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<p>The Ministry of Defence takes very seriously its obligation to provide the best
possible medical treatment for Service personnel wounded on operational service. The
quality of care delivered by the Defence Medical Services (DMS) is directly related
to the thoroughness with which we prepare our deployed surgical teams for the sorts
of serious injuries they will encounter.</p><p>This training is delivered through
a range of different courses and exercises, many of which employ complex simulation
models such as programmable mannequins. However, simulators are currently unable to
replace all trauma training. Even the most sophisticated of them are not technologically
advanced enough to respond physiologically to complex surgical procedures. At present,
the only means for our surgical teams to get the necessary training in the control
of real-time internal haemorrhage from combat injury is through live tissue training
(LTT).</p><p>Up to twice a year, members of the DMS attend surgical training exercises
in Denmark, during which live but fully anaesthetised pigs are given bullet and blast
wounds which are then treated in real-time exercises by surgical teams. The animals
are unconscious during the entire exercise, and feel no pain. They are attended at
all times by veterinary staff, who may withdraw them at any time for any reason, and
the animals are humanely put down at the end of the training procedures without recovering
consciousness.</p><p>The DMS have collaborated on a number of research programmes
into simulator technology, and constantly monitors the latest developments, especially
where they might in future offer an alternative means of delivering this specialised
but vital training.</p>
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