_ajp_4_10.pdf [in English].
Demokratychna Ukraina (2019). Ihor Khomenko: viiskovi medyky vriatuvaly tysiachi soldatskykh zhyttiv. [Democratic Ukraine (2019). Ihor Khomenko: military medics saved thousands of soldiers' lives]. Retrieved from: http://www.dua.com.ua/index.php/army/item/5258-igor-khomenko-vijskovi-mediki-vryatuvali-tisyachi-soldatskikh-zhittiv [in Ukrainian].
Guidelines for Tactical Combat Casualty Care for Combat Lifesaver (TCCC CLS). (2017). HAEMT. Retrieved from: https://www.naemt.org/education/naemt-tccc/tccc-cls-guidelines-and-curriculum [in English].
Gurney, J.M., Stern, C.A., Kotwal, R.R., Cunningham, C.W., Burelison, D.R., Gross, K.R., …Shackelford S.A. (2020). Tactical Combat Casualty Care Training, Knowledge, and Utilization in the US Army. Mil Med., 7 (185) (Suppl 1), 500-507. doi: 10.1093/milmed/usz303. [in English].
Karamyshev D., L. Hordiienko L., & Hranovskyi M. (2022). Aspects of management of medical and evacuation support for the troops in the conditions of the unified medical space of Ukraine. Archiv EuroMedica Special Issue, 12, 1-4. Retrieved from: http://journal-archiveuromedica.eu/archiv-euromedica-sp-2022/5-ASPECTS-OF-MANAGEMENT-OF-MEDICAL-AND-EVACUATION-SUPPORT.html [in English].
Karamyshev D.V., Zhdan V.M., Dvornyk V.M., Hordiienko L.P., & Kundii Zh.P. (2022). Universally applicable approaches to the tactical level of aid and medical support for the personnel of the Armed Forces of Ukraine. World of Medicine and Biology, 4 (82),74-79. doi: 10 26724/2079-8334-2022-4-82-74-79 [in English].
Karamyshev, D.V. (2022). Orhanizatsiino-pravovi zasady tsyvilno-viiskovoi vzaiemodii z pytan oborony ta zhyttiezabezpechennia Zbroinykh Syl Ukrainy v umovakh voiennoho stanu [Organizational and legal principles of civil-military cooperation on matters of defense and life support of the Armed Forces of Ukraine under martial law]. Derzhavne budivnytstvo – State Formation, 1 (31), 7-24. Retrieved from https://ipa.karazin.ua/wp-content/themes/education/filesforpages/science/DERZhAVNE%20BUDIVNICTVO%E2%84%96%201%20(31)2022.pdf [in Ukrainian].
Karamyshev, D.V., Hordiienko, L.P., & Lytvynenko, M. I. (2022). Tsyvilno-viiskova vzaiemodiia u sferi orhanizatsii likuvalno-evakuatsiinoho zabezpechennia Zbroinykh Syl Ukrainy [Civil-military interaction in the field of organization of medical and evacuation support of the Armed Forces of Ukraine]. Aktualni problemy derzhavnoho upravlinnia - Actual problems of public administration, 1 (60), 6-27 [in Ukrainian].
Karamyshev, D.V., Zhdan, V.M., Dvornyk, V.M., Hordiienko, L. P., & Kundii, Zh. P. (2022). Institutional principles of civil-military cooperation regarding medical support of the Armed Forces of Ukraine. Bulletin of Problems in Biology and Medicine, 4 (167), 66–74. doi: 10.29254/2077-4214-2022-4-167-66-75 [in English].
Khomenko, I. P., Halushka, A. M., Zhakhovskyi, V. O., & Livinskyi, V.H. (2020). Rol i znachennia medychnoi evakuatsii v systemi medyko-evakuatsiinykh zakhodiv medychnoho zabezpechennia ZS Ukrainy pid chas ATO/OOS [The role and significance of medical evacuation in the system of medical evacuation measures of medical support of the Armed Forces of Ukraine during ATO/JFO]. Ukrainskyi zhurnal viiskovoi medytsyny - Ukrainian Journal of Military Medicine, 1 (2), 5-14. doi: https://doi.org/10.46847/ujmm.2020.2(1)-005 [in Ukrainian].
