August 1,
2008: Technology, and the war in Iraq,
have combined to create some major advances in emergency medicine. In the past,
troops would often die from loss of blood before a surgeon could get in there
to stop the bleeding. Two new technologies have been developed, and used
heavily, that have sharply reduced the number of troops bleeding to death from
combat wounds (which are often multiple and massive).
Over the
last five years, the U.S. military has received clotting bandages (to stop
heavy bleeding) and granular substances that have the same effect. This was
a major medical advance to come out of
the war effort. But, competition being what it is, there were three clotting
products, each operating a little differently.
Over 95
percent of the time, these clotting devices stop bleeding, especially in areas
where a tourniquet could not be applied. While medics, and troops, prefer the bandage type device, there are
situations where the fine granular substance is a better solution (especially
in the hands of a medic).
In the
first two years of use, over 250,000 of these bandages were obtained for
military needs. This was to make sure everyone in a combat zone had one at all
times. While there are not a lot of casualties in base areas, the occasional
rocket or mortar shell is likely to cause the kinds of wounds where these
bandages can be a lifesaver. So it was a morale boost if everyone could carry
one around (a small first aid kit is a standard part of combat equipment).
Following
the introduction of the clotting devices, there were more cases of wounded
troops getting to a hospital alive, but in need of massive transfusions to
replace lost blood. This led to the development of new, and much improved,
techniques for getting a lot of blood into a patient who needed that done, and
done as quickly as possible without inducing shock or death from blood loss.
The new procedures involved some use of the new clotting agents, but was mainly
about adjusting the amount of saline solution used along with the blood, and
tweaking the overall procedure. This was possible because there were so many
such cases encountered in Iraq to try new techniques on. These were often
situations where you had no choice but to try something new. The new techniques
have reduced bleeding fatalities by over 75 percent, and are one of the reasons
why combat deaths are less than a third of what they were in Vietnam and
previous wars.