Skip to main content

Military Health System

Test of Sitewide Banner

This is a test of the sitewide banner capability. In the case of an emergency, site visitors would be able to visit the news page for addition information.

Medical Advances Since Gulf War Boil Down to Increased Lives Saved

Image of Medical personnel training on how to treat a neck wound. Wyoming Army National Guard Sgt. Shawn Todd, a combat medic assigned to Recruiting and Retention Battalion and Sgt. 1st Class Ethan Schanzenbach, 213th Regional Training Institute senior medical noncommissioned officer, treat a neck wound on a mock patient using modern medical gauze (Photo by: Kentucky National Guard Public Affairs).

Second in a series of articles on advances in military health care and technology since the Persian Gulf War, 30 years ago this year.

Read Part 1, here.

Tactical casualty care – an application of the lessons learned based on data collected during the Vietnam War and analyzed with computers in the 1990s – evolved since being initially published in 1996, noted Alan Hawk, manager of historical collections for the Defense Health Agency’s National Museum of Health and Medicine.

Hawk noted that this resulted in the development of improved hemorrhage control techniques and even early versions of telemedicine, allowing for medical consultations by physicians far from the point of care. He also included rapid vaccine development, from a concept developed by the Defense Advanced Research Projects Agency (DARPA), to develop defenses against novel biological warfare agents.

Tourniquets and gauze

But other tools have been less tech-oriented and just as effective in saving lives. Former Army Col. (Dr.) Leopoldo “Lee” Cancio and Dale Smith, a longtime author and a professor of military medicine and history at the Uniformed Services University of the Health Sciences in Bethesda, Maryland, mentioned advanced forms of battlefield gauze, clotting agents, and combat application tourniquets (“CAT,” or “ratchet” tourniquets) as key ingredients in the rucksacks of not just medics, but all ground troops.

"In 2001, we were using a strap-and-buckle tourniquet," Smith said, which were about 80% efficient - meaning that, above the elbow or above the knee, blood vessels are "big enough that 20% leakage is going to kill you. So, in theater, some surgeons and some medics built a ratchet tourniquet." He described it as "a loop - you can put it on over your own arm and tighten it down. They are more than 98% efficient."

Exsanguination (bleeding to death) is the most common cause of potentially survivable death for wounded warfighters, according to the Army. To be blunt about it, Smith added, once you've already lost a limb, it's about saving your life.

"Today, the ratchet tourniquet is in everybody's kit bag, you can put it on yourself, you can put it on your buddy, and you can stop bleeding in less than 10 minutes," he said. "That's what I mean by survivability. You would've died in 2000 with this injury, but now you're alive and we've got a decent prosthetic device. It's not as nice as (the limb) you were born with, and there's a whole lot of psycho-social issues to being an amputee and a whole lot of learning to do."

The newer tourniquet is "a very nice piece of technology," Cancio agreed. "The concept is simple, but you've got to make it user-friendly."

He added that the mindset of the tourniquet as a last resort also had to be changed as it was introduced. With arrival times from point of injury to aid station of perhaps 30 to 60 minutes, he said, "even if you put it on unnecessarily, you're not going to do any permanent damage to that extremity."

The development of topical dressings to replace traditional gauze has been another big development that saves lives, Cancio said. Several iterations of the new dressings since 2003 have resulted in the "combat gauze" used today - so effective at stopping bleeding that it is not just carried in battle but used in the burn center where he works.

a picture of a tourniquet from 2016
An updated combat application tourniquet from 2016 (Photo by: U.S. Army).

Rule No. 1

These developments and advances in military medicine should not diminish the terrors of being on what Smith calls "the pointy end" of battle.

Suffering a traumatic brain injury or losing a limb are no small matters, no matter how sophisticated the subsequent treatment or prosthetic replacement limb may be. But in many cases, these developments mean not just survivability, but a "return to function," as Cancio put it, or even a "return to ambulation" despite losing one or even both legs. And that return to function could even mean staying on active duty. Gone are the days when losing a leg in battle meant an automatic medical discharge.

"At either end of this long sequence of events and different echelons of care is an individual who is wounded and a combat medic who is taking care of that individual," Cancio said. "That individual at the end of that process is returning to his family and community. So those people are really the most important factors in this whole process – the people, not the technology. And really, none of the technology that we talked about is meaningful or helpful unless we put it in the hands of medics who are properly trained."

Said Smith, "We have pioneered in the military pushing people to the limit of their training. In World War II, we didn't have enough doctors to put on airplanes to evacuate patients, and so we taught nurses to take blood pressures."

Now, he said, there are physician assistants, techs, advance practice nurses, people who do psychosocial work - the works. "You've got all levels of practice from psychiatrists on down to technicians who forward deploy to deal with acute combat reaction in theater. (The USU) even has a campus in San Antonio to get the medics and corpsmen trained up to give them college credit to jump-start their associate degrees, because we see them needing those degrees to move to the limits of practice and certification. So, the military is still in this business of extending the scope of practice of people in order to provide more robust, systematic care, wherever you are."

