Military Medicine: How Far Can We Go?

U.S. Troops Armed with the Latest Lifesaving Medical Breakthroughs

From the WebMD Archives

April 4, 2003 -- Military medicine -- it's not what it used to be. Armed with some of the latest medical products and equipment, U.S. medics are profoundly impacting survival of servicemen and women injured on the battlefield.

A substance that stops blood loss, a one-handed tourniquet, and bandages that speed healing are just some of the breakthroughs in military medicine that have made their way to the front lines.

"Technology has proven itself so well in the laboratory and the operating rooms in the U.S., that [the military] has gone to extraordinary lengths to make them available to our soldiers in the field," Col. Clifford Cloonan, MD, interim chair of the department of military and emergency medicine at the F. Edward Herbert School of Medicine, Uniformed Services University of the Health Sciences in Bethesda, Md., tells WebMD.

Saving Lives on the Front Lines

Since the Civil War, the leading cause of death on the battlefield has been due to blood loss. Now, pioneering breakthroughs in military medicine are changing history. "The overwhelming majority of deaths occur before the wounded reach the hospital," says Cloonan. "If we're going to affect battlefield casualties, we have to do it before the hospital." And that means getting lifesaving tools into the hands of medics and armed forces.

One revolutionary product that is helping soldiers and marines stay alive is a substance that when poured into a wound rapidly stops bleeding. Called QuikClot, the granular product -- with a texture like kosher salt -- can be easily applied by a medic or serviceman or woman before transport to a medical facility. The small packets can be quickly opened and self-applied with one hand.

Another device -- and one that is widely available to U.S. troops, is the one-handed tourniquet. Operated with a ratchet mechanism, the cinch-type device stops bleeding from an extremity without help from a medic or buddy. And it's simple to use. A soldier takes it out of the bag, slips the arm through it, and pulls. "It's new, it's valuable, and it works," says Cloonan. Until now, tourniquets were often not very effective at stopping all bleeding, nor could an individual soldier, sailor, or airman apply them with one hand -- a great advance in military medicine.

Another new entry into military medicine is a "natural" bandage that stops bleeding immediately and never has to be removed. Easy to apply, the blood-clotting agent in the mesh-like material forms a scab or sealant over the wound, and then promotes healing. Later, the body safely absorbs the material.

Although the bandages have never before been used on humans, military officials requested that they be provided to special operations troops, and the FDA has given its stamp of approval. Tests on animals have shown the bandages to be safe, and cut blood loss up to 85%.

On the Home Front

These medical breakthroughs actually began as theories in U.S. laboratories, hospitals, and universities. But soon, these extraordinary products will be used to treat minor wounds as well as battlefield wounds, and be available on the home front as well as in military medicine.

For example, the "natural" fiber bandage has been approved for use in the operating room and is in use right now, according to Cloonan. "The military has taken a capability that exists in the U.S. and is applying it to soldiers on the battlefield," he says. "Eventually, [the bandages] will make their way into pre-hospital trauma care and emergency departments in the U.S."

In addition, the QuikClot product is already making its debut across the U.S. in the law enforcement and emergency medical services markets, and this fall will appear on the shelves of 20,000 pharmacies from coast to coast. "This is truly a major advance in caring for wounded soldiers," Bart Gullong, executive vice president of Z-Medica, manufacturer of QuikClot, tells WebMD. "And it's not just for the military," he adds. "The impact of QuikClot in the hands of average, everyday people will be even more significant than in the hands of warriors."

Military Medicine Suites and Combat Suits

One of the major medical advances in military medicine is the portable hospital that can be a lifesaving haven for injured servicemen and women. "If soldiers can reach the hospital, the chances of surviving are about 97%," says Cloonan.

These mobile medical tents are fully equipped to provide medical care and surgical services, and can be moved to a new site within a few hours to be available near the front lines.

"When you're with a unit that's moving 100 miles a day, if you stop and set up, the next day the troops will be 100 miles from you," Cloonan explains. "So we have to rely on very lightweight, very portable surgical facilities."

Outfitted with operating tables, computers, and state-of-the-art diagnostic equipment, the facilities are staffed by a full operating team of surgeons and nurse anesthetists that can provide medical care where needed and keep up with the troops as they move.

Called Forward Resuscitative Surgical Systems, the moveable operating suites can provide 18 surgeries without being restocked. "It's an operating room in a box with sides that pop out," says Cloonan. "It's temperature controlled, with heating and cooling units, lighting, and flooring. If you went inside, it wouldn't look much different than you'd see in any major hospital."

The goal of the unit is to reach wounded soldiers in the "golden hour" of trauma or within one hour of injury. Some units are equipped with computers linked to satellites to the U.S. so that digital pictures can be transmitted back and forth.

In all these ways, the military continues to work to protect U.S. troops, says Cloonan. "We have invested a tremendous amount of money in the development of protective items and technologies simple enough to be used by soldiers at or near the point of wounding."

Peter Safer, MD, distinguished professor of resuscitation medicine at the University of Pittsburgh, agrees in theory. "Saving the lives of injured soldiers has always been the key principle of military medicine," he says. "But beyond this concept, advances in research, technology, and medicine will continue to enhance the ways that medics care for men and women wounded in combat."

Show Sources

SOURCES: Col. Clifford Cloonan, MD, fellow of the College of Emergency Physicians, interim chairman, department of military and emergency medicine, F. Edward Herbert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Md. Bart Gullong, executive vice president, Z-Medica. Peter Safer, MD, distinguished professor of resuscitation medicine, Safer Center for Resuscitation Research, University of Pittsburgh.
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