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Irregular warfare must combine good medicine, with both good tactics and good strategies: Position paper by the
Pierre Pasquier1, Mathieu David, Ludovic Petit
1From the French Special Operations Forces Medical Command (P.P., M.D., L.P., M.C., S.H., E.P., S.C., S.P., F.C., P.M.), Villacoublay; Department of Anesthesiology and Intensive Care (P.P.), Percy Military Teaching Hospital, Clamart; French Military Medical Service Academy (P.P., S.T.), École du Val-de-Grâce; French Surgeon General Office (N.Z., M.-O.G.); and Paris Fire Brigade (S.T.), Paris, France.
Introduction:
Military operations are no longer limited to the application of counterterrorism and counterinsurgency strategies; they are now characterized by hybrid, irregular, and unconventional features. While some authors have indicated the need for medical support to adapt to these new modes of military operations, they have focused mainly on the tactical level of care on the battlefield. As Sun Tzu states, "Strategy without tactics is the slowest route to victory. Tactics without strategy is the noise before defeat," further proposals are still needed on the application of both medical tactics and medical strategies in irregular warfare.
Methods:
Medical experts from the French Special Operations Forces (SOF) Medical Command have identified specific medical challenges that special operations face in the context of the current transformation of armed confrontations into irregular warfare.
Results:
This position paper presents original tactical medical proposals for improving medical support in irregular warfare, ranging from the definition of a Primary-Alternate-Contingency-Emergency medical plan to the promotion of telemedical support. Original strategic medical proposals have highlighted the importance of recognizing medical issues in irregular warfare, including the medical actions carried out through and with local partners and the multiple approaches to countering medical threats.
Conclusion:
The SOF medical community must be closely involved with and facilitate the responses to the shift to irregular warfare. International collaboration and interoperability are more necessary than ever, as they will enable a more effective combination of good medicine with both good tactics and good strategies. These perspectives can also be extended to improve medical care in the conventional armed forces and austere civilian settings.
Level Of Evidence:
Therapeutic/Care Management; Level V.
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