Warrior Care: Survivability Begins With Soldiers on Battlefield, Leaders Say

By C. Todd Lopez
Special to American Forces Press Service

Nov. 7, 2008 - The increasing ability of soldiers to survive their battlefield wounds starts with the soldiers themselves by way of their training and the equipment given to them, Army leaders said today. "The progress that has been made in taking care of our soldiers and the increasing survivability of soldiers starts with the soldier," Army Secretary Pete Geren told reporters at a Pentagon press conference.

Geren and others from the Army's medical community gathered to discuss warrior care and the progress that has been made in caring for injured soldiers. The event marked the beginning of "Warrior Care Month," an official month-long recognition by the Defense Department to focus on the care of wounded, ill and injured warriors.

The Army's lessons in self-aid and buddy care is a prime factor in the 90-percent survivability rate of combat-injured soldiers, said Maj. Gen. Patricia D. Horoho, commanding general of the Western Regional Medical Command, and chief of the Army nurse corps.

"Every single soldier is trained in self-aid and buddy-aid," said Horoho. "We do that so we have force multipliers across the entire theater of operations. They have the skills to save lives."

Horoho also said advances in the medical equipment soldiers carry with them have contributed to their ability to help themselves and others. The medical kits now include equipment to ensure continued breathing for those with chest wounds, various bandages and a new tourniquet that can be applied with only one hand.

Keeping breathing passages open and stemming blood loss have led to increases in survivability, Horoho said. Soldiers have given particular recognition to the new tourniquets.

"Almost every single one said it was either them placing the tourniquet on themselves or a battle buddy doing it for them which is what saved their lives," she said.

The Army is testing medical products such as Combat Gauze and WoundStat as additional methods of reducing blood loss. Training for Army medics also is contributing to the success rate of soldiers injured in battle, Horoho said.

Every platoon is assigned a combat medic, known as a 68W, who are trained to national standards that are augmented by advanced combat trauma training, she said. "That gives them an advanced skill set to make a difference in the lives of all warriors ... within that first ten minutes," she said.

The Army has worked to improve upon the civilian sector's concept of the "golden hour" of trauma care, where the best way to guarantee survivability is to get the most critical care to a patient within the first hour of an injury, the general said. The Army has recast that concept as the "platinum ten minutes," she said.

When soldiers return to the United States, they receive "level-4" medical care in hospitals like Walter Reed Army Medical Center in Washington, D.C. But following that care, they may move to one of 36 Warrior Transition Units across the United States, Horoho said.

It is in the WTUs that the Army has made great strides in assuring soldiers don't just "get well," but that they get their lives back on track – either transitioning successfully back into the Army, or moving back into the civilian world, according to Brig. Gen. Gary H. Cheek, the Army's assistant surgeon general for warrior care and transition.

There are more than 11,000 soldiers in Warrior Transition Units, Cheek said. "Each one is a soldier with a unique medical condition, with unique goals and aspirations," he said.

The Army has found success with those soldiers by assigning each a triad of care. That includes a squad leader, a nurse case manager to manage medical appointments and schedule medical care, and a primary care provider to oversee managing multiple medical conditions.

"That triad works with the soldier to optimize their medical care," Cheek said. "It's a great system we have set up and the Army has a lot to be proud of."

But Cheek also said the service has a way to go in the way it delivers care to soldiers, especially in making the process more predictable to soldiers and their families. "We can do that by improving performance in administration and making soldiers the centerpiece of this," he said.

(C. Todd Lopez works for the Army News Service).