Improving combat survival rates

  • Published
  • By Lt. Gen. (Dr.) Charles B. Green
  • Surgeon General, Headquarters U.S. Air Force
(Commentary appeared in today's Milwaukee Journal-Sentinel)

Like many people, I could never forget Sept. 11, 2001. Likewise, I could not foresee the changes that would occur in combat medicine. As the nation rallied in support of the victims, so did the men and women of the Air Force Medical Service. Our engagement since that day and the lessons learned have resulted in the highest combat casualty survival rate in history.

But that was the furthest thing from my mind on that day.

I'd become a one-star general five weeks earlier. As part of my new job as command surgeon for the Air Mobility Command at Scott Air Force Base, Ill., I was on a routine visit to McChord Air Force Base, Wash.

My boss, then-AMC commander Gen. Charles T. "Tony" Robertson Jr., ordered us to set up Expeditionary Medical Support at McGuire AFB, N.J., roughly 60 miles southwest of New York City. EMEDS, as we call them, are tent-based rapid response medical facilities used in humanitarian relief, wartime contingencies and disasters. Our goal was to provide patient care for New York victims.

The next morning - with airspace restricted - I boarded a C-130 and flew to McGuire. It was eerie. We were one of a handful of aircraft airborne in the entire country.

When we arrived, our medics were in place. As fate would have it, we weren't called upon to provide assistance, though the tragedy enabled us to ponder linking EMEDS with moving large numbers of wounded patients through our aeromedical evacuation system.

Shortly after the invasion of Iraq, our EMEDS at Balad, 40 miles north of Baghdad, became the key hub for moving wounded service members to higher levels of care in Germany and stateside. A similar hub in Afghanistan would follow.

This required tireless efforts of Air Force, active duty, Reserve and Guard medics. Since November 2001, we have moved more than 90,000 wounded troops from Iraq and Afghanistan. Numbers only begin to tell the story. Every war has brought about innovative medical technologies that benefit military and civilian patients. The past 10 years have been no different.

The enhancement of our aeromedical evacuation system through critical care air transport teams is critical to the improved casualty survival rate. These teams are flying intensive care units that treat the most severely injured and ill patients while flying them from lower to higher levels of care.

With about 750 pounds of high-tech medical equipment, these three-person teams - a critical care nurse, respiratory therapist and surgeon - ensure there's no lapse in care during transport. The teams speed up the patient movement to increasingly more advanced care closer to loved ones and free up hospital space for newer casualties.

Our on-the-ground response has evolved as well into EMEDS Health Response Teams. These newly tested and proven packages enable us to arrive in a chaotic situation, set up and see the first patient within an hour and perform the first surgery within three to five hours. Used successfully in humanitarian missions, they will be the next step in rapid battlefield medicine.

In our theater hospitals, Air Force vascular surgeons have pioneered new methods of hemorrhage control and blood vessel reconstruction based on combat casualty experience. These innovations save limbs and lives and set new standards for military and civilian trauma surgeons.

These critical efforts are captured through the Joint Theater Trauma Registry, a repository that collects all Defense Department trauma-related data, providing timely information on care and outcomes of trauma patients at follow-on facilities. It greatly enhances clinical decision-making and measures subsequent outcomes for improving treatment, establishing invaluable lessons learned.

We've had lots of help getting here. Partnerships with medical schools, federal and private-sector facilities leverage our workforce.

The Air Force Medical Service has a simple mantra: "Trusted Care Anywhere." This fits what we do today and will continue to do. Our airmen and families honor the sacrifices of those lost on 9-11 by answering the nation's call and maintaining a standard of excellence. Even after a decade of combat operations, we remain ready to serve wherever our medics are needed.

Lt. Gen. (Dr.) Charles B. Green is the Air Force surgeon general and a 1978 graduate of the Medical College of Wisconsin in Wauwatosa.