The health assistance of yesterday and today. The means and the figure of the rescuer change

(To Gianluca Celentano)
28/11/18

These were the scenarios that have witnessed our Armed Forces in off-site missions in recent decades imposing a more modern and advanced rescue methodology on defense.

Also in the civil field, the European regulations implemented on the public health service, for example. the DM 553 / 87 and subsequently the DM 487 / 97, have undergone an evolution on the intervention methodology following international guidelines.

If militarily, in addition to the already existing medical officers and marshals, nurses are associated health assistants, from the 2008 the figure of the military rescuer, that is a soldier who adds to his specializations also the operational knowledge for the recovery of the wounded, especially in the critical area, with knowledge superior to the civilian standards of the BLS (Basic Life Support).

For good reason, the litter or ambulance man from the 80s has remained folkloric memories of the military service linked to the memory of the military infirmary and the ambulances parked neatly under the careful supervision of the ward medical officer, often a second lieutenant of lever, but "with very special powers", when it was necessary to mark a visit for a few days of rest in the cot ...

Currently, on the battlefield, the delicate task of health care must be subject to strict and specific NATO protocols and change, compared to the past, not only the preparation, but also the much more complete means of health care.

The Military School of Health and Veterinary at the Cecchignola is the structure dedicated to the training and updating of health personnel but also deals with the preparation of soldiers of other weapons called on mission.

The training cycles can also include the knowledge of the Combat Life Support rather than gods Special Operations Combat Medics.

Hence the importance of providing the personnel with wheeled or tracked tactical vehicles with ambulance equipment, such as LMV Lynx, VTMM Bear or VCC80 Dart private of the armed tower, and precise instructions on behavior before, during and after an attack.

If for missions outside the area the prerogative is the use of tactical vehicles often armored, on Italian roads maybe during events, it may happen to meet the Fiat Duchy, Iveco Daily but also the VM90, downgraded by missions abroad, in an ambulance version; vehicles used in Italy for both military assistance and civil protection tasks.

Alfa Romeo F12 and A12

An icon of this medium, which immediately comes to mind when we remember Military Health, in its characteristic dark green color interrupted by the red cross logo on the sides.

It was in service from the '67 year of its production until the' 80 years and alienated in the barracks until the early '90, and it is curious to remember that F meant van while A in fact, our Alfa Romeo was also produced in a box version, while the van and glass version was set up like a small minibus, even if it was the F900 the deputy mainly used for this purpose.

A pleasant round line with rims of clear Alfista style and a personality that distinguished it from the competition. A little 'muscular and lower on the front where it was housed his aluminum twin-shaft Alfa, the same as the Giulia super 1.3.

Its structure in sheet metal, quite subject to rust, was assembled to the frame keeping the engine longitudinal and front traction, a novelty this for a van.

In fact, the interesting system of referrals within the gearbox and the adoption of front-wheel drive have made school with the evolution of Italian van vehicles, just remember the next Alfa Romeo AR 6, the Fiat Duchy branded Alfa Romeo, with a transverse engine to optimize space but always with traction on the front.

The link between Alfa, the Anonima Lombarda Fabbrica Auto and the Armed Forces has ancient roots that we will perhaps face, remember, just to name a few, the Alfa Romeo "6C 2500 Colonial" of the 1939 rather than the truck 800 RE.

Two engines

Climbed aboard the F12 we are struck by the car's inclination of the Alfa three-spoke steering wheel and the instrumentation with the characteristic binocular shape as well as the arrows and lights controls identical to those of the Alfa Sud; also the starter block is strictly placed on the left side of the steering wheel.

Putting it in motion, however, you do not feel the characteristic feeling transmitted by the sound of the twin-shaft Alfa 4 cylinders, in fact in addition to a different exhaust pipe, the F12 does not have the 78 horses of the Giulia 1.3 but is weakened to only 52 horses with 'adoption of a single-body carburetor that reduces its top speed to only 115 km / h.

Perhaps you will remember that the Giulia 1,3 reached the 155 Km / h and the TI version i 164 km / h, a not inconsiderable milestone in that period that was later replicated with the 1.3 boxer engine Alfa33, with its 172Km / h; in short, it was the one thousand three hundred fastest in the world.

The consumption of the F12 was not its forte even though it was designed to be combined with a petrol engine. Only later was a Perkins Engines aspirated diesel engine - today Caterpillar group, by 1760 cc always with four cylinders and which supplied 50 horses, but if they were to go down the consumption were to rise. The same diesel engine was assembled on the Giulia, but it did not succeed.

Ebro F-100, the Spanish version

The collaboration between Italy and Spain in the automotive field is historic, if we remember the evolution of Seat and Fiat, however Alfa Romeo also granted the license to the Spanish FADISA - Fabricacion de Automoviles Diesel- for the production of F12, renamed and branded Ebro F100. Today, Motor Ibérica SA is majority owned by Nissan, but the Ebro name for models assembled in Spain is still in use.

How was it the F12

Previously, as for the Fiat 500, 600 and 126, it possessed a crossbow between the two wheels and two telescopic shock absorbers, while at the rear only two shock absorbers; the braking system as a modern solution was disc-shaped on the front while drum on the rear. A solution that of the front suspension, which nailed it to the ground, theoretically encouraging more responsiveness to the steering, but at the same time made the structure too stiff especially on the bumpy and after a day's work. Several drivers agree that the F12 swayed a bit too much and was noisy.

It had a mass of about one thousand four hundred kg and the center of gravity moved on the front creating those ideal characteristics to favor the oversteer in corners, especially in the wet or above the pavé, a condition that could trigger pendulums with the rear that could oblige the conductor to quick corrections with steering and accelerator to realign it. His measurements of 4,5 meters however contained the phenomenon especially if you were traveling loads and trimmed.

