Ukrainian Defense Intelligence (HUR) announced today the first successful destruction of an aerial target using a marine drone. The drone, a Magura V5, is reported to have shot done one Russian Mi-8 helicopter with a SeaDragon missile, and damaged a second helicopter.
TALES FROM A PARAMEDIC, PILOT, CAVER, and FIREFIGHTER, WHO MEET IN ANTARCTICA, AND GO ON TO HAVE MANY ADVENTURES IN NEW ZEALAND, TONGA, FIJI, VANUATU, WEST AFRICA, AND UKRAINE. . . . . . . . . . . . . . . Structural Firefighting/ARFF/Joint Antarctic Search and Rescue Team at McMurdo Station Winfly- Summer- Winterover. Sailing a 37' Tayana sailboat in the South Pacific. Ebola Response. Wildland firefighting. War Medic in Ukraine.
Tuesday, December 31, 2024
Monday, December 30, 2024
Ukraine: Frostbite and Trench Foot Prevention and Treatment
FROSTBITE AND TRENCH FOOT
Frostbite is injury due to formation of ice crystals within tissues. Adjacent tissues may be damaged by vasoconstriction, thrombosis, and inflammation,
Determining the severity of a cold injury can be challenging during early phases. Initial signs and symptoms in severe frostbite may appear deceptively benign; conversely, mild cold injuries such as frostnip may present similarly to frostbite.
Prior to rewarming, frostbitten tissues are cold, white, hard, numb, and sometimes blistered. After rewarming, skin becomes blotchy red, swollen, and extremely painful. Blisters tend to appear within 4-6 hours of rewarming. Clear, serum-filled blisters indicate superficial damage, without residual tissue loss. Blood-filled blisters accompany deep tissue damage and likely tissue loss. Longer-term complications can include compartment syndrome, gangrene (usually dry, with a hard black carapace over healthy tissue), need for amputation, and long-term neuropathic symptoms. The full extent of frostbite damage may take several days to several weeks to become clear.
TCCC has four frostbite categories:
First Degree (Superficial): Superficial skin injury, pain on rewarming, numbness, hyperemia, occasionally blue mottling, swelling and superficial desquamation (after ~5 days)
Second Degree (Superficial): Partial thickness injury to skin, in addition to first degree findings, vesiculation of the skin surrounded by erythema and edema (appears around day 2)
Third Degree (Full Thickness): Entire thickness of skin extending into subcutaneous tissue, bluish to black and non-deformable skin, hemorrhagic blisters, vesicles may not be present, eventual ulcerations can be expected, area will likely be surrounded by 1st or 2nd degree injury
Fourth Degree (Full Thickness): Similar to third degree, but full thickness damage including bone. Area may be cold to touch and may feel stiff or woody.
Immersion Foot: Caused by prolonged exposure to moisture. Feet, especially soles, become water-logged, hyperemic, mottled, painful, and edematous, gradually progressing to blistering, hypoperfusion, ulceration, and gangrene if untreated. Treatment is re-warming and drying at room temperature. Pain control and debridement may be required. As with other cold injuries, persistent life-altering symptoms may occur.
TCCC frostbite treatment protocols are as follows:
***Treatment protocols in Ukraine will depend on local guidelines***
Address major trauma and hypothermia before focusing on frostbitten extremities.
PREVENTION in patients: Ukraine conflict conditions and injury patterns can predispose patients to cold injuries, in several ways.
Field conditions: Immediately post-injury, it may be necessary to prioritize movement, cover, and returning fire over keeping patients dry and fixing damaged winter clothing systems. In Ukraine at present, Casualty Collection Point and/or field care is generally provided by personnel with auxiliary training, only at the Combat Lifesaver / EMT-Basic level. Due to large numbers of patients, and pervasive drone, artillery, and direct-fire threats, it is common for this Care Under Fire / Tactical Field Care phase to be extremely prolonged. Patients typically spend 6 - 48 hours, or more, on position prior to casevac.
Nature of Injuries and Medical Interventions: Patients’ mobility, and their ability to protect their own limbs, may be reduced due to injuries and altered mental status (from medication or trauma). Circulation to limbs may be further impaired due to direct trauma, hypotension, shock, global hypothermia, and bleeding control measures. During early care phases, global hypothermia prevention is much more effective against cold injuries than localized hypothermia prevention. Hypothermia is particularly dangerous in trauma patients, as it combines with coagulopathy and acidosis to form a positive feedback loop (“the Lethal Triad”). Climate control systems may be inadequate or absent in transport vehicles and treatment areas (ideally you should be uncomfortably warm in the room where you treat a trauma patient). Preheat chemical blankets, and turn up the heat in the patient compartment while enroute to the AXP. Minimize opening doors and patient transfer time into the ambulance. Even the best care teams may allow a patient to become hypothermic while focused on performing advanced procedures. Remove clothing and blankets from the patient only long enough to perform essential exams and medical interventions. Consider using multiple blankets to “burrito wrap” the patient.
