今天的D简报-更多的导弹击中乌克兰-巴赫穆特前后的照片

![](/media/202412//1733466507.3138738.png)美国的内科医生必须从中学习 乌克兰更严厉的战争，报道

说

![](/media/202412//1733466507.321758.png)

俄罗斯的炮兵和操纵员 使战场医学更加困难 而且比在里面更危险 阿富汗和伊拉克。

山姆斯科夫

工作人员录入 2023年5月18日

迪玛是一名乌克兰的药师，她非常清楚如何这样做

危险的医疗后送可能是这样的。我在附近对国防一号发表讲话

去年11月，赫尔森描述了俄罗斯的坦克曾经是如何开火的 他的救护车，发射弹片穿过它的薄侧边。

根据一份新的报告，迪玛的经历远非不寻常 描述了乌克兰前线特种部队外科医生的经验。 发表在《美国外科医生学会杂志》上

U.S.应该准备好迎接由大炮定义的战争，而不是自制的战争吗 在阿富汗看到的炸弹。

“如果你看看下一场战争将会是什么，每一件事都会发生

成为一个大规模伤亡事件， ”亚伦 ·爱泼斯坦，一个医生和总统 制作这份报告的小组在一次采访时说。

美国。S.军方的医疗界需要弄清楚

事情，如何在越来越精确的火炮中处理伤亡 罢工，如何处理电子干扰， 以及如何抵御

该报告称，医疗车辆遭到袭击。

该报告背后的组织，全球外科和医疗组织

支持小组，从战争开始就一直在乌克兰工作， 训练乌克兰士兵并提供医疗支持。它是

主要由前美国人组成。军事医务人员，包括 许多前美国人。特种作战部队打击医务人员。

该组织与乌克兰特种部队和

U.S.爱泼斯坦说，欧洲特种作战司令部 他们不执行国防部的任务。报告的作者

采访了乌克兰特种部队的外科医生和那些为

乌克兰的军事情报部门，尽管他们很专业，但他们还是要对待所有人 乌克兰陆地部队的一个分支机构。

参与该报道的乌克兰外科医生说，炮兵和

火箭弹造成了70%的人受伤和死亡。防坦克制导

导弹也是一个主要威胁；该报告援引乌克兰消息来源称

他说，这通常是在打击非装甲或轻装甲车辆 杀死了里面70%的人。

与简易爆炸装置相比，美国。S.面对

在阿富汗和伊拉克，这些武器也可能更加致命。

一件俄罗斯热压武器立即杀死了12人 而200英尺外的另一个人则遭受了损失 烧伤了超过80%的身体，随后死亡。

受伤的高人数意味着乌克兰的外科医生必须受伤

报告称，他们夜以继日地帮助他们。一名外科医生 接受采访时说，他们在一周内治疗了200名病人

轰炸，或者每天大约有28名病人。

乌克兰的防弹衣和头盔似乎有助于预防

受伤，但缺乏全躯干保护是一个问题。约60

受伤的比例发生在士兵的两侧，在他们的前面和前面之间

后方防弹甲；30%的人发生在它们之下 上述的10%的受伤者有炮弹刺穿他们

没有穿盔甲或没有穿盔甲。

外科医生发现，治疗被炮火击中的士兵具有挑战性

因为他们经常遭受多种类型的伤害， 比如生命- 危险的伤口，被投掷造成的钝器创伤， 以及

创伤性脑损伤。

俄罗斯进一步瞄准了医疗人员和设施

使任务复杂化。外科医生通常没有任何警告

来的病人，无论是一线单位还是外科医生都没有 能够承受干扰或躲避的加密通信

盯梢

爱泼斯坦说，几个月来，他的组织一直在告诉美国。 乌克兰外科医生要求进行更多的通信

设备他被告知，最近的通信设备

发送到美国。4月份的军事援助计划可能会交给他的外科医生 组织支持。

医疗中心非常害怕成为俄罗斯的攻击目标，所以他们可能会成为攻击目标 不使用发电机，俄罗斯可以看到它的温暖

使用热视觉。这意味着，尽管人们对血液的需求很旺盛

输血后，乌克兰的外科医生不能储存血液供应 电冰箱或加热冻干的血液。

另一种选择是“行走血库 ”，其中士兵们用

普遍可用的血液提供了他们自己的血液，这是不可行的 外科医生补充说，乌克兰的伤亡率很高。

与此同时，俄罗斯在路上袭击医务人员意味着 外科医生不能立即疏散受伤的病人。医疗的

空中疏散风险太大，战斗失控的道路可能会受到攻击 有几天的时间。

该报告认为，这些情况表明，美国。医学的

人员必须准备好在靠近前线的地方治疗更多伤亡

并保护他们更长的时间，甚至有可能购买 快速隧道机器可以帮助保护医疗点。

爱泼斯坦说，美国。政府还没有正式联系到他的政府

尽管他已经听到了来自美国的消息。特殊的 外科手术迫使外科医生们广泛分享它。

“我们现在需要吸取教训，因为这是一种新的形式 战争， ”爱泼斯坦说。“没有时间的学习曲线

下一场战争。 ”

![](/media/202412//1733466518.306324.png)

US Medics Must Learn from Ukraine’s Harsher War, Report Says

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**Russia’s artillery and jammers**

**make battlefield medicine harder and more dangerous than in**

**Afghanistan and Iraq.**

[By Sam Skove](https://www.defenseone.com/voices/sam-skove/25034/?oref=d1-post-author)

Staff Writer

May 18, 2023

Dima, a Ukrainian mortician-turned-medic, knows all too well how

dangerous medical evacuations can be. Speaking to *Defense One* near Kherson last November, he described how Russian tanks once fired on his ambulance, sending shrapnel through its thinsides.

