Bone Cement for Traumatic Wound Repair. Photo: Pulse Lavage
With better medical care and equipment, one in every four troops who died of their wounds in the Afghanistan and Iraq wars could have been saved, according to an unpublished study from the U.S. Army Institute of Surgical Research.
“This study does not imply we are leaving our warriors on the battlefield languishing,” the study’s author, trauma surgeon Col. Brian Eastridge, tells Army Times. ” ‘Potentially survivable’ implies there are potential improvements.”
Simply put, the military needs to focus on improving its immediate response to injuries — and get better at treating wounds in the field. Troops are now rushed into trauma care faster than ever before, thanks to improvements in military medicine and rescue operations. But another speed increase could means hundreds more lives saved. The study reveals that 90 percent of the 4,596 deaths happened before the wounded servicemember reached a medical facility. Only 506 made it to a medical center before dying. All of these numbers were presented by Col. Eastridge to the Defense Health Board on June 25.
Studies like this one can have a major impact, potentially. “There’s a tremendous amount of information we can gain and potentially improve clinical care if we know why casualties die on the battlefield,” said Col. Eastridge. He referred to tourniquets as a perfect example. Using tourniquets was previously discouraged to avoid limb loss, until the Trauma Combat Casualty Care strongly recommended their use. It’s a policy change that resulted in a significant drop in hemorrhage-related deaths, from 26 a year to 9.
These are the kinds of deaths where there’s the most room for improvement; 90 percent of preventable deaths were caused by “bleed-outs.” And in fact, this is the area where the military has focused the most lately, introducing two new devices meant to prevent “bleed-outs.”
The Combat Ready Clamp, which is already used in the field, is designed to stop or slow down bleeding in the pelvic region when traditional tourniquets cannot be used. The other device, called Abdominal Aortic Tourniquet, is a belt-like device that is cuffed onto the abdomen and provides pressure to slow down blood flow and prevent deathly loss of blood.
And a new wave of military-funded medical research could prevent even more fatalities. Pentagon-funded scientists at Texas A&M are currently investigating the potential of “suspended animation” (temporarily halting breathing, heart function and even brain activity) to rapidly thwart blood loss. Darpa-backed investigators have already devised synthetic blood that’d permanently stymie shortages of the real deal during critical transfusions. And let’s not forget the plasma knife: A laser-powered cutting tool that seals off wounds — thereby preventing infection and blood loss — with a swipe of the medic’s hand.
The study also had a breakdown on the types of death suffered by military service-members. Sixty-five percent were due to an explosion, 22 percent to gunshot wounds. Dismemberment was the main cause of instantaneous death, closely followed by brain injury and heart and thoracic injury.
Despite these grim numbers, combat has never been safer. Soldiers have a much higher chance of surviving a wound today than in previous wars. As a way of comparison, in Vietnam and World War II, 16.1 percent and 19.1 percent of all injuries resulted in death. In Afghanistan and Iraq, it’s only 10 percent.
