A new study, which appears in JAMA Surgery, is showing that a relatively new method of combat care could be saving soldiers' lives. It's called Damage Control Resuscitation. This method of servicemember care is intended to optimize wounded soldier outcomes by reducing blood loss and increasing tissue oxygenation, according to an infographic released by the JR Army Med Corps, and it encompasses an eight-step process after a soldier is wounded in the field:
- Novel hemostatics reduce blood loss and dress wounds
- Battlefield Advanced Trauma Life Support or emergency on-site surgery is provided to buy time to move servicemembers to the next level of care
- Enhanced Medical Emergency Response Teams composed of four-practitioners provide advanced interventions while the soldier is rapidly transported
- The wounded soldier goes through consultant based resuscitation at a nearby hospital or field hospital
- Hemostatic resuscitation – restoring and sustaining normal tissue blood flow – is pursued
- Physicians run bedside diagnostics
- Damage control surgery is performed
- An intensive therapy/treatment unit or Critical Care Air Support Team is dispatched for ongoing treatment or transport
This system brings wounded soldiers from the point of wounding and battlefield care to hospitals. According to Military Times, JAMA Surgery researchers are calling DCR "one of the most important medical breakthroughs of our current conflicts."
A silver lining
Unfortunately, the tremendous improvement in battlefield care has brought surviving soldiers to hospitals, which may have pushed in-hospital deaths of Iraq and Afghanistan soldiers to reach historic heights. To put it into perspective, the amount of servicemember deaths in Iraq and Afghanistan has been very low. However, DCR services provide such speedy evacuations and effective care that critically wounded soldiers make it to hospitals but succumb to their wounds despite the efforts.
Many believe that more soldiers would have died of their wounds without the DCR treatment. In fact, Military Times reports that JAMA Surgery author Nicholas Langan attributes many of the deaths to head injuries, not hemorrhaging or blood loss. Such an assessment suggests that DCR is improving survivability for troops.
Helping enhance in-hospital outcomes
Moving wounded troops to hospitals faster and in better condition increases their chances of survival. Now, researchers must make determining how to improve emergency room outcomes a priority. JAMA Surgery officials think there is a possibility of saving a great deal of patients by giving in-hospital care more attention.
"There appears to be a significant potential for salvage in up to 50 percent of patients who die of wounds at a military treatment facility," Langan wrote in the study, according to Military Times.
Nonetheless, there is wide agreement that DCR efforts have vastly improved wounded soldiers' outcomes since the procedure's adoption in 2006. Of the 57,179 troops wounded in Iraq and Afghanistan only 4.5 percent have died due to their injuries. Of that amount, 80 percent died within 24 hours of arriving to a military treatment facility.
Moreover, many military medical professionals claim that this high attention to combat casualty outcomes could likely improve patient results in future wars. The Pentagon is working to chronicle all combat casualties in the Joint Trauma Registry, and the compiled data could lead to further medical breakthroughs.