Volunteer Surgeons

Dr. David Gillespie, of the Society of Vascular Surgeons, started a volunteer program for stateside vascular surgeons to go out on two week rotations to the Landstuhl Regional Army Hospital in Germany. This allows the surgeons to assist the staff at Landstuhl with more serious surgeries that include the repairing of arteries and veins of battlefield casualties. Since the need for such expertise is not in high demand at the facility, this program allows local doctors to assist our soldiers as needed, and have the satisfaction of doing so.

Recently, Dr. Yaron Sternbach returned from his time in Germany as a volunteer surgeon. Although he does not agree with the current War on Iraq, Dr. Sternbach says he felt taking care of our wounded soldiers over seas was "professionally gratifying" and encourages other doctors to do the same.

Pain Management

Dr. Buckenmaier, III, is Chief of the Army Regional Anesthesia and Pain Management Initiative (ARAPMI) at the Walter Reed Army Medical Center in Washington, DC. This program has been on the front lines of pain research over the past several years. Medscape.com interviewed Dr. Buckenmaier concerning the program's research and practical application. ARAPMI has been around since 2000, but really took off at the start of the War on Iraq in 2003. Its' primary responsibility is to enhance the ability to manage the pain of battlefield casualties, emphasizing the multimodal approach to pain management. In short, this means that the method of treating each patients' pain is best suited to their situation.

Dr. Buckenmaier describes pain as a disease process, and like all diseases can be appropriately treated. Such methods include patient-controlled dosage, which allows the patient to administer a dose of painkillers as they need it. This may sound dangerous, but the system is a safety within itself; should the patient become over-sedated, he or she will not be able to press the button for additional doses. Also, another example is the pill pack carried by Special Forces that contains a painkiller, an anti-inflammatory, and different anti-biotics that are to be taken when a soldier is initially injured. This is a great first step to the treatment of not only pain, but the injury itself. Another point that Dr. Buckenmaier touches on is the idea of having, at the least, a clinician dedicated to the pain management of casualties. Studies show injured soldiers having very high levels of pain prior to their arrival at definitive care, suggesting the need for better pain management of these patients before transport.

More harm than good?

Recently the U.S. Air Force gave a grant to researchers at the University of Cincinnati in the amount of over $2 million to determine if evacuating severe casualties from the battlefield can do more harm then overall good. Since field hospitals in a war zone are aimed at stabilizing patients until they can get to definitive care, it is imperative to be able to transport those injured soldiers as fast as possible. This is most commonly done via a "medical evaluation plane", which flies the casualties out to safety, at high altitudes of about 8,000 feet. Because of the higher altitude, there is less oxygen concentration in the air, which a body in a state of shock is desperately in need of. The job of these researchers is to determine when it is appropriate to fly these more serious patients out as to not cause any additional injury.

This is an area where little or no research exists. It has always been thought that getting patients to the proper treatment as soon as possible will yield the best outcome. Though I find the reason for this research credible because with any battlefield casualty, the condition is often severe. Should the field hospital work to stabilize this casualty, fly them out too soon only to have the stress of the flight send them into a severe state of shock, then all their hard work was in vain.

On Call In Hell

On Call In Hell, by CDR. Richard Jadick, is a very accurate account of combat medicine in the modern battlefield. In his book, written in a first-person recollection of events, CDR. Jadick describes in great, and sometimes gruesome detail of what is really happening on the frontlines in the War on Iraq.

CDR. Jadick helped to revolutionize the way in which battlefield causulties reached medical care more quickly and efficiently than ever before. I highly reccomend this book to anyone who wants a true feel for what it's like to be a trauma doctor in todays modern warfare.

Available at Amazon.com

Welcome

Hi, my name is Joe, and through my blog I intend to bring the field of combat medicine more visibly into the eyes of the public. Many advances have been made in the battlefield, including the care of injured soldiers. I will give reviews of news article, as well as books, concerning these advances, and the people making them possible. I hope you enjoy my blog and stay tuned for updates.