Koshova, S., Mykhalchuk, V., & Radysh, Ya. (2021). Yedynyi medychnyi prostir Ukrainy – nova paradyhma rozvytku natsionalnoi systemy okhorony zdorovia [The unified medical space of Ukraine is a new paradigm for the development of the national health care system]. Derzhavne upravlinnia: udoskonalennia ta rozvytok - Public administration: improvement and development, 9, 1-8. Retrieved from http://www.dy.nayka.com.ua/pdf/9_2021/32.pdf. doi: 10.32702/2307-2156-2021.9.30 [in Ukrainian].
Ministry of Defense. Allied Joint Doctrine for Medical Support. NATO Standard AJP-4.10. (02.05.2023). Retrieved from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/922182/doctrine_nato_med_spt_ajp_4_10.pdf. [in English].
Nastanovy TSSS dlia nemedychnoho personalu [TCCC guidelines for non-medical personnel]. НАЕМТ. (2017). НАЕМТ. [in English].
NATO Logistics Handbook. Chapter 16: Medical Support. (n.d.). Retrieved from: https://www.nato.int/docu/logi-en/1997/lo-1610.htm. [in English].
NATO STANDARD AJMedP-2 Allied joint medical doctrine for medical evacuation. Edition A Version 1. (2018). Retrieved from : https://www.coemed.org/files/stanags/02_AJMEDP/AJMedP-2_EDA_V1_E_2546.pdf. [in English]
NATO STANDARD AJMedP-8. Allied joint medical doctrine for military health care (MHC). Edition A Version 1. (2018). Retrieved from: https://www.coemed.org/files/stanags/02_AJMEDP/AJMedP-8_EDA_V1_E_2598.pdf. [in English].
NATO STANDARD AJP-4.10. Allied joint doctrine for medical support. Edition C Version 1. (2019). Retrieved from : https:/www.coemed.org/files/stanags/01_AJP/AJP-4.10_EDC_V1_E_2228.pdf. [in English]
North Atlantic Treaty Organization. NATO Standardization Agreements (STANAG). (n.d.). Retrieved from: https://www.nato.int/cps/en/natohq/topics_69269.htm [in English].
Openko, P.V., Myroniuk, M.Iu., Hnes, B.M., Khavrych, H.P., & Kozachuk V.L. (2022). Metodychnyi pidkhid shchodo vyznachennia osnovnykh parametriv systemy evakuatsii poranenykh operatyvnoho uhrupovuvannia viisk iz zaluchenniam riznykh vydiv transportu [A methodical approach to determining the main parameters of the evacuation system of the wounded operational group of troops with the involvement of various types of transport]. Zbirnyk naukovykh prats Derzhavnoho naukovo-doslidnoho instytutu vyprobuvan i sertyfikatsii ozbroiennia ta viiskovoi tekhniky - Collection of scientific works of the State Research Institute of Testing and Certification of Weapons and Military Equipment, 3 (13), 88-96. doi: 10.37701/dndivsovt.13.2022.09 [in Ukrainian].
Perelik shtatnykh posad riadovoho, serzhantskoho i starshynskoho skladu ta vidpovidnykh yim viiskovykh zvan i taryfnykh rozriadiv posad : Nakaz Ministerstva oborony Ukrainy, 317 vid 07.09.2020 [List of full-time positions of private, sergeant and senior staff and their corresponding military ranks and tariff categories of positions: order of the Ministry of Defense of Ukraine, 317 dated 09.07.2020]. Retrieved from https://zakon.rada.gov.ua/laws/show/z0927-20#Text [in Ukrainian].
