Earliest care key to cut combat deaths
About one of every four U.S. servicemembers killed in combat in Iraq or Afghanistan in the past decade -- about 1,000 people -- might have survived with more advanced combat medicine on the battlefield, according to an Army study.
In 90% of those cases servicemembers bled to death, something medics and corpsmen with the right tools and training might prevent, Army Col. Brian Eastridge said in presenting study results last week to a Pentagon advisory panel here.
"It's a tremendous amount of people we're losing before they even reach medical care," Eastridge, a trauma surgeon, told the Defense Health Board meeting at Fort Detrick.
New ways of saving these lives include delivering blood products to casualties soon after they are wounded, drugs that control blood loss and devices that clamp off major severed arteries, retired Navy captain Frank Butler, a second trauma expert, told the panel.
U.S. troops have a 90% chance of surviving wounds, higher now than in any previous American war. But Eastridge, Butler and other military trauma specialists said the success rate could be even higher with better tools.
"We have made advancements," Eastridge said. "We have made improvements. But we need to see if there is anything we can do to even further improve combat casualty care."
The analysis by the U.S. Army Institute of Surgical Research and the Armed Forces Medical Examiner Services analyzed records on every American combat death from Sept. 11, 2001, through last year -- 4,596 cases. Deaths because of illnesses were excluded.
Of the 4,090 troops who died of injuries before reaching a medical facility, 1,391 died instantly, most from exposure to a blast, the study found. Nearly 2,700 victims survived for a time but died before reaching a field hospital. Of those, 1,075 were "potentially survivable," according to the analysis.
That number included more than 300 deaths where the servicemember would have had a 70% chance or better of survival if he or she had reached a doctor.
Eastridge said the analysis did not take into consideration extenuating circumstances such as the difficulty of evacuating a casualty during a firefight or the distance and weather that might impede helicopter delivery to a treatment center.
Among hundreds of cases where a servicemember bled to death, the vast majority involved hemorrhaging from wounds in areas of the body where standard battlefield blood-loss control devices, such as a tourniquet, are ineffective.
In 675 of those combat deaths where survival might have been possible with more sophisticated care, troops bled to death from wounds to the trunk of the body.
New ways for combat medics or Navy corpsmen to restore lost blood, induce clotting or stem massive bleeding are needed, Eastridge said.
The key, he explained, is keeping the servicemember alive from the moment he or she is wounded until the casualty arrives at a field hospital, where chances of recovery improve dramatically.
"That's why we did this study," Eastridge said. "It's really about developing a (research and development) strategy so that we can address these problems for the end of this war and the war of the future."
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