Tüm yazıları Alper Yeşil

The Invisible Wounds of Soldiers

According to U.S. Department of Veterans Affairs, there are nearly 20 million living veterans, approximately 16.5 million of whom are veterans of combat deployments. The debilitating negative effects of combat are not simply battle fatigue, combat-related stress, and visible wounds. Soldiers must often grapple with guiltshame, resentment, and an incapacitating disorientation about the meaning and power of their actions.

Many military personnel question their moral principles, relationship with God, and their sense of self as a relational partner, parent, and community member. Such invisible wounds can last for a lifetime post-deployment. A betrayal of moral principles can be reflective of a moral injury. Moral injuries can result from committing, witnessing, or failing to stop an injustice and happen whenever fundamental moral commitments are challenged.

A moral injury is a type of trauma. Veterans, like all people, may deal with traumatic events in many different ways. Some people engage in self-care through proper diet, exercise, and sleep habits, as well as maintaining close relationships with friends and family members, establishing a strong support network, and working to develop a post-deployment career. All of these activities reflect active, interactive engagement in managing post-deployment life.

Yet not all Veterans may choose healthy ways of dealing with post-deployment stress. Many Veterans turn to substances such as alcohol and drugs, while others engage in compulsive behaviors such as drinking, sex, gambling, internet gaming, and overeating. All of these activities, when taken to the extreme, can take control of a person’s life, resulting in irreparable damage to the Veteran’s relationships, career, emotional health, and overall sense of self.

For the Veteran, compulsive behaviors may serve as a source of avoidance, as the compulsive behavior provides a way to temporarily numb the emotions associated with memories associated with deployment, and provides a distraction to directly managing the stress of returning to civilian life. Yet avoidance can also be conveyed through carefully choosing what to say to others about combat life. Many Veterans say that they do not tell friends and family members about the more traumatic sides of combat including witnessing death, crumbling loneliness, and questions about who one is as a person during combat and while at home.

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So how should soldiers deal with moral injuries? Anyone experiencing a moral injury should embrace the experience as one for personal growth. This is not easy—in our society we want to be seen as strong and independent by other people. And for soldiers, adhering to the code of commitment and honor may make it difficult to reveal an invisible scar to others.

But reaching out to a trusted person who will not judge one’s experiences can help a person move beyond a moral injury. For some Veterans this can be a spouse or close friend. For other Veterans, finding a community of people with similar combat experiences through a local VFW, DAV or other local groups has been more effective. The important thing to remember is that not everyone manages a moral injury the same way, but the key is to think about the best strategies to stop avoiding and start talking about the military experience.

Jennifer A. Samp Ph.D.,Conflict Matters

LANDMINES

Landmines…
There are estimated 110million in the ground now.
It costs about $3 -$30 and removing cost is $300-$1000.
More than 5000 people die from mines every year.And 45% of it are children.
Top 3 landmined area in the world
Egypt(23million)
Angola(10-15million)
Iran(16million)
Yearly 100000 mines are removed,but 2000000 are planted somewhere every year.
Landmine explodes quicker than you saw on a holywood film!

Alper Yesil

Tactical Europe

NARCO-WORLD

2019 World Health Organisation(WHO)
Narkotic Reports say apx. 35 million people suffers from drug use disorders and require treatment.
In 2017,11 million people injected drugs.So 1.4 million with HIV,5.6 million with Hepatitis and the rest needs deep attention.
In 2017,in USA 47000 people died by overdose opioid.
Yearly opioid production is apx. 500 tonnes.
In 2017 only 125 tonnes are captured.
Afganistan is the largest opioids producer(93%)
And Iran is the most drug-addicted country in the world.(apx.2000000 people)

Alper Yesil

Tactical Europe

Is Shell Shock the Same as PTSD?(In English)

Shell shock is a term originally coined in 1915 by Charles Myers to describe soldiers who were involuntarily shivering, crying, fearful, and had constant intrusions of memory. It is not a term used in psychiatric practice today but remains in everyday use.

In a previous post, a question was asked of me by a young veteran of the Iraq War about the difference between post-traumatic stress and shell shock. He wrote:

“… I experienced an abrupt, highly jarring event during my first tour of combat in Iraq that caused me thereafter, for a couple of years, to react bracingly to the sound of low-flying aircraft. This reaction, to me, was ‘shell shock.’

During my second tour, I was exposed to prolonged combat, a constant sense of hopelessness, and an environment characterized by above-average friendly casualties. Although I failed to admit to its occurrence initially, my reaction upon return from this tour was (and, perhaps, continues to be) something I consider more akin to post-traumatic stress. For a few years, for example, I dove fairly heavily into alcohol consumption. Methods less detrimental to my health, such as writing and reading, have replaced alcohol presently. However, the cause for all of these activities is the samea desire for mental escape, which I relate to a prolonged state of reaction to my probable post-traumatic stress.”

Is shell shock the same as PTSD? This is an intriguing question; one that I’ve been scratching my head over for the last couple of weeks.

The answer I’ve come up with is that PTSD and shell shock are the same. And they are different.

They are the same because shell shock was an intellectual forerunner to PTSD. PTSD was influenced by the experiences of psychiatrists working with veterans returning from Vietnam. As such, the two ideas set out to do pretty much the same thing.

The difference, however, is that shell shock was specific to the experiences of combat whereas the concept of PTSD has developed to be more wide-ranging. DSM-IV lists 17 symptoms. But not all of the symptoms have to be present for a diagnosis to be made. At least one of the five re-experiencing symptoms (B1-B5), at least three of the seven avoidance symptoms (C1-C7) and at least two of the five arousal symptoms (D1-D5), have to be present for the diagnosis to be made.

The implication is that two cases of PTSD may be different in how they present. For example, to fulfill the criteria for re-experiencing and arousal one person may present with physiological reactivity (B5), hypervigilance (D4) and an exaggerated startle response (D5) whereas another person may present with intrusive and distressing recollections (B1), difficulty sleeping (D1) and concentrating (D3).

Both would receive the same diagnosis of PTSD. But the first description seems much more resonant with the idea of shell shock and fear conditioning whereas the second seems to be more of a depressive reaction. These two forms of PTSD would indeed seem to be, psychologically, very different experiences.

The question may have been about shell shock but what it also illustrates is that the diagnostic criteria for PTSD pull together a range of human experience under one umbrella, which is just too big.

Stephen Joseph Ph.D.University of Nottingham

 

 

SAVUNMA ONLEMLERI 1

Muharebe alanında en iyi ilaç ateş üstünlüğüdür. Muharebe görevinde

hızla üstünlüğe sahip olmak, diğer personelin yaralanma riskini ve yaralılara

ek olarak diğer yaralanmaları önlemenin en iyi yoludur. Taktik ilkyardım

personeli kendisini ve yanındaki yaralıları savunmak için küçük silah

taşırlar. Taktik ilk yardım personelinin ek ateş gücü, ateş üstünlüğünü elde

etmek için gerekebilir. Başlangıç olarak taktik ilk yardım personeli yaralının

tedavisini gerçekleştirecektir, fakat birim üyeleri ateş desteğine ihtiyaç

duyabilir. Ayrıca hayatı tehdit etmeyecek şekilde yaralananlar, mücadeleye

katılması mümkün olanlarla birlikte ateş desteğine katkı sağlamalıdır.

Taktik ilkyardım personeli yaralıya yönlendirildiğinde temel amacı yaralının

ek yaralanmalara maruz kalmasını önlemektir. Yaralı askerler mümkün

olduğunca siper arkasında hareketsiz ve yere düz bir şekilde olmalıdır.Eğer

yaralandığı yerde siper olarak kullanılacak materyal veya yer bulunmuyorsa

mümkün olduğunca çabuk bir şekilde güvenli bölgeye taşıyın.

Alper Yesil

BAŞ YARALANMALARI

Muharebe alanında, travmaya bağlı baş yaralanmalarının %70 ı şarapnel veya basınç savrulması ile oluşur. Buna bağlı olarak başta yüzeysel yaralar , kırıklar, beyin sarsıntıları ve/ya kanamaları meydana gelebilir.

  1. Baş yaralanmalarının belirtileri
  • Başta şişlik, yara , kanama
  • Çöken kırık
  • Baş ağrısı, baş dönmesi
  • Göz çevresinde morluk
  • Göz bebeklerinde büyüklük farkı ( biri küçük diğeri büyük )
  • Kızarmış yüz
  • Deriden hissedilen nabız
  • Bulantı – Kusma
  • Hırıltılı soğuk alma
  • Tam veya yarı felç
  • Geçici hafıza kaybı
  • Bilinç kaybı, Koma
  • Beyin kanaması var ise kulak ve burundan önce sarımsı bir sıvı (BOS)Sonra kan gelmesi

DrMercan

KARIN YARALANMALARI

Patlama/savrulma, vurma çarpma ve basınç altında kalmaya bağlı olarak açık ve kapalı karın yaralanmaları meydana gelir. iç organların dışarı çıkması veya organların patlaması ile sonuçlanabilir,

1.Karın Yaralanmalarının Belirtileri (iç kanama/internal bleeding)

Kapalı karın yaralanmasında

Karında kızarıklık morarma

– Karında setlik

– Şok

– Kusma bulantı

– Karında kramplar

– Susuzluk hissi

Açık karın yaralanmasında

Gözle görülen yara

– İç organların görünmesi veya dışarı çıkması

– Kusma bulantı

– Yaygın ağrı

 

Taktik Hemsire

GOGUS YARALANMALARI

Askeri yaralanmalarda, göğüs, kalp ❤️ yaralanmaları yüksek enerjili mühimmatların kullanılması nedeniyle yüksek mortaliteye sahiptir. Az aşağıda askeri yaralanmalarda bağlı göğüs-kalp damar yaralanmalarında nasıl müdahale edeceğimizi tıp dili(!) kullanmadan aktardım.

Göğüste Açık ve kapalı yara meydana gelebilir. Göğüs bölgesinde yüzeysel yaralar olabileceği gibi kaburga kırıkları sonucu kaburganın göğsü delip dışarı çıkması veya akciğere batması , sıkışma nedeniyle akciğer dokusunda harabiyet görülebilir.
a. Gögüs Yaralanmalarının Belirtileri
• Yara
• Solunum güçlüğü morarma
• ağzından açık kırmızı, köpüklü öksürükle kan gelmesi
• Kaburga kırığı,batma hissi
• Ağrı
• Şok belirtileri
b. Gögüs Yaralanmalarında İlk yardım
• Göğüste delici yara var ise bu delikten hava girmesi temiz bez üzerine naylon koyarak veya ıslak bezle elin ayası ile engellenir
• Batan cisim çıkarılmaz
• Kapalı göğüz yarası ise soğuk uygulanır
• Kaburga kırığı sabitlenir • Yarı oturur veya oturur pozisyonda sevk edilir.

Tactical Hospital