Second Chances at Life

...policy that Iraqi civilians stay in U.S...

...The Army Medical Corps continues to seek out new technologies that will help them save even more lives on the battlefield...

...But the truly remarkable untold story of Iraq is that of combat medicine...

...To have an ICU in a Third World country is amazing," she said...

...As a result, combat medicine used to refer to "the golden hour" to describe the all-important initial care that a soldier receives after being wounded...

...9 Chitosan bonds with blood celiSr forming a clot...

...And while all of this is de rigueur for the Army medical staff...

...If it was a mass casualty, if you were walking wounded and not in immediate need to see a doctor, I was the one seeing you...

...Once we get past the golden hour, we have personnel to make sure they survive the next 24 hours...

...Our Army Corps of Engineers, Navy Seabees, and others are helping to rebuild vital infrastructure either destroyed by the terrorists or never deemed important by Saddam Hussein...

...T'S MOST AMAZING is that all of this operes relatively smoothly in an intense cornat environment with shifting lines of engagement against terrorists who are increasingly innovative at hitting U.S...

...Indeed, many of the doctors who served in Iraq or Afghanistan said that upwards of half the patients in U.S...

...There's nothing that can compare to it on the civilian side...

...Put succinctly, there are soldiers coming home today maimed or wounded who ten years ago would have been killed...

...For instance, because the U.S...

...It is U.S...

...has been able to improve infrastructure in Iraq and assure that there's a steady, reliable supply of electricity at most bases, hospitals have been able to import blood from the U.S...

...They're surviving injuries they didn't used to survive...

...That's where Captain Blake and Colonel Searle return to their more traditional roles of physical therapist and orthopedic surgeon, as do so many of their colleagues in stateside military and Veterans Affairs hospitals across the country...

...Indeed, on November 11, Veterans Day, they gathered for a candlelight vigil, holding signs that read, "Why isn't war a war crime" and "Support Our Troops: Bring Them Home Now...

...9 In tests, effectively stanched a wound bleeding at a rate of 300 milliliters per 30 seconds...

...We had a personnel officer helping to ventilate patients...

...Advances in body armor have saved a lot of lives as well...

...military has taken on the added responsibility of treating Iraqi civilians-be they wounded by a suicide bomber or suffering from more common ailments...

...Soldiers are walking on prostheses that wouldn't have lived before," said Lieutenant Colonel Clark Searle, an Army orthopedic surgeon who served in Iraq in 2003 with the 86th and 21st Combat Support Hospitals...

...It's a seamless chain that starts with a Combat Lifesaver treating a soldier on the Syrian border, to the medic, the doctor, the medevac crew, the CASH and the surgeon and support staff...

...I've seen amputations, the whole gamut...

...9 Allows an isolated Soldier to stop bleeding in an arm or leg without assistance...

...That training is one of the reasons why more BY MARK YOST 16 THE AMERICAN SPECTATOR FEBRUARY 2006 soldiers are surviving after being wounded," he said...

...FEBRUARY 2006 THE AMERICAN SPECTATOR 19...

...We've made great strides in teaching a lot of soldiers first-aid skills," said Lieutenant Colonel Mike Place, deputy commander at Blanchfield Army Community Hospital at Fort Campbell, Kentucky...

...The military medical facilities take care of three groups," Colonel Place said...

...That requires a pretty sophisticated supply line," Major Maxwell said...

...What I love about Army rehab is that every soldier who wants to come back is expected to be running through the woods and shooting his weapon like every 18 THE AMERICAN SPECTATOR FEBRUARY 2006 MARK YOST other soldier," Captain Blake said...

...Injuries that were automatic amputations 10 years ago aren't so anymore...

...Coalition hospitals are often all that's available," Colonel Place said...

...and its allies have also set up local medical clinics where Iraqis can go to get treatment for everyday maladies...

...Tourniquets were really frowned on before because of the time it took from when they were applied to when a wounded soldier first saw a doctor or other trained medical professional," Colonel Place said...

...At IBM, it's all about getting back behind a desk and maybe doing some recreational sports...

...But that's clearly not the case...

...9 Created by the Walter Reed Army Institute of Research...

...Fibrin Bandage: Contains fibrinogen and thrombin, clotting proteins in blood...

...And, of course, once a soldier recovers from his wounds he'll often begin a long rehabilitation process...

...A major arterial bleed will cause you to die within five minutes," said Major Lisa Maxwell, a general surgeon who deployed to Iraq in 2005 with the 86th Combat Support Hospital...

...All you hear about are kidnappings, beheadings, and suicide bombings...

...They knew our treatment, our literature," he said...

...It's the more complicated blood products that have become available more recently...

...9 Designed to transport blood to surgical teams deployed far-forward in combat...

...military hospitals until they're ready to be released or can be transferred to an Iraqi civilian hospital that can adequately care for them...

...On other occasions, the group was seen holding signs that read, "Maimed for a lie...

...To heckle amputees going out for dinner and a movie...

...Paul Pioneer Press...

...Captain Charles Blake is an Army physical therapist who was deployed in Iraq with the 86th Combat Support Hospital for most of 2005...

...Another advancement in combat medicine is a bandage made of chitosan (see Sidebar on page I9), a biodegradable carbohydrate found in shrimp and lobster shells that bonds with blood cells and helps form a clot...

...In the Army, there's the full expectation that they'll run two miles on a prosthetic limb for the Army's annual PT test...

...But because the transportation time has been drastically reduced, we don't admonish anyone from putting on a tourniquet...

...is key...

...One reason is that the U.S...

...9 Consists of loops of nylon webbing that tighten when pulled to shut off blood flow...

...The prosthetics are phenomenal," Captain Blake said...

...Army medics call rFVI[A "a remarkable, life-saving drug...

...Colonel Searle worked regularly with Iraqi doctors, most of whom were Western trained and educated, but who suffered from a lack of trained nurses and equipment...

...9 Can reduce blood loss by 50 to 85 percent...

...Yet it's remarkable to see that kind of carnage and to know that all of them that get to you [at a CASH] are going to survive...

...9 Approved by the Food and Drug Administration for investigational use by special operations Soldiers, with informed consent by the patient...

...There's another bandage that contains fibrinogen and thrombin, clotting proteins that can reduce blood loss by up to 85 percent...

...But like much in the military, it succeeds because of teamwork and selfless dedication...

...they still sometimes stand back and marvel at how well it all works...

...What we're trying to do is focus more on point-of-injury care to stop the initial bleeding, and then use transportation to get them to a hospital...

...military has started giving basic first-aid instruction to as many soldiers as possible-not just medics and corpsmen-through a program called Combat Lifesavers...

...Just walking with a rucksack and weapon on patrol is going to result in twisted ankles, wrenched knees, and other injuries," he said...

...The purpose...

...His father, Captain George E Yost, was a thoracic surgeon in a MASH unit in Korea and worked for the Veterans Administration for 20 years...

...We're training Iraqi forces to police their own country and hunt down terrorists who continue to kill and maim innocent citizens...

...Just look at Napoleon's march through Russia...

...is making slow but steady progress in Iraq...

...In addition to training and technology, transportation plays an important role in assuring that our soldiers get the best care possible, as soon as possible...

...I wonder if they even care...

...Today, thanks to Combat Lifesavers and some of the new medical technology, the talk is about "the platinum five minutes...

...Blood was pretty readily available from the start of the conflict," Major Maxwell said in a November 2005 interview...

...helicopters collided over Mosul in November 2003, killing 17 soldiers, one of the critically injured survivors was in the burn unit at Fort Sam Houston in San Antonio, Texas, within 48 hours...

...9 Approved by the Food and Drug Administration in November 2002...

...Army doctors aren't stopping there...

...I saw neuro musculo skeletal injuries and determined if they could stay in theater and undergo treatment or had to go stateside," Captain Blake said...

...F RANKLY, I THINK THAT ALL OF THEM are remarkable, in everything they do...

...rFVIIa stops bleeding in trauma patients when their own clotting mechanisms are not working properly," according to Army literature...

...Because of all them, the soldier lives...

...And because platelets expire in a week from the time they're drawn from the donor, it's important to have the infrastructure to both harvest them and store them...

...Of course, while every combat death is an individual tragedy, the U.S...

...Body armor prevents a number of traumatic injuries to the torso," Colonel Place said...

...For instance, because of the assets available to U.S...

...SAVERS IN IRAO AND AFGHANISTAN Chitosan Bandage: Made of chitosan, a biodegradable carbohydrate found in the shells of shrimp, lobsters, and other animals...

...also has some of the most advanced equipment and techniques for evacuating soldiers who need treatment at our base hospitals in Germany or the U.S...

...In late 2005 U.S...

...military hospitals in Iraq acquired the ability to make platelets, which are also vital to stopping bleeding in trauma patients...

...The CCTs are staffed by intensive care nurses and doctors and have everything you'd expect in an ICU, except they're at 10,000 feet," Major Maxwell said...

...Trauma Training: Forward Surgical Teams undergo trauma training at the Army Trauma Training Center at Jackson Memorial Hospital in Miami, Florida...

