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Study: 25% of war deaths medically preventable - Army News | News from Afghanistan & Iraq - Army Times

03 July 2012

Study: 25% of war deaths medically preventable

Army Times, By Patricia Kime - Staff writer
Thursday Jun 28, 2012 16:04:10 EDT

A new study finds that nearly a quarter of the 4,596 combat deaths in Iraq and Afghanistan between 2001 and 2011 were “potentially survivable,” meaning that under ideal conditions — and with the right equipment or latest medical techniques — the troops may have had a fighting chance.

But the study also notes that 90 percent of the deaths occurred before the injured reached a medical facility: of the 4,090 troops who suffered mortal wounds on the battlefield, 1,391 died instantly and 2,699 succumbed before arriving at a treatment center.

Just 506 service members made it to a field hospital before dying of injuries — an indication that military researchers should work to improve field treatment capability, says trauma surgeon Col. Brian Eastridge with the U.S. Army Institute of Surgical Research.

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+3 # Sadly - This is Old NewsMEDEVACmatters.org 2012-07-03 17:22
There have been three interesting Army reports over the past few years that should have been eye-openers but never caught anyone's attention.

The first report done in 2009 said that as of the time of the research that over 1000 of the deaths of American troops in Afghanistan and Iraq would have been avoided if the Army had implemented Tactical Combat Casualty Care training across the entire force. TC3 was developed for and by the Rangers and Special Forces in the mid-1990's and data showing its statistically superior life-saving results were available in the middle of the last decade. Instead, the Army waited to the end of the decade to begin expanding its implementation to regular troops.

The next DoD/Army report was based on extensive reviews of all the deaths of American troops in Afghanistan. It showed that 51.4% of all those that reached a medical treatment facility alive but subsequently died did so from potentially survivable wounds. So, when you hear about the Army gloating that its survival rate is 92% or 95% keep this in mind. On the other side of the argument, AMEDD doctors and researchers have made some very important breakthroughs in treatment philosophy in the field and operating theater, as well as improved equipment and supplies. Especially in the area of hemorrhages of the torso and upper leg. It finally set aside its conviction dating back to WWII that tourniquets were a bad thing that led to amputations and acknowledged research that showed advanced tourniquets properly applied saved lives and limbs.

Finally, the Army has known at least since the 1990's that survival rates for wounded soldiers was 67% higher if they were evacuated from the battlefied by a National Guard MEDEVAC helicoper and crew than if by a regular Army MEDEVAC helicopter and crew. The reason is largely due to the Army Medical Department's stubborn refusal to train its flight medics beyond the EMT-Basic level of skills. Meanwhile National Guard flight medics are commonly full-time paramedics in their civilian life. Despite literally decades of articles from the Army's own medical officers pleading for regular Army flight medic training to be improved to paramedic level the Army refused to act until February 2012 when it began a 5 year transition of flight medic training to paramedic level skills.

The failure of Army leadership has been appalling in this area. They failed the dedicated flight medics and surgeons who are limited by what the Army makes available to them in terms of training and equipment and supplies, and often quashes personal initiative when individuals seek improved skills using their own time and money. Most of all, Army leaders have failed to act to save American lives when the knowledge and ability was there to do so.
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+2 # RE: Study: 25% of war deaths medically preventable - Army News | News from Afghanistan & Iraq - Army TimesRobin 2012-07-03 17:54
My nephew is a doctor in the air force. He is on his third deployment in Afghanistan now. He volunteered for new program with army to fly on rescue helicopters to wounded troops in the field. He is one of 3 doctors that they are testing this new idea with. All prayers would be greatly appreciated as there will be numerous kinks to be worked out in the system before things will run smoothly.
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# Air Force Doctor Flying with Army?epador 2012-07-04 20:36
If this is accurate, it says way too much that AMEDD has to use USAF docs to help out its mission. USAF flight docs have flown USAF on PEDRO missions for over a decade in A-stan, so that is nothing new.
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+3 # MEDEVACmatters. orgHeywood Jablomi 2012-07-03 20:49
Thank you for your astute comments on AMEDD policy.

There is no question that the Pentagon has implemented policies that save a greater percentage of casualties than ever before in history, but there is no room for the bureaucracy to rest on its laurels.

I utterly agree that AMEDD should not be gloating. As you point out, there are improvements that could have been made decades ago, and which should have been made. My question is, what inept bureaucrat failed to do so?

For once, I would like to read names, and I would like to blame and shame authorities who should have acted and who failed. We have a disgusting tradition in the US government where decision-makers are not held responsible for their bad choices. Why? Those who failed to implement better training standards for Army Combat Medics should be purged, rather than permitted to retire honorably. Where is the honor in failing to do what is best for the force? We are not talking about astrophysics or theoretical genetics. We are talking about nuts and bolts combat medicine, and the training curriculum of conventional forces combat medics has been a disgrace for as long as any of us can remember.

When I first started in the US Army as a young man, it was as a 91B Combat Medic. We were derisively dismissed as "91-band-aids," and for good reason. That is all that we were taught: basic tourniquets, bandages, rudimentary splinting. All that we were trained to do was to preserve an airway and to stop bleeding. I will never forget sitting in classes at the Academy of Health Sciences at Ft. Sam that were taught at a fifth-grade level.

When I arrived at my first duty assignment, a Ranger Battalion, the Battalion surgeon was a farsighted individual who trained us to a much more exacting standard. IV's, venous cut-downs, airways, chest tubes, far more advanced emergency procedures were on the agenda. He was, of course, a former SF Medic. You could tell.

When I later went to the SF Medic course myself, it was an incredible relief. At last, a realistic standard. But that is what it took, in those days, to get a combat medic trained to a useful standard: you had to attend 300F1, OJT, and MedLab. And that curriculum was a smoker, with an incredible attrition rate. And there was no way to produce enough SF Medics just to fill SF slots. We were perennially under strength.

Current special ops medics attend a training pipeline that was spearheaded by my former Ranger Battalion surgeon. His name has probably been forgotten by everyone on active duty. The program should have been named in his honor. But it took more than 30 years for Army combat medicine to get to its current status--and the regular Army is still lagging, and badly.

AMEDD should never brag about its survival rates. There is always, and I mean always, room for improvement.

RLTW and DOL,

Heywood Jablomi
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