For example, “the Joint Trauma Registry has been a huge factor in educating people and keeping one group from not knowing what the previous group did – they are now getting better at that. All of this has contributed to improved survivability.” That includes intra-service communications, Smith said. “You’ve got more people at the table, they’re talking more frequently, both in the line and in medicine.”

At that, he paused, remembering a line from a fictional doctor -, the beloved Col. Henry Blake from the first few seasons of the TV show "MASH." Blake was consoling the usually irreverent main character, Army Capt. Benjamin "Hawkeye" Pierce, who was upset after one of his patients died.

Blake stated: "Look, all I know is ... there are certain rules about a war. And rule No. 1 is young men die. And rule No. 2 is ... doctors can't change rule No. 1."

"We can't change rule No. 1," said Smith. "But we can amend it, and we have been amending it, really, for the past 70 years, but phenomenally in the last generation."

Continuing this summer

(July): Advances in prosthetic limbs and quality of life after traumatic injury. (August): How 3-D printing is re-writing what's possible in post-traumatic care.

You also may be interested in...

Transformed U.S. Army Pharmacy Readiness Training Course Enhances Force Sustainment for Future Combat Operations

Article Around MHS
5/31/2023
U.S. Army Capt Lauren Kaminski of Evans Army Community Hospital, Fort Carson and U.S. Army Staff Sgt. Rosalinda Bermea-Arriaga from Schofield Barracks, Hawaii, log controlled substance medications in the pharmacy at the training field hospital at Camp Bullis, Texas. Proper management of controlled substances is vital to the safety, security, and legal compliance of our forces. (Courtesy photo)

U.S. Army pharmacists and pharmacy specialists from across the country traveled to Camp Bullis, Texas, this week to participate in a 40-hour deployment readiness course hosted by the U.S. Army Medical Center of Excellence. The course is designed to prepare personnel to provide efficient pharmaceutical in an austere, multi-domain, large-scale operating environment.

Medical Exercise Certifies Mission Ready Casualty Receiving Treatment Ship

Article Around MHS
5/16/2023
U.S. Navy sailors from Fleet Surgical Team 6 treat a simulated patient aboard the amphibious assault ship USS Bataan in the operating room during a medical mass casualty drill. Sailors from USS Bataan and Fleet Surgical team 6 participated in an all-day medical training evolution to increase operational readiness. (Photo by U.S. Navy Mass Comm.  Spc. Seaman Apprentice Levi Decker)

Sailors from Navy Medicine Readiness and Training Command Portsmouth enhanced a casualty receiving treatment and amphibious assault ship USS Bataan and conducted a three-day certification exercise as part of a continued commitment to mission readiness, March 21.

Local Health Care Partners are Critical to Blanchfield’s Medical Mission

Article Around MHS
5/3/2023
U.S. Army Col. Vincent B. Myers, commander of Blanchfield Army Community Hospital talks with TRICARE network providers from the local community about the hospital's medical mission during a network partner event on Fort Campbell, Kentucky, on April 13. Regional TRICARE contractors provide health care services and support beyond what's available at military hospitals and clinics for eligible beneficiaries. (Photo by Fred Holly, Blanchfield Army Community Hospital)

Army Medicine, Defense Health Agency, and TRICARE East region contractor Humana Military representatives welcomed local TRICARE network health care providers to the Sabalauski Air Assault School on Fort Campbell, Kentucky, on April 13.

Ultimate Caduceus 2023 Tests Defense Health Agency Readiness in Emergencies

Article
4/27/2023
Ultimate Caduceus 2023 Tests Defense Health Agency Readiness in Emergencies

For the first time, medical representatives from the Defense Health Agency participated in a combatant command movement exercise, the Ultimate Caduceus 2023 held in March. The objective was to test the Department of Defense’s aeromedical evacuation and critical care transport capabilities.

86th Aeromedical Evacuation Squadron Makes History

Article Around MHS
4/20/2023
U.S. Air Force Tech. Sgt. Brendon Bowman, 86th Aeromedical Evacuation Squadron flight examiner and emergency medical paramedic, unloads medical equipment from a C-21 Learjet at Ramstein Air Base, Germany.  (Photo by U.S. Air Force Airman 1st Class Jordan Lazaro)

The 86th Aeromedical Evacuation Squadron embarks on the U.S. Air Force’s first-ever AE paramedic-led flight in charge of an all-enlisted medical crew.