...Maxwell, Place, and Searle and other Army Medical Corps are doing in Iraq and elsewhere...

...He also noted that while much of the military medical community is focused on combat injuries, there are still the everyday injuries associated with just being a soldier...

...Both products have been highly effective and there are many reports from the field where they have been able to stop bleeding that normal bandages have not been able to control," according to Army literature...

...Twenty years ago, we would have been writing letters to his parents...

...I saw people brought in and the entire CASH was focused on that patient...

...In Iraq, physical therapists perform triage and treat non-life threat. . . . enmg mjurms...

...newspaper or the evening news on cable and network television and you'd think Iraq really was another Vietnam...

...medical facilities, they also receive great longterm care...

...Afghanistan is much the same way...

...Not only do our soldiers and Iraqi civilians get cutting-edge trauma treatment when they first come into U.S...

...It's an entire team," said Colonel Place...

...I saw soldiers who were victims of IED explosions that were entirely peppered with shrapnel, including in and around their eyes, face, and chest," Colonel Place said...

...It allows people who would otherwise die to have only severe extremity trauma...

...It's a great story...

...And while some of the wounded will take years to fully recover, their second chance at life is made possible by some incredible advances in combat medicine that are receiving scant attention from the mainstream media...

...One of the reasons we have people alive today is body armor," Colonel Place said...

...As a result of this collaboration, rFVIIa is now being used in major trauma centers throughout the world and has been used on over 400 wounded patients in Iraq...

...Once we developed a fixed facility, we had ICUs, some very high-tech ventilators that saved a lot of lives, and we had intensive care physicians on the ground," Major Maxwell said...

...hospitals were civilians...

...When you dive to the ground because an IED went off nearby, even if you're not hit by shrapnel you're going to have dislocated shoulders...

...One-handed Tourniquet: All Soldiers are taught to stop bleeding as a Common Task, including applying a pressure dressing and a tourniquet if needed...

...Golden Hour Container: Transports red blood cell units without the use of batteries, ice, or electricity...

...I wonder if any of them know the work that Drs...

...Every death in I r a q - b e it U.S., Coalition, or civilian--is reported as if it were the assassination of Lincoln or Kennedy...

...and Coalition forces...

...Those blood supplies are saving lives," Major Maxwell said...

...People are keeping limbs that ten years ago they would have lost...

...Too bad the war on terror has divided us so that we all can't put our political differences aside and acknowledge what truly remarkable work these doctors, nurses, and physical therapists are doing to treat our soldiers, both in Iraq and here in the U.S...

...Indeed, bleeding is the number one preventable cause of death in combat...

...This is the specialty of the Air Force, which has Critical Care Air Transport Teams (CCT) that transport soldiers on C-17 cargo planes that are converted into flying ICUs...

...And we're helping to foster democracy among a people who were brutalized by an unflinching dictator for more than three decades...

...B ECAUSE SOLDIERS ARE USUALLY n o more t h a n 2 0 minutes away from a Combat Support Hospital, or CASH, the Combat Lifesavers can use a new one-hand tourniquet designed to stop severe bleeding...

...The most rewarding thing that I experienced over there was the teamwork," Major Maxwell said...

...We've set up literally hundreds of public health clinics over there," Colonel Searle said...

...Because of advances in combat medicine, people are keeping extremities that they wouldn't have kept 10 or 15 years ago," Colonel Searle said...

...Coalition forces, Iraqi civilians, and Iraqi detainees...

...medical teams, when two U.S...

...He was a division surgeon with the lOlst Airborne in Iraq in 2003 and 2004...

...It works...

...k Mark Yost is associate editorial page editor of the St...

...military is working with the Israelis to adopt recombinant activated Factor VII (rFVIIa), used to stem severe surgical bleeding in trauma patients...

...If your buddy next to you knows what to do if you're hit, your chances of survival go way up...

...lLE SOME CRITICS WOULD ARGUE that we've ade the lives of Iraqis worse, not better, e doctors clearly don't see it that way...

...A good safe supply of blood from the U.S...

...For instance, the U.S...

...Primarily because it protects the torso, which if damaged by shrapnel can result in wounds that not even the best surgeons can close fast enough...

...They just didn't have our equipment...

...It was amazing to see how everyone came together...

...That's because the U.S...

...The U.S...

...FEBRUARY 2006 THE AMERICAN SPECTATOR 17 SECOND CHANCES AT LiFE In addition to treating Iraqi civilian trauma patients, the U.S...

...An anti-war group called Code Pink has regularly gathered outside the gates at Walter Reed Army Medical Center in suburban Washington...

...LI...

...The lesson there was don't outrun your supply lines...