TREATMENT: Hospital / Prolonged Field Care Phase: The core of frostbite treatment is rapidly rewarming the frostbitten area in warm water (37-40 degrees celsius) This should take 15-30 min if water is kept continuously at 37-40. (TCCC calls for 40-42 degree water; however recent studies have shown this causes additional pain without improving outcomes). The longer the tissue remains frozen, the greater the damage. A general rule of thumb is that if the patient cannot reach a hospital in the next two hours, field rewarming should be undertaken. However, NEVER THAW tissue unless it can be guaranteed that it will not re-freeze. Do not thaw feet if the patient will have to walk on them in the near future; thawed tissue is delicate and susceptible to trauma. Dry heat sources should be avoided; they may burn numb tissue. Avoid the temptation to prematurely end rewarming due to pain; rapid rewarming is more painful but produces better outcomes than slow rewarming. Liberal use of pain medication is highly encouraged during the rewarming process. The patient should move the affected part gently during rewarming. Do not rub affected areas, or apply snow or oil. Leave blisters intact to prevent infection and deep tissue dessication. Preventing infection is paramount. The hospital may use vasodilators, anticlotting meds, NSAIDs, and elevation to encourage reperfusion. Patients should avoid vasoconstrictors such as nicotine, and be monitored for electrolyte abnormalities. Acute, persistent pain will generally subside within the first three days, although intermittent nerve pain may continue for an extended period.
Previous Medical Spotlights
Blood Loss and the Lethal Triad
Ketamine in War, Including Use in TBI Patients
Crush Injury and Compartment Syndrome
Saturday, December 28, 2024
Joke: A Ukrainian Man Goes Before Saint Peter:
Saint Peter asks 'Where were you born?'
The man thinks for a moment and says 'Austria-Hungary, Lemberg.'
'Where did you go to school?'
'Poland, Lwow.'
'Where were you married?'
'The Ukrainian S.S.R., Lviv.'
Surprised, Saint Peter asks 'Where was your first child born?'
'In the German Reich.'
'And where did you die?'
'At home in Lvov, in the Soviet Union.'
Astonished, Saint Peter shouts 'My, you moved around a lot!'
'What are you talking about? I never left the city!'
Thursday, December 26, 2024
Ukraine: Human Rights Watch Report Summary on Torture of Civilians by Russian Military in Izium
Human Rights Watch Investigators visited Izium in the fall of 2022, after the city was liberated by the Ukrainian counter-offensive. Multiple civilian residents describe being detained and tortured by Russian soldiers in the report.
NEWS ARTICLE: Human Rights Watch Report Summary on Torture of Civilians by Russian Military in Izium
Wednesday, December 25, 2024
Downing Drones with Radio Waves
This British Ministry of Defense reports successful testing of its RFDEW. This platform can shoot down drones up to a kilometer away, using radio waves, at the cost of 10 pence per shot.
Monday, December 23, 2024
Ukraine: One of the Longest Armored Movements Behind Enemy Lines in History: The Raid of the 95th Brigade (2014)
During the Donbas War, elements of the Ukrainian Army reportedly made a 170km dash behind enemy lines, in order to resupply a cut-off unit. According to Potomoc Institute for Policy Studies historian, Dr, Philip Karber, this was one of the longest armored raids in history.
Between 19 July and 10 August, units of the Ukrainian 95th Air Assault Brigade, reinforced with elements of the 25th Airborne and 30th and 51st Mechanized Brigades, conducted a 470 km raid, of which 170km was behind Russian and Separatist lines. All those who took part in the operation on the Ukrainian side were volunteers. The raid was successful, allowing for the creation of a safety corridor to evacuate Ukrainian units trapped behind enemy lines at the Russia-Ukraine border. 3,000 troops and over 250 pieces of equipment of the 24th, 72nd Mechanized, and 79th Air Assault Brigades.
This was the first direct clash between Ukrainian and Russian troops of the Donbas War. The soldiers involved have been praised by military experts and historians for the skill and daring that went into the raid.
Watch a youtube video from Battle Order, about the raid:
Sunday, December 22, 2024
Volunteer Group Platsdarm is bringing fallen soldiers home, from both sides of the Ukraine Conflict
Oleksii Yukov's volunteer group, Platsdarm, has been working in Eastern Ukraine since 2014. In this time, it has conducted respectful recovery of the remains of over 2,000 fallen soldiers, and returned them to their families in Ukraine and Russia. This provides crucial closure for families of those who went missing in the conflict. Prior to the Donbas war, Mr Yukov worked with groups that recovered remains of soldiers lost in WWI and WWII.
Link to Voice of America video story on Platsdam:
Ukraine: Christmas Memorial Installation in Kiev
Saturday, December 21, 2024
Ukraine: Christmas Message from Dr. John Quinn
"To All of You and cross posting:
You are doing extraordinary work. Keep it up. We face gaps, challenges, and immense headwinds. It is critical that we keep our focus aligned on one shared mission: to reduce preventable morbidity and mortality among the Ukrainian warfighter, the volunteer warfighter, and all volunteers and medical support elements across the FLOT.
We all know the stakes. If we lose focus, people die. People are injured. Projects stall. Partnerships falter. And ultimately, we may lose. The fragmentation I’m seeing as I depart is a direct result of the enemy’s efforts to divide us. Do not let this happen.
