'Providing the World's Very Best Medical Care'

By Kiley, Kevin C. | Army, July 2006 | Go to article overview

'Providing the World's Very Best Medical Care'


Kiley, Kevin C., Army


Like many Americans, I was moved while watching the HBO film "Baghdad ER" this spring. The one-hour documentary was a graphic look at the emergency room of the 86th Combat Support Hospital in Baghdad. The warrior ethos and soldier camaraderie resonate throughout the film. It is a testament to the courage and sacrifice of servicemembers wounded in combat and to the extraordinary compassion, skill and determination of the military medical personnel who care for them.

This film confirms what soldiers already know-that Army medical personnel are highly trained and well-equipped, providing the world's very best medical care under arduous conditions. As a result of their expertise and dedication, 90 percent of the U.S. personnul wounded in Iraq and Afghanistan between October 7, 2001, and March 24, 2006, have lived, and 53 percent of these were able to return to duty in three days or less.

Improvements in medical skills and resources have enhanced combat casualty care from point of injury through the rapid medical evacuation system to definitive care in the United States. It is not unusual for severely wounded soldiers to be transported to Landstuhl Regional Medical Center in Germany within a day and to a medical center in the U.S. within 96 hours after injury.

The leading edge of this system is the combat medic. More than 4,000 91W Army medics have deployed with advanced trauma skills and emergency medical technician training, while others have received this training in theater. Consequently, 243 combat medics deployed in support of Operations Iraqi Freedom and Enduring Freedom have received awards for heroism to date.

Training in tactical combat casualty care addresses the patterns of combat injury and how the environment of care on the battlefield differs from civilian experience. Soldiers receiving first-aid training and combat lifesavers learn skills necessary for battlefield resuscitation, while physicians, physician assistants and nurses learn these principles in the tactical combat medical care course. These skills help keep soldiers alive until they can be brought to a medical facility for surgical care.

An advance in individual training is the VIRGIL chest trauma training system, which uses a mannequin and computer-based graphic interface to help medics learn how to insert chest darts and chest tubes. The interactive system provides feedback to the user.

Forward surgical team members receive hands-on trauma training in the busy emergency room of Jackson Memorial Hospital in Miami, FIa. They observe and assist the experienced civilian shift, then take over and operate the facility, polishing both individual and team skills before deploying to the combat theater.

These well-trained warriors also have received new tools to help them save lives. Hemostatic bandages that improve clotting and self-applied tourniquets are helping to stop uncontrolled bleeding, the leading cause of death on the battlefield. The improved first aid kit for soldiers and the warrior aid and litter kit for vehicles contain the newly fielded dressings and tourniquets.

The golden hour container, developed by Walter Reed Army Institute of Research, can transport red blood cells to forward-deployed surgical teams without using batteries, ice or electricity. The container is reusable and maintains the contents at appropriate temperatures for more than 78 hours.

The battlefield medical information system-telemedicine (BMIS-T) is similar to a handheld computer. It can be used to record patient clinical encounters and transmit those records to a central repository. The system can hold servicemembers' medical records, including immunisations, dental and vision records and drug allergies. BMIS-T is also programmed with health-care reference manuals and can provide medical personnel with suggested diagnosis and treatment plans.

The electronic information carrier (HIC) is a wireless data-storage device the size of a clog tag that can store up to four gigabytes of information. …

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