Surgery, health care  

US army surgeons save 9 out of 10 casualties due to advancements in care and technology

20 January 2005

According to a report in the December 9, 2004 issue of the New England Journal of Medicine, 90% of casualties have survived during Operation Iraqi Freedom and Operation Enduring Freedom, up from a 76% casualty survival rate in Vietnam and the Persian Gulf War.

The article, Casualties of War — Military Care for the Wounded from Iraq and Afghanistan, states the dramatic increase in survival is due in part to a significant effort by the US Army Health Care team to overhaul battlefield techniques and implement new surgical teams, as well as advanced technology and new armour.

"The Army Health Care team has made a commitment to aggressive surgical care," says Col. Thomas Knuth, surgical consultant to the Army Medical Department (AMEDD) Center and School, Fort Sam Houston, Texas. "We've used this aggressive mindset to address lessons learned quickly and completely, to get surgical providers trained and ready. Rapid transport in forward surgical teams ensures the best care in the world on the battlefield. Our Soldiers then
receive the best reconstructive and rehabilitation care in the world in the hospital."

According to the report, the average time for transportation from the front line to a US hospital has decreased significantly — from 45 days in Vietnam to four days or less in the Global War on Terrorism. The Army's new forward surgical teams (FSTs), developed after the Persian Gulf War, are the primary source of immediate medical care for soldiers on the battlefield, assessing and treating injured soldiers before they are transported to field hospitals for long-term care.  Each team consists of three general surgeons, one orthopaedic surgeon, two nurse anaesthetists, three nurses, as well as, combat medics and support personnel.

"You have the cream of the crop when you're looking at a forward surgical team," Says Sgt 1st Class Jeffery Pinnell, instructor, AMEDD Center and School, Fort Sam Houston, Texas. "It's definitely the wave of the future. They can provide faster medical treatment than anything else in the world."

In addition to implementing new surgical teams, the Army Health Care team researches the latest improvements in medical technique and technology, ensuring surgeons have all the supplies and support they need to rapidly treat patients and extend the "golden hour" for treatment. In locations such as Fort Sam Houston's Institute for Surgical Research and Washington, DC's Walter Reed Army Medical Center, teams of Army researchers pioneer procedures that will save lives and limbs.

"Medically, things have gotten smaller, more miniscule in recent years —  I can walk around with an ultrasound in my pocket," says US Army Reserve Maj Edgar Chauvin, 936th Forward Surgical Team cardiovascular surgeon and commander.  "The Army has devices, such as the one-tent hospital, that can do just about everything. We have ultrasound and lab capabilities in the field. We have new IVs without poles. Big battles don't exist anymore, so the Army may not need a whole hospital — but we need to fix soldiers and get them back rapidly. And that's what we've accomplished."

See the full article in the New England Journal of Medicine


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