Engage. Partner. Support. Do what you do best, what you know is right, and what is needed—always. If in doubt, ask for forgiveness, not permission.
Despite the challenges—financial, relational, and operational—you must persist. Do not give up. Do not surrender. Do not let the enemy win.
Wishing you all a Merry Christmas (whichever one you celebrate), Happy Hanukkah, and Happy Holidays. Stay strong, stay united, and stay focused.
With respect and gratitude, Slava Ukraine! -Quinn"
-Message from Dr. John Quinn, an American physician who has been going to Ukraine since the start of the Donbas War. He has been instrumental in approval of blood products for prehospital use in Ukraine
Friday, December 20, 2024
Thursday, December 19, 2024
Ukraine: Trench Candles and the Palmer Furnace
Trench warfare and caving... two cold, wet, and dangerous activities, which have both inspired creative ways to stay warm.
Caver and hypothermia expert Jonathan Palmer invented the Palmer Furnace, for use underground. Cavers, especially expedition cavers, often traverse tight, wet passages, in caves which may have an ambient temperature in the 30's or 40's Fahrenheit. This is commonly followed by long periods of inactivity, sitting on cold ground, surveying new passage. This combination can easily result in hypothermia.
Palmer's invention is a simple combination of a large trash bag and a candle. The person sits with the lit candle between their legs, and covers themselves, legs and all, with the trash bag. A small hole should be cut, so that the face is outside the trash bag, and the top of the head is inside. The bag traps air warmed by the candle, creating a cozy microclimate. Beeswax candles work best, burning for a long time at a high temperature.
Photo from How to Make a Trench Candle at Home
And here's a good video on Youtube, showing the trench candle-making process
News Story: Volunteers in Ukraine Make Trench Candles
Monday, December 16, 2024
Saturday, December 14, 2024
Friday, December 13, 2024
Thursday, December 12, 2024
Wednesday, December 11, 2024
Ukraine: Russian Submarine Missile Launch
This video reportedly shows a submarine missile launch, which targeted Ukraine in December 2024.
Tuesday, December 10, 2024
Sunday, December 8, 2024
Ukraine: The Cost in Dollars of Supporting Ukraine vs Letting Russia Win
Elaine McCusker, Senior Fellow at the American Enterprise Institute, provides a cost comparison:
~112 billion: Cost to the US so far, to support Ukraine with weapons and other equipment (most of this money goes to US arms manufacturers
vs
~808 billion: Projected additional US defense spending that will be needed over the next 5 years, if Russia wins the Ukraine war, including:
- $88 billion for 270,000 more US service members
- $31 billion to harden US facilities
- $109 billion to increase US air combat capabilities
- $28 billion for drone development
- $173 billion in air defenses
- $63 billion to enhance munitions production capability
- $50 in shipbuilding
- $185 in additional training and exercises
- $33 billion in spare parts stockpiling
- $10 expanding special operations forces
- $36 billion expanding space and cyber systems
Saturday, December 7, 2024
Ukraine: IAEA vehicle hit by Russian FPV
IAEA Director General Raphael Grossi reported significant damage to the vehicle, and called the strike "unacceptable". There were no injuries.
Thursday, December 5, 2024
Ukraine: Eliminating Enemy Surveillance drones and Shaheds
Wednesday, December 4, 2024
Tuesday, December 3, 2024
Ukraine: Soldier survives 24 days with a tourniquet in place
Monday, December 2, 2024
Sunday, December 1, 2024
"A Testament" - Poem by Borys Humenyuk, MIA
Today we are digging the earth again
This hateful Donetsk earth
This stale, petrified earth
We press ourselves into it
We hide in it
Still alive
We hide behind it
Sit silently in it
Like little children behind their mother’s back
We hear its heart beating
Its weary breath
We are warm and comfortable
Still alive
Tomorrow we will die
Maybe some of us
Maybe all of us
Don’t take us from the earth
Don’t tear us away from our mother
Don’t gather our remains from the field
Don’t try to put us back together again
And — we beg you — don’t erect crosses
Monuments or memorial slabs
We don’t need them
Because it isn’t for us —
You erect these monuments for yourselves.
Don’t engrave our names,
Simply remember:
On this field
In this earth
Ukrainian soldiers lie
And — that is all.
We don’t need funerals
We know where our place is
Simply cover us with earth
And move on
It would be nice if there was a field
Where rye is swaying
A lark flies overhead
And — the sky
The endless sky —
Can you imagine the grain a field
Where warriors are lying will yield?
To remember us, eat the grain from the field
Where we laid down our lives
It would be good if there were meadows there
And many flowers
And a bee under each flower
And lovers who come in the evening
To weave wreaths
To make love till dawn
And during the day, let new parents
Bring their young children
Don’t keep children from coming to us
But this will be tomorrow
Today we are still digging the earth
This cherished Ukrainian earth
This sweet, gentle earth
And with a soldier’s spade we write as one
On its body
The last Ukrainian poem of the last poets
Left alive
- Boris Humenyuk, currently MIA
Click to text excerpt below to link to Luke Harding's full Dec 2023 story in The Guardian: