Joint Logistic Support Force No. 910 Hospital Puts into Practice the Real-World Task of 'The Stage for Grassroots Military Physicians Is at the Front Line'

Editor's Note: Grassroots medical support forces are an important pillar of combat effectiveness generation and an important line of defense in safeguarding the health of officers and soldiers. From routine disease prevention and treatment to accompanying support on the training ground, from emergency treatment of the wounded and sick to the provision of mental health services, military physicians, nurses, and medics each fulfill their respective duties, together weaving a health protection network for military camps. However, in actual work, grassroots military physicians, nurses, and medics frequently face different sources of confusion: How should military physicians find their proper wartime position between busy outpatient clinics and training-ground support? How should grassroots medics serve as effective health sentinels on the training ground? Centering on these questions, we have gone deep to the front line in search of answers and are launching a series of articles. We hope this group of reports will prompt reflection on grassroots medical support (基层卫勤) construction, and we welcome readers to participate in the discussion and contribute wisdom toward improving grassroots medical support capabilities.

The Stage for Grassroots Military Physicians Is at the Front Line

■ Sun Mengxing, Ba Tao; PLA Daily reporter Sun Xingwei

Photo ①: Medical personnel of the hospital urgently transport a batch of "casualties" to a "tent hospital" for treatment. Photo by Ba Tao.

Photo ②: A military physician from the hospital's Department of Rehabilitation Medicine administers physical therapy to grassroots officers and soldiers. Photo by Fu Xinda.

Photo ③: The hospital uses an unmanned aerial vehicle to urgently transfer a "casualty." Photo by Chen Bingui.

Grassroots military physicians are the backbone of medical support (卫勤保障), but does "good service attitude" equal "great contribution to winning"? Does "frequent home-visit rounds" mean "life channels are unobstructed"? Does "high professional skill" represent "effective battlefield rescue"? Joint Logistic Support Force No. 910 Hospital uses these three examination questions as the driving force to explore how grassroots military physicians can better improve their medical support capabilities.

I

On the training ground of an Army brigade, Corporal Xiao Wang said excitedly to Chen Minkui, an orthopedic military physician from the hospital: "Dr. Chen, I've been doing the rehabilitation exercises you taught me, and my lower back injury hasn't recurred!"

Half a year ago, Xiao Wang suffered a mild lumbar vertebral slippage due to high-intensity tactical training, and after treatment it kept recurring. Officers and soldiers with similar experiences were not few in number. Statistical data on the treatment of military patients at the hospital showed that the rate of officers and soldiers seeking treatment for training injuries remained persistently high, exhibiting a cycle of "treatment—recurrence—re-treatment." This prompted deep reflection by the hospital Party committee: serving officers and soldiers cannot remain only at the level of careful diagnosis and treatment; the service threshold must be moved forward, transforming "treating existing illness" into "preventing illness before it occurs," and reducing the incidence of training injuries at the source.

Thus, an initiative to "move the outpatient clinic to the training ground" was launched. The hospital drew on backbone personnel from orthopedics, rehabilitation medicine, and other departments to form a training injury prevention and treatment team, which fanned out in multiple directions deep into the training front line.

At an artillery brigade, the military physicians discovered that many soldiers habitually used their lower backs when boarding vehicles, and that the confined space inside vehicles made lumbar injuries easy to sustain. They conducted on-site instruction, teaching officers and soldiers hand-in-hand how to use leg strength and maintain correct lumbar posture, and designed a set of lumbar protective training exercises tailored to the characteristics of the training.

"Before, I thought training injuries were inevitable. I never imagined that adjusting movements could effectively prevent them," said Xiao Chen, a training backbone, with feeling.

In addition to correcting on the spot the ingrained movements and bad habits that officers and soldiers had developed during training, the training injury prevention and treatment team also worked together with the training backbone personnel of affiliated units to formulate scientific training plans based on the training intensity of different branches and different subjects. For example, when officers and soldiers conduct high-risk subjects such as climbing, diving, and parachuting, the military physicians recommended increasing warm-up time, moderately relaxing midway through, and rationally setting rest intervals, so that officers and soldiers could gradually adapt to the physical discomfort brought on by high-intensity training. For officers and soldiers who had already sustained training injuries, the experts conducted targeted one-on-one functional rehabilitation training, followed up with tracking visits to understand their recovery, and guided subsequent rehabilitation training.

Sergeant Xiao Liu is a top training performer in a special operations brigade, but repeated ankle sprains had affected his training. Rehabilitation medicine physician Luo Guiwen formulated a personalized rehabilitation training plan for him and at the same time recommended that Xiao Liu temporarily suspend participation in high-intensity training. Three months later, Xiao Liu's ankle had fully recovered.

In addition, the training injury prevention and treatment team combined the training tasks borne by officers and soldiers to conduct popular science lectures on training injuries in plain and easy-to-understand language, taking root in the minds of officers and soldiers the concept of scientific training.

Company Commander Sun of the medical company of an Army brigade told the reporter that now, with the military physicians' all-around health escort, the training enthusiasm of officers and soldiers has risen even higher, and the rate of training-related injuries has dropped markedly.

II

"It was thanks to the relay rescue by the local health clinic and the military hospital that the consequences weren't unthinkable!" Recalling the experience of being rescued, Soldier Xiao Shen of an Army brigade still felt a lingering fear. The "relay rescue" he spoke of is the hospital's innovative practice for solving the problem of emergency medical care for officers and soldiers in small, dispersed, and remote units.

The company where Xiao Shen is stationed is more than one hour's drive from the affiliated hospital. One summer two years ago, after training, Xiao Shen suddenly began gasping for breath and fell into a coma. The company medic made a preliminary judgment of sudden cardiac death, immediately called 120 emergency services, performed cardiopulmonary resuscitation, and simultaneously called for help from the affiliated hospital.

After Li Yixin, director of the hospital's Department of Critical Care Medicine, received the call, he organized rescue backbone personnel to rush to the scene while telephoning the "forward medical point" (前置医疗点)—a local township health clinic—to have it make all preparations for emergency treatment. After 70 minutes of uninterrupted rescue by the township health clinic and the hospital, Xiao Shen was finally out of danger.

"Before, we were always worried that officers and soldiers would not receive timely treatment after a sudden acute or critical illness. Now that we have the military-civilian 'relay rescue' mechanism, we feel much more at ease!" said the brigade's medic.

During home-visit rounds, the hospital's experts discovered that although the frequency of rounds was high, it was difficult to cover the emergency treatment needs arising from officers and soldiers' sudden acute conditions; especially for small, dispersed, and remote units, once an officer or soldier suffered an acute or critical illness, the golden treatment window might be missed due to the long distance.

After careful study, the hospital signed agreements with more than 20 local township health clinics near affiliated units, establishing forward medical points for the treatment of officers and soldiers. These township health clinics are closer to small, dispersed, and remote units and can respond to emergency medical needs at the first moment. Moreover, the hospital also regularly organizes experts to conduct critical care and emergency rescue training for the medical personnel of forward medical points, imparting professional skills.

"Becoming a forward medical point, we are also beneficiaries. Over the past few years, under the mentorship of the military hospital, the medical level of our health clinic has improved considerably," said Director Yan of the Shengxin Township Health Clinic in Nan'an City, Fujian Province.

To achieve seamless connection in "relay rescue," the hospital also established a remote guidance system. Once an officer or soldier in a small, dispersed, or remote unit suffers a sudden acute or critical illness, the grassroots medic can contact the forward medical point at the first moment; when the medical personnel of the forward medical point are conducting initial treatment, they can connect in real time with hospital experts through the remote system, with the experts providing remote guidance on the treatment plan. At the same time, the hospital rapidly dispatches emergency rescue experts to the forward medical point to receive the patient, forming a direct-line medical support and treatment chain of "grassroots initial assessment—forward treatment—remote guidance—expert reception," opening up the "last mile" in the treatment of critically ill patients.

III

"The casualty's femoral artery is ruptured—immediately apply hemostasis and bandaging." "Three casualties are trapped—immediately dispatch a forward reception detachment for rescue." … As one order after another was issued, various treatment actions were immediately launched. This is a scene from the hospital's mass-casualty treatment training.

This rapid response capability is the transformation brought about by the military physicians' day-after-day training. The hospital's leadership frankly acknowledged that they had also encountered their "Waterloo."

On one occasion, the hospital organized medical personnel to conduct treatment training and assessment under special conditions. Some departmental experts, faced with treating "casualties" on a "swinging board," hesitated for a long time and dared not act. "This kind of treatment condition tests not only professional skill, but is also a great challenge to psychological quality, physical balance, and judgment," said one department director who did not complete the assessment within the allotted time.

Good professional skill does not equal strong battlefield rescue skill (战救技能). The clinic has a stable environment, complete equipment, and standardized procedures, allowing military physicians to diagnose calmly and treat precisely. The battlefield treatment environment, however, is complex and harsh—especially with scarce diagnostic and treatment equipment and rapidly changing wound conditions—requiring military physicians to make on-the-spot judgments and handle situations quickly.

Thus, a competition to strengthen capabilities by breaking the "clinic mindset" was launched comprehensively throughout the hospital. Military fundamentals arena competitions, mutual-casualty opponent competitions, close-to-actual-combat skill competitions … a series of skills competitions forced medical personnel to temper their physical fitness and improve their skills under extreme conditions.

During one assessment, the "casualty" played by Military Physician Xiao Xue not only concealed part of the injury, but also temporarily exhibited stress syndrome behaviors such as shouting loudly and running around erratically. Faced with the escalating difficulty of the assessment, the receiving military physician You Ruijin accurately assessed the injury through keen observation and properly handled the "casualty's" abnormal behavior. "This kind of training is extremely meaningful—it has improved our capacity for on-the-spot diagnosis and our level of handling," said You Ruijin.

In addition, the hospital vigorously carries out cross-posting training activities of "internal medicine learning surgery, specialist learning general practice" and "one specialty, multiple capabilities; one person, multiple posts," cultivating "general practitioners" who can both treat illness and understand battlefield rescue.

Beyond continuously improving their own battlefield rescue skills, the hospital's physicians also train together and drill together with affiliated units, winning the "pass" to practice medicine on the battlefield amid artillery fire and smoke.

During a joint training exercise last year, a soldier accidentally slid from a height, his thigh pierced by a tree branch, resulting in wound infection and soft tissue injuries across multiple areas of the body. The military physicians of the hospital's medical support detachment rapidly performed debridement, suturing, and anti-infection treatment, successfully carrying out the rescue relying on solid skills despite incomplete equipment.

"Encountering real casualties during actual training genuinely tests our emergency rescue capabilities," said the medical support detachment commander.

Today, the hospital's military physicians are not only proficient in diagnosis and treatment techniques, but are also the vanguard of medical support on the battlefield. Joint Logistic Support Force No. 910 Hospital has put into practice the real-world task of "the stage for grassroots military physicians is at the front line": military medical personnel cannot remain only within the traditional definition of "saving the dying and healing the wounded," but must anchor to the fundamental orientation of "bearing the military's name and serving war" (姓军为战), solidly shoulder the mission responsibility of "protecting health in peacetime, protecting victory in wartime," innovate service and support models through the tempering of blood and fire, and consolidate the medical support line of defense.

Graphic production: Xu Shuo