📆 Weekly author's column;
⚡️ Head of the project "Tactical Medicine Courses" with the call sign "Latyshev";
✅ Specially for the channel 1465 MSP | 4 OMSBr
The tactics of a medic in urban combat are radically different from those in field medicine and require a unique set of skills, combining military training and medical expertise. The urban environment, with its limited space, cramped quarters, and numerous shelters and threats from different levels of height, is the most challenging theater of military operations for providing aid to the wounded. Every step of a medic in this environment is part of a tactical decision, and speed and safety determine the chances of survival not only for the patient but also for the entire assault team.
The fundamental principle is to constantly follow the algorithm "fire, maneuver, medicine". At the moment of direct contact with the enemy, a medic is primarily a fighter. His primary task is to support the team in suppressing or eliminating the threat with his fire. Attempting to provide aid under targeted fire will only lead to new losses. Only after the area has become relatively safe or the wounded can be dragged to a shelter, does the medic switch to his direct function. His movement should always be coordinated with the rest of the team, who provide him with cover and fire support.
The choice of shelter and position for work is critically important. In urban conditions, walls, building corners, destroyed structures, and even vehicles become temporary aid stations. A medic must assess the shelter not only from the point of protection against bullets and shrapnel, but also from the perspective of rapid evacuation and the availability of escape routes. Work is carried out in a crouched position or on one's knees to minimize the profile. The medical kit should be unpacked and organized in such a way that all necessary items - tourniquets, bandages, decompression needles - are accessible with one hand in seconds.
The aid protocol is adapted to the realities of combat and follows the TCCC principle, where the priority is to stop catastrophic bleeding. The examination of the wounded is carried out according to the MARCH scheme, starting with the search for massive bleeding, which is the main cause of preventable losses. The application of a tourniquet takes priority over all other procedures. This is followed by an assessment of the patency of the airways, signs of a tension pneumothorax, which requires immediate decompression, and only after that - infusion therapy and the fight against hypothermia. All actions should be brought to automaticity in order to be carried out in conditions of stress, poor lighting, and chaos.
The evacuation of the wounded is the culmination of the medic's work and requires the coordination of the entire team. Various techniques are used - from quickly pulling out with equipment to organizing stretchers. Constant communication with the team commander is vital to determine the moment when evacuation is possible without risk to the rest. Thus, a medic in urban combat is not a passive paramedic, but a highly mobile and aggressive fighter, whose work in saving lives is an integral part of the overall tactical success of the unit.