Fascinating article in today's Washington Post about how instructive, and even transformative, the Iraq and Afghanistan wars and the Somali debacle of '93 have been in the trauma care protocols of U.S. military medics. The article focus is on treating blood loss. They have actually gone back to some WW I and II strategies as well as implementing new technology.


http://www.washingtonpost.com/wp-dyn/content/article/2010/11/01/AR2010110104802.html?hpid=sec-health

The single most important change was the endorsement of tourniquets, ancient devices that for the second half of the 20th century were considered too dangerous to use because extended use can cause tissue damage. The new ones optimize the force distributed across the strap and can be tightened and locked with one hand. Every soldier carries one, and medics carry a half-dozen.

A new generation of bandage, called Combat Gauze....

Medics are now taught not to worry if a person's blood pressure is as low as 85/40 (normal is 120/80) as long as the patient is alert.


Content of a military medics' bag:

http://www.washingtonpost.com/wp-srv/spe...ST2010110104926

Very interesting. Any links to pics or info on the new tuirniquets? The NYT photo was too small and didn't disply it well.

billvann... look up Special Operations Forces Tactical Tourniquet
SOFTT

Interesting article. I do remember always reading that tourniquets were a tool of absolute last resort.

Can anyone explain this sentence to me?

"Data presented at a conference in August revealed that 8.8 percent of the U.S. combat casualties in Iraq and Afghanistan died, either on the battlefield or later of wounds."

So either they died immediately or later?

"80% of the time it works every time."

Ajax, probably just bad grammer. I think that's talking about the rate of combat injury death. But I agree, poorly worded.

This topic has been discussed before (not with this article though). When I did my combat medicine course in April, tourniquets were big. The big push was try for a few minutes with gauze, if not working, tourniquet 'em and transport 'em.

The other big news is "who cares about BP if the brain is perfusing." It helps decrease the weight of IV bags. Plus, too much IV fluids can decrease clotting, worsen bleeding, and "push out" the blood (there's only so much room for fluid in the blood vessels).

As a non-native English speaker with English as my secondary professional language, this is a challenge I can't resist



They died. Some died immediately, some died later.



Translates to: 80% of the time it works. Plain and simple. The "every time" is superfluous and does not add anything but confusion.

Yes, the KISS principle absolutely applies to writing as well.

It's amazing how much more effective regular fresh blood is vice components or IVs.

Only man would try to improve on a machine as ingenious as man.

In Wilderness First Aid last summer they were also more supportive of tourniquets than they had been 2-3 years before. Still only to be applied if you can't stop bleeding any other way, pressure will work 95% of the time, and only worthwhile if you have a ready made TQ and not just a length of paracord. In other words, don't leap to a later option if others are still available to you and work, and don't be stupid with your choice of TQ material.

FWIW I have a CAT style tourniquet on what I call my Bloodstopper 2000 kit, which rides in the trunk of my car and is outfitted solely for stopping profuse bleeding at car accidents and the like, until professional help arrives (pronto). The CAT is on the outside of the kit and available, but the kit also contains kerlix (roll gauze) and 4x4s which have actually seen duty after accidents. Happy to say I still have never encountered a medical scene requiring a TQ.

I appreciate the effort but my question was mostly rhetorical. Of course combat deaths occurred either on the battlefield or later, where else could they happen?

I remember the old combat bandages. I always carried two, on the idea that bullets can make two holes, one in, one out. My small signal mirror rode between the two bandages, which cushioned and protected the mirror. I also carried some bandaids in the same small pouch, as it was easier to treat small booboos than find the medic. And as with most grunts, I always had a bottle of Tylenol or Motrin in my ruck.

It's nice to see that the new IFAK have some real stuff in them. The medics can't be everywhere.