Willingness to accept casualties or, inversely, unwillingness amongst a nation’s various influential personalities, may or may not contribute to the success of military operations. This observation at a strategic level can be translated at tactical level as the management of the complete process of taking charge of casualties, requiring considerable resources, in both men and materiel. The time factor is a key element of this process. On the one hand the prognosis for the seriously injured is dependent on rapid mobilisation of the appropriate resources, and on the other the maintenance of combat units’ operational capability depends on the time taken to evacuate casualties from the combat zone. To provide more effective management of an increased quantity of resources in the shortest possible time, and to increase the survival ratio of those wounded in combat, a project called CORTIM (Organisational Concept for the Reception and Transmission of Medical Data) has been set up. The project was launched on the basis of the following assumption: in the contemporary context of digitisation of the battlefield, emphasis should be given to the management of medical data in order to achieve a more effective commitment of medical resources, with the consequent enhancement of the treatment process. After four years of trials, CORTIM came to the conclusion that better information management was not just a technical matter, but one that led to major changes in the entire process of casualty handling. Access to the whole picture allows us to go beyond the simple logistic aspect of the process and create a Theatre Medical Control System (RMT). The RMT has a number of implications, described below.

Current Challenges

The conditions in which our armed forces deploy have evolved rapidly in recent years. Conflict control operations, with a predictably low casualty rate, are now the norm. However, local crises that generate periodical spates of casualties can occur, as was the case in Côte d’Ivoire in 2004. The risk of an influx of casualties liable, temporarily, to swamp the medical chain must therefore be taken into account from the earliest planning stages of an operation. However, the management of these peaks of activity is all the more difficult inasmuch as they occur haphazardly. The risk creates a new constraint on forward field casualty management. It has to be said that operational conditions are no longer exceptional. Hence the need to improve the casualty process, and medico-legal responsibility implies a personalisation of the treatment offered to each individual casualty. In this new environment, the mass treatment system inherited from the Cold War no longer seems appropriate. Aware of the development of information technology in the medical field, where it was already in use, we asked ourselves the following question: ‘In view of these new constraints, how can forward casualty management be enhanced by the use of IT tools?’

Operational Field Casualty Management

Today

For a better understanding of the benefits of CORTIM we will describe two methods currently in use in Western armed forces.