Only around the 90 kilometers per hour felt the sound of the Alfa and the most suitable gear to match performance and torque was certainly the third, the least tied. Nevertheless his progression was not bad in the urban cycle, even if objectively very limited. The battery was housed on the rear left side and its ambulance compartment communicating with the cabin, was covered in washable vinyl and accompanied by two overlapping sheets one of which retractable. The sanitary facilities were also minimal and, in addition to the additional fuel tank, there were two oxygen tanks and two seats for the operators, which were more conductive and front of the machine.

The Alfa Romeo F12 and F11 were also produced in the tow truck version and also widespread in Germany, but in addition to this appreciable civil spread, it was the public sector that bought several lots.

It is important to note that on the podium among the civil competitors of the AR F12, the Ford was the most outstanding Transit, the Bedford Vauxhall - a real mule - and the Volkswagen T1 Transport - the van Beetle -, all vehicles with rear-wheel drive.

However, its best testers were the workers, that is, the ambulance drivers, both military and civilian, who perhaps today with the overwhelming electronics are looking with nostalgia for the advantages of simplicity in the components.

The military ambulance in memories ...

It was a task that partly took away from the collective military life of company, in fact someone claimed that they were "ambushes" who spent most of their time waiting to move the ambulance or inside the infirmary.

In reality the ambulance drivers were doing all the fields and exercises, where yesterday as today was the presence of health care.

"Visit or report? "

Who knows how many you will remember the day's corporal shortly after the alarm, exclaim the classic ritual phrase "Down from the brande" followed in his second round in the dormitories by the request for "visit or relationship".

If the military routine in all its phases punctuated by the speakers was more or less assimilated willingly, the visit in a certain sense it represented an unknown factor that perhaps aroused some fear during the lever. In fact, as soon as you answered "visit", the corporal wrote down our name and from that moment we passed from the available force to the only one present. Most of the time a few days of rest was assigned to the company with the obvious deprivation of free exit. The ration was brought with a tray in dormitory from the piantoni, while the most "interesting" cases could be spent in the infirmary or in the military hospital the days of hospitalization.

If you answered "relationship" it meant to request an interview with the company commander most of the time to get a few days of license or to request a different assignment. The company commanders, though young, had to have sensitivity and authority, in short it was not really easy to make the lieutenant or the captain company commander.

What are the differences between military and civil ambulance?

A very recurring question, but to answer we go back more than two centuries ...

It was the French doctor Dominique Jean Larrey one of the first in the 1792 to realize the need to have a specialized vehicle for rescue during the Napoleonic war campaigns, but it was above all the English nurse Florence Nightingale who made her understand during the Crimean War of the 1853 concept still today endorsed that: "satisfactory transportation of the sick and wounded is the first requirement to save their lives". The US Army in Vietnam and later in the Middle East also drafted detailed intervention protocols in the critical area.

Ambulances, military or civil, are in principle all the same but to change, in addition to the colors, are the roles to which they are used. Tactical ambulances are understandably the most fully equipped with medical devices such as the ECG or the AED etc, equipment still present on the civil 118 for advanced rescue. Civil diversification is divided into three groups: A, B or C based on the type of equipment / intervention.

Before the nineties the material on board was really minimal even if oxygen tanks were never lacking, while today, among the supplied equipment as well as complete medical and first aid packs, there are torches, fire extinguishers, spinal board, aspirators for the airways and material to stabilize the patient but much more besides a greater competence of the operators.

The military rescuer

The qualification of "Military rescuer" it is introduced in the Armed Forces with the DL 209 /2008 offering a new and necessary figure as a response to attacks and unconventional wars that can make a significant number of civilian and military casualties. The new qualification involves a study superior to basic knowledge, resulting much more detailed and adaptable in tactical contexts, an internship that the military called to the missions must know.

In particular, specific health personnel are given competent health care and equipped also in emergency and pre-hospital medicine. The necessary intervention prerogatives to align with the other armies therefore follow different steps and specific training.

The competence also includes techniques and procedures for positioning and covering during the recovery and transportation of the injured in strongly hostile environments, not only geographically, and the ability to cope with large emergencies and large numbers of victims with specific triage observing the MEDEVAC procedures as well as regulatory knowledge international humanitarian law.

For this reason, the security offered by tactical armor use ambulance, such as the VTMM and the antimina variant Advanced Combat Reconaissance Team (ACRT), they play a fundamental role for our army called out of the area.

Admittedly the White Cross of Milan and their F12

Thanks to the great courtesy and simplicity that distinguish the professionalism of the volunteers of the White Cross of Milan, I had the pleasure to meet Giuseppe Comandulli, vice president and responsible for the means of the rescue and civil protection association that has always chosen to put in first plan the meritocratic and human capacities for service to others. An admirable and non-arriving aspect that is immediately evident from the availability of its volunteers 5000 distributed between Milan and the main neighboring municipalities.

An historic specimen of Alfa Romeo F12 ambulance is kept in the historical park of Croce Bianca in Paullo and various information about the vehicle comes from the Historical Museum of military motorization.

I dedicate the article ...

To all the volunteers, but also to the memory of my grandfather Celestino Mario Giannini (Photo), a medical officer serving in the anti-aircraft artillery of the Royal Army in Catania.

A very simple person, nice and helpful, a Tuscan from Pietrasanta, a good doctor and eccentric inventor who, among other things, taught me to drive ...

(photo: web / Army / Iveco Defense Vehicles / author)