Training in wound ballistics: operation exercise at the Defence Medical Training Centre

The Defence Medical Training Centre has for a number of years been conducting exercises to give Danish National Service (conscript) surgeons and dentists the opportunity to observe and treat gunshot wounds. The exercises are intended to complement the theoretical training given at the Centre, which has been granted permission by the Ministry of Justice to use experimental animals in the training program. The animals used are shot in the abdomen and both thighs and are kept anesthetized during the exercise but, if possible, breathe spontaneously. Assisted ventilation is available at all times. The weapons used are military weapons: a low velocity 9-mm semiautomatic pistol, SIG P210, a medium velocity rifle, US M1 Carbine, and a high velocity rifle, the AK-74. The ammunition used is conventional, full metal jacketed bullets. Having been shot, the animals are given first aid by the participants who play the roles of ordinary soldiers. The animals are then taken to the regimental aid post, where they are attended by a surgeon for the first time. Intravenous tubes, chest tubes, hemostats, etc. are applied, whereupon the animals are transported by military ambulance to the field hospital. There the abdominal wounds are examined by laparotomy and relevant intraabdominal procedures are performed. The leg wounds are treated by debridement along the lines advocated by the Emergency War Surgery-NATO Handbook. This exercise allows the Defence Medical training Centre to teach wound ballistics in a realistic setting. It is hoped that the pupils will never need the skills acquired at the exercise, but, next to going to war or to some of the more violent parts of the world, Operation Exercise is the best preparation for the demands placed on a medical officer.