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Combat casualties surviving at higher rate

By Pfc. Kevin M. Beebe Jr. | | September 24, 2008

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The ratio of casualties dying from combat wounds in the Long War, less than one in ten, is lower than that of recent 20th-century wars, including Operation Desert Storm, according to a recent comparison study.

The Center for Strategic and International Studies has shown 9.7 percent of wounded American service members died in Operation Iraqi Freedom, a contrasting figure to 22 percent in Vietnam and 17 percent in Desert Storm.

Rear Adm. William M. Roberts, medical officer of the Marine Corps, said vast improvements in combat casualty care are to thank for present-day survivability; moreover, Marines and sailors not in the medical field are doing a welcomed share of the lifesaving.

Prevention, training and education, as well as actual battlefield treatment, are saving lives.

In Iraq, Medical treatment has moved closer to the fight and on a grander scale than in the past, staying available within one-hour rings around combat operations. Known as the "golden hour," this time of opportunity is the first 60 minutes after a severe trauma injury. If the wounded can receive swift medical attention in this time, they have the greatest chance of survival.

Marines and field corpsmen alike know and administer "buddy" first aid. "I think (the survival rate) has a lot to do with the quickness in which medical attention is received," said Navy Seaman Greg Norman, a corpsman with 3rd Battalion, 6th Marine Regiment. This immediate, on-site treatment is "the difference maker," said Norman.

Casualties sustained by first aid survive their wounds or injuries 90 percent of the time, according to Roberts.

The en route care is just as critical, Roberts said. Shock-trauma platoons and forward resuscitative surgery systems, which are fast-acting emergency response teams that can administer medicine and surgery, are keeping more casualties alive and seeing them transported to the next level of care.

Designated helicopters that also fly combat missions are evacuating casualties from danger zones. No Marine or naval helicopter fleet is dedicated solely to emergency evacuations, but Roberts insists that does not mean lifesaving is compromised. "I do not know of a single case," said Roberts, about helicopters not being able to retrieve a wounded Marine or sailor.

Shock-trauma platoons, in essence, are rolling emergency rooms consisting of 25 people, including emergency physicians, physician assistants, nurses, corpsmen and Marines. A forward resuscitative surgery system is a mobile unit that deploys as Marine combat-service support and is staffed with two surgeons, a nurse, an anesthesiologist and four corpsmen. Casualties still alive in this care have a 97 percent chance of surviving, Roberts said.

From these small emergency rooms, casualties are transported to hospitals in Iraq cities such as Al Asad, Baghdad or Balad, and on to Landstuhl Regional Medical Center in Germany for advanced surgeries and re-evaluation.

Marines and Navy corpsmen are receiving more training on first aid and casualty care. Marines must pass written and practical first-aid tests in basic training, and corpsmen attend courses after basic corps school to hone their skills.

Field Medical Training Battalion, which makes basically trained corpsmen and prepares sailors for service in the Fleet Marine Force, teaches "care under combat," taught by teachers who have served in Operation Iraqi Freedom.

This eight-week course uses in-depth simulators to help reenact life-like combat situations to help prepare for combat, said Navy Lt. Juan Rosario, training company commanding officer, Field Medical Training Battalion East.

The new teaching techniques are leaving corpsmen with "increased medical skill," he added.

The training battalion also teaches sailors Marine Corps Martial Arts, land navigation and rifle marksmanship.

"It was definitely a good school," said Norman. "You learn a lot from (the veterans') experiences. It's not like learning from a book."

In training such as the Tactical Combat Casualty Care Course and the Navy Trauma Training Course, "corpsmen are learning from trained experts and each other's experiences," Roberts said. The Navy Trauma Training Course is a four-week, "unbelievably rigorous experience" that takes an entire team preparing to deploy and trains them under stressful conditions where they treat injuries similar to those that they will see in combat.

"They are putting everything they've learned to use," said Norman.


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