Medical and pharmaceutical aspects of providing first aid in military field conditions: stability of injectable drugs

Abstract

In modern combat conditions, the issue of emergency medical care on the front lines is becoming particularly relevant. First aid to the wounded is provided directly in the field – at the site of injury and during subsequent evacuation to the hospital. The prehospital stage is the initial link in the «chain of survival» and largely determines the effectiveness of subsequent stages of treatment. An important task is to critically analyze all aspects of care, including mortality rates and causes, especially those cases that could potentially be avoided. The use of injectable drugs in front-line conditions is justified due to their numerous advantages, which make them a key tool in providing emergency medical care.

Aim. To summarize the literature data on the analysis of the causes of death of the military personnel on the battlefield; to study the range of injectable drugs that should be included in the combat medic’s backpack, as well as the stability of individual drugs used in combat conditions.

Materials and methods. The scientific literature and modern approaches to the use of ready-made injectable drugs in combat conditions were analyzed. The stability of drugs, such as tranexamic acid, ondansetron, and dexketoprofen stored in boxes in combat positions were studied. The quantitative determination of active substances was performed using absorption spectrophotometry (dexketoprofen) and HPLC (tranexamic acid and ondansetron). The statistical processing of the results was performed according to generally accepted methods of the State Pharmacopoeia of Ukraine.

Results. The article analyzes the data of literary sources on medical conditions that pose a threat to the lives of the military personnel during combat operations. The rapid initiation of medical care is a decisive factor in increasing the victim’s chances of survival and recovery of physical functions. The critical importance of this aspect is due to the concept of the «golden hour» – the first 60 minutes after injury when effective and skilled medical care can significantly reduce the risk of fatal complications and help to stabilize the condition. During this period of time, the priority is to control bleeding, ensure airway patience, stabilize vital functions, and prepare for further evacuation. The range of drugs most commonly used to reduce the risk of mortality and prevent life-threatening conditions has been studied. Pre-filled syringes as drugs used on the battlefield and alternative packaging for injectable drugs have been considered. Quality control of drugs stored in 3D-printed boxes has been performed.

Conclusions. The literature sources on the stages of providing emergency care on the front lines have been summarized and injectable drugs suitable for military first-aid kits have been studied. An experimental quality check of tranexamic acid, ondansetron, and dexketoprofen has been conducted; it has confirmed their compliance with standards within 3–6 months of storage. The use of special 3D-printed boxes for syringes filled with drugs from ampoules is promising.