Pro rishennia Rady natsionalnoi bezpeky i oborony Ukrainy vid 14 veresnia 2020 roku «Pro Stratehiiu natsionalnoi bezpeky Ukrainy»: Ukaz Prezydenta Ukrainy, 392 vid 14.09.2020 [On the decision of the National Security and Defense Council of Ukraine dated September 14, 2020 "On the National Security Strategy of Ukraine": Decree of the President of Ukraine, 392 dated September 14, 2020]. Retrieved from: https://zakon.rada.gov.ua/laws/show/392/2020#Text] [in Ukrainian].
Pro rishennia Rady natsionalnoi bezpeky i oborony Ukrainy vid 20 serpnia 2021 roku "Pro Stratehichnyi oboronnyi biuleten Ukrainy": Ukaz Prezydenta Ukrainy, 473 vid 17.09.2021 [On the decision of the National Security and Defense Council of Ukraine dated August 20, 2021 "On the Strategic Defense Bulletin of Ukraine": Decree of the President of Ukraine, 473 dated September 17, 2021]. Retrieved from: https://www.president.gov.ua/documents/4732021-40121 [in Ukrainian].
Pro rishennia Rady natsionalnoi bezpeky i oborony Ukrainy vid 25 bereznia 2021 roku «Pro Stratehiiu voiennoi bezpeky Ukrainy»: Ukaz Prezydenta Ukrainy, 121 vid 25.03.2021 [On the decision of the National Security and Defense Council of Ukraine dated March 25, 2021 "On the Military Security Strategy of Ukraine": Decree of the President of Ukraine, 121 of March 25, 2021]. Retrieved: https://zakon.rada.gov.ua/laws/show/121/2021#Text [in Ukrainian].
Pro vnesennia zmin do Pereliku orhaniv viiskovoho upravlinnia, yurysdyktsiia yakykh poshyriuietsia na vsiu terytoriiu Ukrainy : nakaz Ministerstva oborony Ukrainy, 624 vid 10.12.2019 [On making changes to the List of military administration bodies whose jurisdiction extends to the entire territory of Ukraine: order of the Ministry of Defense of Ukraine, 624 dated 10.12.2019]. Retrieved from https://zakon.rada.gov.ua/laws/show/z1275-19#Text [in Ukrainian].
Pro zatverdzhennia Kerivnytstva z medychnoi evakuatsii u Zbroinykh Sylakh Ukrainy: nakaz Heneralnoho shtabu Zbroinykh Syl Ukrainy, 258 vid 09.07.2018 [On the approval of the Guidelines for medical evacuation in the Armed Forces of Ukraine: Order of the General Staff of the Armed Forces of Ukraine, 258 dated 07.09.2018]. [in Ukrainian].
Pro zatverdzhennia Nastanovy z medychnoho zabezpechennia Zbroinykh Syl Ukrainy na osoblyvyi period: nakaz Heneralnoho shtabu Zbroinykh Syl Ukrainy, 60 vid 11.02.2019. [On the approval of the Guidelines on the medical support of the Armed Forces of Ukraine for a special period: order of the General Staff of the Armed Forces of Ukraine, 60 dated 11.02.2019.] [in Ukrainian].
Pro zatverdzhennia Standartu ekstrennoi medychnoi dopomohy «Medychne sortuvannia pry masovomu nadkhodzhenni postrazhdalykh na rannomu hospitalnomu etapi» : nakaz Ministerstva okhorony zdorovia Ukrainy, 368 vid 24.02.2022. [On the approval of the Emergency Medical Care Standard «Medical triage during mass admission of victims at the early hospital stage»: order of the Ministry of Health of Ukraine, 368 dated 24.02.2022.]. Retrieved from https://www.dec.gov.ua/wp-content/uploads/2022/03/2022_368_ms_.pdf [in Ukrainian].
Pro zatverdzhennia Stratehii rozvytku Medychnykh syl Zbroinykh Syl Ukrainy do 2025 roku: nakaz Heneralnoho shtabu Zbroinykh Syl Ukrainy, 100 vid 12.03.2020 [On the approval of the Strategy for the Development of the Medical Forces of the Armed Forces of Ukraine until 2025: order of the General Staff of the Armed Forces of Ukraine, 100 dated 12.03.2020.]. [in Ukrainian].
