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En markør får behandling i innsatsstyrke Rypes sanitetstelt under en sanitetsøvelse med Luftforsvarets baseforsvarstaktiske skole og NAMS

Command team FSANs liste

Dette er en side med artikler, podkast-episoder, videoer og bøker som sjef og sjefssersjant for Forsvarets sanitet anbefaler for faglig oppdatering. Frem over vil utgavene være tema-basert.

Tema for mai er sanitetssystemer, og i anledning av at det er 80 år siden frigjøringen har vi med en ny bok i listen. Neste måned vil temaet være tidligere konflikter, med spesielt fokus på andre verdenskrig.

Sjefen og sjefssersjanten vil gjerne ha tips til nye ting som bør deles. Dette kan sendes fsan.info@mil.no. Tipsene gjennomgås av en redaksjonskomité ledet av Command teamet og siden oppdateres hver måned.

FSAN understreker at denne siden kun er ment for kompetanseheving. Den representerer ikke føringer, råd og anbefalinger for sanitetsvirksomheten i Forsvaret.

Toppbilde for mai: En markør får behandling i HV-12s innsatsstyrke Rypes sanitetstelt under en sanitetsøvelse med Luftforsvarets baseforsvarstaktiske skole og NAMS. 📷Kristian Kapelrud / Forsvaret

Lettlest
📰Artikkel: Inside Ukraine’s medical corps where NATO standards face drone war reality check
  • Euromaidan press
  • Behind Ukraine’s front lines, a 500-strong volunteer medical force discovers what happens when their ambulances become top targets for cutting-edge war tech, forcing them to create rules Western armies rush to adopt.
📰Artikkel: Operativ Resilienstrening (ORT) – Utdanning i Forsvaret for et mer robust forsvar
  • Forsvarets sanitet
  • Norge et av de første landene som har utviklet et kurs som er både praktisk og konkret i å hjelpe soldater å håndtere stress og psykisk påkjenning. Erfaringene er blant annet hentet fra Ukraina.
📰Artikkel: To Conserve Fighting Strength in Large-Scale Combat Operations
  • Lt. Gen. Mary Krueger Izaguirre, et.al.
  • Military Review
  • As the U.S. Army considers near-peer threats associated with multidomain operations (MDO) and large-scale combat operations (LSCO), it must assess medical implications on overall combat effectiveness and mission success. Estimates for LSCO suggest casualty rates the likes not seen since World War II, requiring the joint force and the Military Health System to reimagine triage, combat casualty care, medical evacuation, force health protection (FHP), and prolonged casualty care to minimize the risk to force.

Dybde sanitet
📰Artikkel: The SHADER model: forward surgical teams managing high-intensity, low-frequency military surgery incidents
  • David N. Naumann, et.al.
  • BMJ Military Health 
  • Ikke fri tilgang.
📰Artikkel: A Narrative Review of Military Reverse Triage
  • Daniel J. Hurst
  • Military Medicine
  • Military reverse triage has been described at several points in the literature. However, an extensive review of the concept and any gaps that may exist has not been conducted. This narrative review seeks to understand how reverse triage is used in the military literature and how it might be implemented in practice, as well as the documented historical applications of reverse triage.
📰Artikkel: A qualitative assessment of disease and non-battle injuries in Ukraine since the Russian invasion
  • Amandari Kanagaratnam, et.al.
  • Conflict and Health
  • Disease and non-battle injuries (DNBI) often account for more military casualties than those from combat wounds. The February 2022 Russian invasion of Ukraine has severely limited access to care in areas with increasing patient care needs beyond combat injuries. The expansion of the draft resulted in an older military population susceptible to musculoskeletal injuries, while trench warfare and harsh winters create conditions conducive to cold weather injuries and infectious diseases. This study aims to assess the prevalence and scope of DNBI in Ukraine. Methods 
📰Artikkel: Assessing Intent: Repetitive Strikes on Ukrainian Health Care Facilities
  • Dennis G. Barten, et.al.
  • Prehospital and Disaster Medicine
  • Attacks on health care – which are potential war crimes – are increasingly observed in contemporary armed conflicts. The full-scale Russian invasion of Ukraine is no exception to this worrisome trend. War crime prosecutions of suspected deliberate attacks on health care facilities require proof that they were the intended target, which is extremely challenging. If health care facilities are attacked more than once, this may increase the likelihood of intent. The Ukrainian Healthcare Center (UHC) began documenting attacks on health infrastructure since the start of the full-scale Russian invasion of Ukraine. In this study, the aim was to assess repetitive attacks on Ukrainian health care facilities from February 24, 2022 through October 24, 2023.