Dima’s experience is far from unusual, according to a new [report](https://journals.lww.com/journalacs/Abstract/9900/Putting_Medical_Boots_on_the_Ground__Lessons_from.609.aspx) that describes the experience of frontline Ukrainian special forces surgeons. Published in the *Journal of the American College of Surgeons*, it says the U.S. should get ready for wars defined by artillery, not the homemade bombs seen in Afghanistan.

“If you look at what the next war is gonna be, every incident is going to be a mass-casualty incident,” Aaron Epstein, a doctor and president of the group that produced the report, said in an interview.

The U.S. military’s medical community needs to figure out, among other things, how to treat casualties amid [ever-more-accurate](https://twitter.com/TrentTelenko/status/1658202870640943116) artillery

strikes, how to deal with electronic jamming, and how to ward off attacks on medical vehicles, the report said.

![](/media/202412//1733466518.329622.png)[The organization behind the report, Global Surgical and Medical](https://www.gsmsg.org/)

[Support Group, has worked in Ukraine since the beginning of the war,](https://www.gsmsg.org/) training Ukrainian soldiers and providing medical support. It is

primarily staffed by former U.S. military medical personnel, including many former U.S. special operations forces combat medics.

The organization coordinates with both Ukrainian special forces and U.S. Special Operations Command in Europe, Epstein said, although they do not carry out Defense Department tasks. The report’s authors interviewed Ukrainian special forces surgeons and those working for Ukrainian military intelligence, who, despite their specialty, treat all branches of the Ukrainian land forces.

Ukrainian surgeons who contributed to the report said artillery and rockets caused 70 percent of wounds and deaths. Anti-tank guided

missiles are also a major threat; the report cites a Ukrainian source as saying that strikes on unarmored or lightly armored vehicles typically killed 70 percent of those inside.

Compared to the improvised explosive devices the U.S. faced in

Afghanistan and Iraq, these weapons can also be radically more deadly. One Russian thermobaric weapon killed 12 people immediately within 65 feet of the impact point, while another person 200 feet away suffered burns over 80 percent of their body and subsequently died.

The high numbers of wounded means that Ukrainian surgeons must work round the clock to help them, the report said. One surgeon

interviewed said they treated 200 patients in a week while under bombardment, or around 28 patients a day.

Ukrainian body armor and helmets appeared helpful in preventing

injuries, but the lack of full-torso protection was a problem. Around 60 percent of wounds occurred in soldiers’ sides, between their front and rear body armor plates; and 30 percent occurred below them, the report said. Ten percent of those injured either had projectiles pierce their

armor or were not wearing armor.

Surgeons found it challenging to treat soldiers hit by artillery fire because they often suffer multiple types of injuries, such as life- threatening wounds, blunt-force trauma from being thrown, and traumatic brain injuries.

Russia’s targeting of medical personnel and facilities further

complicates the task. Surgeons typically have no warning about

incoming patients, as neither frontline units nor the surgeons have encrypted communications that can withstand jamming or elude surveillance.

For months, Epstein said, his organization had been telling the U.S.

military about Ukrainian surgeons’ requests for more communications equipment. He was told that the communications equipment recently sent in U.S. military aid packages in April may go to the surgeons his organization supports.

Medical centers are so fearful of being targeted by Russia that they may not use electrical generators, whose warmth Russia can see through the use of thermal vision. That means that, despite the high need for blood transfusions, Ukrainian surgeons cannot store supplies of blood in

refrigerators or warm up freeze-dried blood.

Another alternative, the “walking blood bank,” in which soldiers with universally-usable blood provide their own blood, isn’tfeasible in

Ukraine, the surgeons added, due to the high rate of casualties.

Russian targeting of medical staff on the road, meanwhile, means that surgeons can’t immediately evacuate wounded patients. Medical

evacuation by air is too risky, and roads out of combat maybe under fire for days at time.

These conditions, the report argues, suggest that U.S. medical

personnel must prepare to treat more casualties closer to the frontline and protect them for longer periods of time, potentially even buying rapid tunneling machines that could help protect medical points.

Epstein said the U.S. government had yet to formally reach out to his organization about the report, although he has heard from U.S. special operations forces surgeons that they are widely sharing it.

“We need to learn the lessons now, because this is a new form of

warfare,” Epstein said. “There’s no time for that learning curve in the next war.”