Project 112 SHAD

FAQs
4/19/2023

Questions and answers about Project 112 SHAD

Human Subject Research at Fort Detrick

FAQs
4/19/2023

Questions and answers about Human Subject Research at Ft. Detrick

New Center a ‘Seismic Shift’ in Army Fitness

Article Around MHS
4/7/2023
U.S. Army Col. Kent Solheim, 165th Infantry Brigade commander, pauses for a moment while climbing a rope during the “Kay Workout of the Day” at the Drill Sergeant Timothy Kay Soldier Performance Readiness Center. (Photo by Robert Timmons, Fort Jackson Public Affairs Office)

The Drill Sergeant Timothy Kay Soldier Performance Readiness Center, “represents a seismic shift” towards how the U.S. Army approaches how troops are trained, evaluated, and sustained, said U.S. Army Brig. Gen. Jason E. Kelly, Fort Jackson’s commander. “It is an investment in individual soldier preparedness.” The Drill Sergeant Timothy Kay Soldier Performance Readiness Center, “represents a seismic shift” towards how the U.S. Army approaches how troops are trained, evaluated, and sustained, said U.S. Army Brig. Gen. Jason E. Kelly, Fort Jackson’s commander. “It is an investment in individual soldier preparedness.” U.S. Army Col. Kent Solheim, 165th Infantry Brigade commander, pauses for a moment while climbing a rope during the “Kay Workout of the Day” on March 24 at the Drill Sergeant Timothy Kay Soldier Performance Readiness Center. The workout was part of the facility's grand opening. (Photo by Robert Timmons, Fort Jackson Public Affairs Office)

Protecting the Warfighter's Health and Readiness, Now and Into the Future

Article Around MHS
3/30/2023
An anopheles mosquito specimen sample sits under the microscope during a demonstration of the U.S. Army’s medical technology development and modernization efforts, Fort Detrick, Maryland, on Feb. 23. (Photo by Summer Abdoh, U.S. Army)

A cure for a debilitating and sometimes deadly disease, new treatments for working military dogs, a snakebite antidote, and a treatment for respiratory disease! See how years of research collaborations are providing protections for warfighters in remote places like never before.

Brooke Army Medical Center Interventional Radiology Offers Less-Invasive Option for Patients with Disc Degeneration

Article Around MHS
3/21/2023
U.S. Air Force Maj. (Dr.) Matthew Taon, interventional radiologist, demonstrates a minimally invasive image guided procedure at Brooke Army Medical Center, Fort Sam Houston, Texas. (Photo by Jason W. Edwards, Brooke Army Medical Center)

You may not have to go "under the knife" to ease debilitating back issues, thanks to a new technology. Find out how surgeons at Brooke Army Medical Center are relieving patients from pain where surgery was once the only option.

Belvoir Hospital Reaches Milestone with Robotic-Assisted Joint Replacement Surgery

Article Around MHS
3/20/2023
Fort Belvoir Community Hospital is the first military hospital in the Defense Health Agency to employ this robotic-assisted platform, and the cutting-edge technology provides the joint replacement surgeons an unparalleled amount of real-time surgical data.  (Photo by Reese Brown, Fort Belvoir Community Hospital)

Would you trust your surgical procedure to a robot? See the cutting-edge technology that's taking Belvoir Hospital's joint replacement surgery into a new era.

USU President Encourages Attendees to “Think Outside the Box” at Infectious Disease Symposium

Article Around MHS
3/17/2023
Uniformed Services University President Dr. Jonathan Woodson delivered opening remarks during IDCRP's first annual Science Symposium March 6-10. The event was held in collaboration with the Defense Health Agency Infectious Disease Working Group Subcommittee. (Photo by  HJF communications)

Infectious diseases like COVID-19, HIV, and battlefield wound infections cause illness and disruptions that threaten health and military readiness around the world. To help foster collaboration in the field and share best practices, the Uniformed Services University’s Infectious Disease Clinical Research Program hosted its first Science Symposium March 6-10.

Walter Reed Audiology and Speech Pathology Center Focuses on Improving Quality of Life for Military Health System Beneficiaries

Article Around MHS
3/15/2023
World Hearing Day is observed annually on March 3, and this year’s theme is “Ear and Hearing Care for All.”  (Courtesy photo)

Although World Hearing Day is observed just one day during the year, the Audiology and Speech Pathology Center at Walter Reed National Military Medical Center focuses on improving the health and quality of life for MHS beneficiaries nearly every day of the year.

New Training Course Offers Medics and Nurses Hands-On Experience in Austere Environment

Article Around MHS
3/14/2023
U.S. Army Capt. Morgan Bobinski and U.S. Army Capt. Lauren Blake, burn intensive care unit nurses, treat a simulated patient during the Tactical Trauma Reaction and Evacuation Crossover Course at Joint Base San Antonio-Lackland, Texas. (Photo by Jason W. Edwards, U.S. Army)

Battlefield trauma simulations, evacuation procedures, and trauma care are just a few of the scenarios that medics and nurses experience in a new training platform. Find out what makes the TTREX course so impressive that participants are volunteering to teach it.

How This USU Student's Daughter Inspired His Surgery Invention

Article Around MHS
3/13/2023
U.S. Army 2nd Lt. Harvey Harper and his daughter, Niyah, who was integral to the development of the Harper Innovative Safety Suture Kit. (Photo by U.S. Army 2nd Lt. Harvey Harper)

A surgical tool inspired by a child's toy? The father-daughter collaboration that gave us the Harper Innovative Safety Suture Kit.

Page 1 of 49 , showing items 1 - 15
First < 1 2 3 4 5  ... > Last 
Refine your search
Last Updated: July 20, 2022
Follow us on Instagram Follow us on LinkedIn Follow us on Facebook Follow us on Twitter Follow us on YouTube Sign up on GovDelivery