 

 

Militærfaglig generelt

📰Artikkel: Tactical Developments During the Third Year of the Russo–Ukrainian War

  • Dr Jack Watling and Nick Reynolds
  • RUSI
  • This paper outlines tactical developments by Russian and Ukrainian forces during 2024 and highlights areas where military–technical assistance to Ukraine can be improved.

Nettsider

Stratagem

Uptodate (gratis for Forsvaret) Oppslagsverk. Anbefaler å laste ned appen.

Podkaster

WarDocs

Ukrainapodden (Nettavisen)

Ukraina the latest (The Telegraph)

Det store bilde (Eirik Bergersen og Sofie Høgestøl)

Krigens krav (Heimevernssamfunnet)

Forsvarspodden (Forsvaret)

FRAMSnakk (Helse Midt RHF)

April 2025

LETTHØRT/LETTLEST/LETTSETT

📹Video: Arktis - Iskald frontlinje

- NRK TV

- Gir en god overordnet situasjonsforståelse for situasjonen i nord-områdene.

 

📹Video: Frokostmøte om samarbeid
mellom Forsvaret og helsetjenesten i kriser og krig

- Den Norske Legeforening
- På siden er det både kort intervju med innledere
til møte og link til Facebook opptak fra hele møte.​​​​​​​

 

📹Video: Underground Role 2E (LinkedIn)

- Roman Kuziv, Commander, MFSG East, Armed Forces of Ukraine

- Underground Role 2E 10-12 km from the contact line time

of evacuation (25 minutes - 6 hours). One of our most effective

evacuation schemes POI - CCP/XP - Role2E - Role4.  

The work is prioritized for the seriously wounded, if necessary,

such specific specialists as: thoracic, vascular or neurosurgeons

are involved.

 

🎙️Podkast: Medevac

- Spotify - Apple

- WHO: Health in Europe

- Crisis and conflict dominate the headlines. The ongoing war in Ukraine and the conflict between Israel and the occupied Palestinian territory have brought death, destruction and displacement. But among the major disasters and conflicts. It's important to look for the stories of the people who are helping. As we mark over 5,000 medical evacuations from Ukraine, in this episode of Health in Europe, we'll share stories about some of the sick and injured people who have been transported away from war zones and other emergencies, and of their welcome, medical treatment, recovery and eventual repatriation. We'll also explore the Region's Emergency Medical Teams to learn about people who, with sometimes only hours notice, drop everything to travel to emergency zones. Who are they and what motivates them?

 

📰Artikkel: Fighting the war in Ukraine on the electromagnetic spectrum

- The Economist

- Drone operators and jammers are in a high-tech arms race

 

 

​​​​​​​DYBDE PÅ SANITET GENERELT

📰Artikkel: The “Survival Chain” Medical Support to Military
Operations on the Future Battlefield

- JFQ

- Col. Gurney, et.al.

 

📰Artikkel: Guerilla Casualty Care Nodes and Web Networks on
the Future Battlefield

- Military Review

- Col. Brown, et.al.

- Health service support for the combat wounded must adapt to changing conditions on the battlefield. While the last twenty years of combat have focused on counterinsurgency operations, future conflicts will likely feature large-scale combat operations (LSCO), with concurrent guerilla and irregular warfare shaping and kinetic operations. The National Security Strategyoutlines that the world is reaching an “inflection point” in which major powers will compete to shape the international order. Underpinning this new era of global campaigning is the continuing threat of conflict with peer and near-peer adversaries.

 

📰Artikkel: Refocusing the Military Health System to support Role 4
definitive care in future large-scale combat operations

- The Journal of trauma ans Acute CARE Surgery

- Remondelli, et.al.

- The last 20 years of sustained combat operations during the Global War on Terror generated significant advancements in combat casualty care. Improvements in point-of-injury care, en route care, and forward surgical care appropriately aligned with the survival, evacuation, and return to duty needs of the small-scale unconventional conflict. However, casualty numbers in large-scale combat operations have brought into focus the critical need for modernized casualty receiving and convalescence: Role 4 definitive care.

 

📰Three years of war: rising demand for mental health support, trauma care and rehabilitation

- WHO

- Three years of war: rising demand for mental health support, trauma care and rehabilitation

 

 

MILITÆRPSYKOLOGI
🎙️Podkast: Intervju med militærpsykolog Andreas Nordstrand
og tidligere KJK-offiser Ronny Kristoffersen

- NRK Kompass

- I 2007 var Ronny soldat i Afghanistan og drap eit anna menneske i ei dramatisk skotveksling. KVA har hendinga gjort med han?

 

🎙️Podkast: Er det skadelig å ta liv? Ikke nødvendigvis, forteller Andreas Espetvedt Nordstrand som er orlogskaptein og militærspsykolog i Forsvarets sanitet.

- BFO Befaler - Nettside og Spotify

- Bred oppsummering av militærpsykologi/-psykiatri

 

📰Artikkel: Soldater kan takle å ta liv

- Gemini

- Forskere undersøkte psyken til alle veteraner fra Libanon og Afghanistan. Én faktor avgjør om de sliter etter å ha tatt liv.

Mars 2025

LETTHØRT/LETTLEST/LETTSETT

Video: Can you hear me? The Invisible Battles og Ukrainian
Military Medics

Podkast: Transforming NATO for the Future Fight
Podkast: Hvordan takle stress?
  • Nordstrand fra Forsvarets sanitet og Mental helse svarer på dette i denne episoden fra NRK Ekko.
Artikkel: Modern Warfare Is Breeding Deadly Superbugs. Why?
  • NY times
  • Researchers are trying to understand why resistant pathogens are so prevalent in the war-torn nations of the Middle East.​​​​​​​​​​​​​​
DYBDE PÅ SANITET GENERELT
Artikkel: War and disaster are forcing a major rethink around mass casualty
management (ikke åpen tilgang)
  • Horne et.al 2024, BMJ Military Health
  • Mass casualty events (MASCAL) do not follow the same rules as typical major incidents. In the West at least, the latter often occur in stable, networked trauma systems, whereas MASCAL are characterised by overwhelming numbers of patients, compounded by protracted scene and transport times, decompensated response systems and significant disruption to infrastructure, command and control.
Artikkel: Medical Changes Needed for Large-Scale Combat Operations 
- Observations from Mission Command Training Program Warfighter Exercises
  • Fandre 2020, Military Review
  • Successful treatment of combat casualties, for the most part, has become an expectation throughout the past eighteen years of combat operations. The U.S. military has the highest level of survival for preventable death in history, with a 92 percent survivability of battlefield injuries.1 The lessons learned in the treatment of these casualties have not been lost; however, when looking through the lens of large-scale combat operations (LSCO), many of these underlying assumptions and expectations cannot be taken for granted by commanders, soldiers, and the American public.
Rapport: Tactical Developments During the Third Year 
of the Russo–Ukrainian War
  • The Royal United Institute (RUSI) 2025
Artikkel: What is the medical requirement for a quick
release system in a body armour vest?
  • Breeze et.al. 2024, BMJ Military Health
SKADEFOREBYGGING

Artikkel: Infantry training outcomes: are they improved
with an initial reduction in load carriage mass and 
additional sprint intensity exercise?
  • Groeller et.al. 2025, BMJ Military Health
  • Infantry is a physically demanding trade that is associated with elevated rates of musculoskeletal injury. A 17-week longitudinal intervention assessed the effect of a progressive increase in load carriage mass and sprint-intensity intervals on physical performance, physical complaints, medical encounters, physical activity and sleep in infantry trainees.
Artikkel: Qualitative assessment of combat-related 
injury patterns and injury prevention in Ukraine since 
the Russian invasion
  • Lawry et.al 2025, BMJ Military Health
  • The ongoing invasion of Ukraine by the Russian Federation represents one of the largest ongoing conventional military engagements in the last 20 years. Since the start of the war, an estimated 210 000 Ukrainian soldiers have been injured or killed as a result of combat. This experience could help prognosticate the nature of large-scale combat operations for modern militaries. The aim of this study was to assess current patterns of injuries among military combatants in Ukraine and identify prevention and mitigation methods.
MILTÆRPSYKOLOGI
Artikkel: A novel intervention for acute stress reaction:
exploring the feasibility of ReSTART among Norwegian soldiers
  • Nordstrand et.al. 2024, Eur J Psychotraumatol
  • ReSTART training shows potential as an effective tool when preparing soldiers to manage ASRs in high-risk environments, enhancing military units' capacity to support each other and effectively respond to stress-induced functional disruptions. This study adds evidence supporting the utility of peer-based ASR management in operational settings and highlights the need for broader implementation and systematic evaluation.
​​​​​​​Artikkel: Positive-expectancy factors on long-term posttraumatic
​​​​​​​stress disorder symptoms: A prospective 2-year follow-up investigation among military veterans.

Februar 2025

Tidsskrift-utgave med flere artikler: Svensk kirurgi - Tema: Krigskirurgi
Artikkel: ‘Golden day’ is a myth: rethinking medical timelines and risk in large scale combat operations
  • Joshua Dilday et.al — BMJ Military Health

  • The evolving landscape of battlefield medicine forces medical planners to prepare for large-scale combat operations (LSCO) against peer adversaries, requiring reassessment of recent medical strategies.

Artikkel: Expanding the Toolkit for Medics in Combat: 
Operational Resilience Training
  • Andreas E. Nordstrand et.al - Wehrmedizinische Monatsschrift
Artikkel: Beredskapskritiske medikamenter kan benyttes
etter utløpsdato
  • Stig Opdøhl — Tidsskrift for den norske legeforening

  • Et system for testing og oppbevaring av utgåtte medikamenter kan styrke legemiddelberedskapen i fredstid, krise og krig.

Artikkel: Characteristics of Medical Evacuation by
Train in Ukraine, 2022
  • Stig Walravens, MD; Albina Zharkova, MD, PhD; Anja De Weggheleire, MD, MPH; et al — JAMA

  • How can medical evacuation trains be implemented in a war zone and what type of patients can be expected?

Artikkel: Minimum Requirements for the Interoperability
of Special Operations Surgical Teams:
An Assessment Based on Current National Standards and
NATO Doctrines
  • KLEMMER, FRANK; KYLE, STIGALL; MICHAEL, HETZLER; SAMUEL A., ROCKER; GRIET, VERMEULEN; — Military-medicine.com

  • The shared insights among nations and syndicates regarding Selection and Training, SOST Platforms and Configurations, DCR and DCS capabilities, and SOST Evaluation Methods indicate that foundational data for establishing minimum NATO requirements is available. The data shows a wide variance in SOF medical capabilities across multiple NATO countries supporting the need for formalized NATO doctrine focused on a standardized approach to medical interoperability. 

Stortingsmelding: Meld. St. 9 (2024–2025) Totalberedskapsmeldingen — Forberedt på kriser og krig
  • Regjeringen

Januar 2025

Artikkel - Military Medicine (jan/feb 24): Prehospital Lessons From the War in Ukraine: Damage Control Resuscitation and Surgery Experiences From Point of Injury to Role 2

  • «The ongoing war in Ukraine presents unique challenges to prehospital medical care for wounded combatants and civilians. The purpose of this article is to identify, describe, and address gaps in prehospital care, casualty evacuation, and medical evacuation throughout Ukraine to share lessons for other providers.»

Artikkel BMJ Military Health: Removal of tourniquets: the next step in saving lives and limbs

  • «Data from the current conflict, provided to us by the Ukrainian Ministry of Defence, suggest that up to 60% of tourniquets were left in situ for more than 2 hours. 70–80% of tourniquets applied could have been converted to pressure»

Artikkel BMJ Military Health: Transferable military medical lessons from the Russo-Ukraine war

  • «The first year of the war in Ukraine has presented critical lessons for the UK’s Defence Medical Services (DMS) regarding its preparedness to support the nation for warfighting at scale. There are tactical, clinical, and strategic challenges that must be addressed.»

Artikkel - Business Innsider: Top US generals warned the 'golden hour' for saving injured soldiers could disappear. That future has come.

  • «The US military has warned that lifesaving "golden hour" care may not exist in future wars.
  • The experiences of Ukrainian soldiers reflect those warnings.
  • Getting treatment can take hours, if not days, leading to lasting injuries, amputations, and deaths.»

Artikkel - The Conversation: Which infectius disease is likely to be the biggest emerging problem in 2025?

  • «This work all falls under the umbrella of “one health”: looking at human, animal and environmental health as interconnected entities, all with equal importance and effect on each other.«»

Artikkel - The Economist: Hell, horror and heroism in Ukraine’s battlefield hospitals

  • «The gruesome lessons its doctors are learning reveal the nature of war in the 21st century»

Artikkel - Assessment: Development and Validation of a Brief Warzone Stressor Exposure Index

  • «Existing scales mainly focus on danger-based threats of death and bodily harm to assess exposure to traumatic events in war zone. However, major provocations and transgression of deeply held values and moral beliefs, as well as witnessing the suffering of others can be as traumatic as fear-inducing danger-based events. This raises the need for scales that assess both danger and nondanger-based events among soldiers operating in modern war zones.»

Magasin - The Medical Journal: Fall 2024

Podkast - Prehospital FRAm-SNAKK: Sanitetssoldat i Ukraina - Kan vi lære noe? Spotify - Podtail

  • «Krigen i Ukraina har rast i over tusen dager. Hundretusener, sivile og militære, er drept og såret. Vi snakker med nordmannen "Eskil", som har sanitetsbakgrunn og har vært ved fronten som soldat på ukrainsk side i syv måneder. Hva kan det prehospitale Norge lære av hans erfaringer? Bli med og få et lærerikt innblikk i en mørk verden de fleste av oss vet lite om.»

Video - Facebook: President Zelensky besøker underjordisk feltsykehus