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Evolution of hot zone care: MARA.
1Medical Support Unit, Hereford, UK john.miles446@mod.gov.uk.
BMJ Military Health
|April 29, 2020
Summary
Modern conflicts create complex environments, delaying critical medical care. A new approach, Major Haemorrhage, Airway, Respiration, Analgesia (MHARA), is proposed to bridge the gap between immediate care and tactical field care (TFC).
Area of Science:
- Military Medicine
- Emergency Medical Services
- Trauma Care
Background:
- Modern conflicts involve complex, three-dimensional environments, unlike traditional two-dimensional battlespaces.
- Contested spaces and perceived threats complicate traditional response zones, potentially delaying medical interventions.
- A 'time and space gap' exists between immediate care under fire and the initiation of tactical field care (TFC).
Purpose of the Study:
- To address the challenges in providing timely medical care in modern, complex conflict zones.
- To propose a rethought approach to tactical field care (TFC) in environments with ongoing threats.
- To introduce the Major Haemorrhage, Airway, Respiration, Analgesia (MHARA) framework.
Main Methods:
- Conceptual framework development based on evolving battlefield dynamics.
- Analysis of delays in care due to contested spaces and threat perception.
- Proposal of the MHARA mnemonic as a revised approach to TFC.
Main Results:
- Traditional TFC initiation may be delayed or inappropriate in complex environments.
- The 'time and space gap' poses a risk to patient outcomes.
- The MHARA approach offers a structured method for care prioritization.
Conclusions:
- The MHARA framework is proposed to optimize tactical field care (TFC) in modern, complex conflict scenarios.
- This approach aims to mitigate delays and improve patient outcomes by addressing critical needs.
- Rethinking TFC is crucial for adapting to the evolving nature of warfare and terrorism.
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