Pro zatverdzhennia Voienno-medychnoi doktryny Ukrainy: Postanova Kabinetu Ministriv Ukrainy, 910 vid 31.10.2018 [On the approval of the Military Medical Doctrine of Ukraine: Resolution of the Cabinet of Ministers of Ukraine, 910 dated 31.10.2018]. Retrieved from https://www.kmu.gov.ua/npas/pro-zatverdzhennya-voyenno-medichnoyi-doktrini-ukrayini [in Ukrainian].
Puryear, B., Roarty, J., & Knight, C. (2022). EMS Tactical Combat Casualty Care. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK532260/ [in English].
Roshchin, H.H., Mazurenko, O.V., Humeniuk, K.V., Kuzmin, V.Iu., Slychko, I.I., Ivanov, V.I., Dorosh, V.M., & Humeniuk, N.I. (2020). Yedyni protokoly nadannia ekstrenoi medychnoi dopomohy yak element tsyvilno-viiskovoi vzaiemodii na terytoriiakh provedennia spetsialnykh operatsii v Ukraini [Unified protocols for the provision of emergency medical assistance as an element of civil-military interaction in the territories of special operations in Ukraine]. Travma - Trauma , 21 (2), 74-87. doi: 10.22141/1608-1706.2.21.2020.202236 [in Ukrainian].
Sait Ministerstva oborony Ukrainy (2023). Struktura orhanizatsii diialnosti medychykh syl Zbroinykh Syl Ukrainy [Website of the Ministry of Defense of Ukraine (2023). The structure of the organization of the activities of the medical forces of the Armed Forces of Ukraine]. Retrived from: https://www.mil.gov.ua/diyalnist/vijskova-mediczina/ [in Ukrainian].
Salnikova, O., Kushnir, V., & Proshchyn, I. (2019). Tsyvilno-viiskove spivrobitnytstvo yak element systemy stratehichnykh komunikatsii [Civil-military cooperation as an element of the strategic communications system]. Державне управління: удосконалення та розвиток Derzhavne upravlinnia: udoskonalennia ta rozvytok - Public Administration: Improvement and Development, 7, 1-6. Retrieved from http://www.dy.nayka.com.ua/pdf/7_2019/3.pdf doi: 10.32702/2307-2156-2019.7.1 [in Ukrainian].
Serdiuk, A.M., Ryhan, M.M., Antonenko, L.P., & Skaletskyi, Yu.M. (2016). Spivpratsia derzhavnoi ta vidomchykh system okhorony zdorovia na osoblyvyi period — aktualna problema dlia Ukrainy [Cooperation of state and departmental health care systems for a special period is an urgent problem for Ukraine]. V.I. Tsymbaliuk, A.M. Serdiuk (Eds.). Medychne zabezpechennia antyterorystychnoi operatsii: naukovo-orhanizatsiini ta medyko-sotsialni aspekty - Medical support of an anti-terrorist operation: scientific-organizational and medical-social aspects: - : Collection of scientific papers. (pp. 27-32). Kyiv: NVTs «Priorytety». Retrived from https://library.gov.ua/medychne-zabezpechennya-antyterorystychnoyi-operatsiyi-naukovo-organizatsijni-ta-medyko-sotsialni-aspekty/ [in Ukrainian].
Tactical Combat Casualty Care (TCCC) Guidelines for Medical Personnel. (2021). Retrieved from: https://www.naemt.org [in English].
Verba, A.V., Zhakhovskyi, V.O., Livinskyi, V.H. (2017). Medychne zabezpechennia Zbroinykh Syl Ukrainy: stan ta pohliady na perspektyvy rozvytku [Medical support of the Armed Forces of Ukraine: state and views on development prospects ]. Kyiv : SPD Chalchynska N.V. [in Ukrainian].









.png)






.png)


















