"The Front Lines of Saving Lives" (WP article)

[JJR512]

There's an interesting article in today's Washington Post called "The Front Lines of Saving Lives". It basically follows a military flight medic on a run to rescue a wounded soldier. It also describes how both new practices as well as some very old practices are used by modern military medics, and discusses why some of those old techniques went out of favor and why they're being used again.

You may need to register to view the complete article, but it's free.

First few paragraphs:

Military medics combine ultramodern and time-honored methods to save lives on the battlefield

By David Brown
Washington Post Staff Writer
Sunday, October 17, 2010; 1:14 AM

FORWARD OPERATING BASE WILSON The first sign this isn't a routine pickup is the rhythmic right and left banking of the helicopter.

It's the kind of thing kids do on bikes to feel the thrill of heeling over. Only this is done to make the aircraft a less easy target.

At 6:09 p.m., Dustoff 57 has just left this base deep in Taliban-infiltrated Kandahar province, headed for a POI, or point of injury. On board are two pilots, a crew chief and a flight medic, as well as two litters for carrying the wounded and numerous black nylon bags stuffed with ultramodern medical gear and some of the oldest lifesaving tricks of the battlefield. That combination of new and old - of specially developed porcelain-powder gauze and old-fashioned tourniquets - is key to keeping gravely wounded soldiers alive in the minutes before they get to the hospital. It's also the basis of evolving frontline strategies that may eventually trickle down in modified form to civilian ambulances, emergency rooms and trauma centers in the United States.

Somewhere ahead of the aircraft is a soldier who minutes earlier stepped on an improvised explosive device, the signature weapon of the wars in Iraq and Afghanistan. All the helicopter crew knows is that he's "category A" - critical.

Much more of this article at http://www.washingtonpost.com/wp-dy...10/16/AR2010101602974.html?hpid=moreheadlines

 

[Harvey]

Gotta Love the Fly Boys, One thing I'll say about the the Air Force, When you need a MEDEVAC they dont mess around!

 

[rhan101277]

Hetastarch, a volume increaser. I wonder why it isn't use more in civilian EMS medicine.

 

[abckidsmom]

Hetastarch, a volume increaser. I wonder why it isn't use more in civilian EMS medicine.

Because it is expensive, expires much more quickly that crystalloids, and is rarely needed. Until we have the levels of blast- and penetrating trauma that are present on battlefields, we're really going to be ok, in civilian EMS.

The number of people who need this level of volume replacement is actually pretty low, and in our country, a hospital is rarely more than an hour away, maybe 90-120 minutes if a really technical extrication is required, and the further away from the hospital you get, the less likely you're going to be dealing with penetrating trauma, as a rule.

 

[zmedic]

Also very little if any evidence that it improves mortality. The main reason the military uses it is because it is much lighter to carry 500ccs of Hetastartch than 2 liters of saline.

I'd note that the military often puts treatments into the field with little data that it helps and then studies them afterwards. Often these treatments get pulled a few years later when the data comes in.