ARLINGTON, Va. -- About this time last year, I deployed to Afghanistan as the surgeon general for U.S. Forces Afghanistan and the medical advisor for the International Security Assistance Force Joint Command. I oversaw the health care of the U.S. forces there as well as the forces from the 50 NATO coalition nations.
I had the privilege to see firsthand the latest medical advances we have made in Afghanistan, that help us save more lives and return more service members to duty, and ultimately to their families.
These improvements to our already incredible lifesaving practices have the potential to reach beyond our combat zones and into the streets of the United States. We have further medical advances on the horizon that give us great hope. Here are just a few examples of what we are doing now, and what we hope to do in the future:
We have deployed the largest number of Army, Air Force and NATO coalition aeromedical evacuation units in the history of warfare. As a result, it takes us less than 60 minutes for a medical team to fly out to wounded service members in combat zones and bring them back to a trauma treatment facility.
We have recently added four major improvements to this already unheard-of level of performance, including training all flight medics to become fully qualified paramedics; administering blood transfusions in flight to replace lost blood before surgery; flying critical care nurses to the battlefield to treat wounded service members and accompany them en route to treatment; and creating our version of the British Medical Emergency Response Team -- three to four person medical teams that include an ER physician to provide emergency treatment in flight.
These enhancements allow us to send the right capability for the right injury at the right time so we can save more lives.
Concussion Care Centers in Theater
Another advancement we have made to our medical care in Afghanistan is the creation of concussion care centers to treat mild traumatic brain injuries.
In the past, service members with concussions were evacuated to our medical center in Landstuhl, Germany. However, our understanding of brain injury and recovery has increased, prompting us to create 11 concussion care centers in Afghanistan, where service members can receive testing, meals, counseling, and perhaps most importantly, a quiet place to sleep and relax so that their brains can recover after a concussion. At least 96 percent of service members who are treated at these centers end up returning to duty.
Ketamine is a well-known anesthetic agent that markedly decreases the amount of morphine needed to control pain, and its amnestic properties erase the memory of the pain of a traumatic event. It is already used at some of our medical treatment facilities, but we are now developing a method for using it in theater. Soon, field medics will be able to give ketamine to trauma casualties using a specially designed applicator.
Researchers believe that one of the causes of post-traumatic stress disorder is a pain-induced imprint of the traumatic event; if we eliminate the pain and the memory of the event, perhaps we can prevent the development of PTSD.
Tranexamic acid is a medication that prevents or controls bleeding and has been used in surgery for several years. As with ketamine, we hope to be able to use this medication on the battlefield. It can significantly reduce bleeding if administered in the first three hours after an injury.
Freeze Dried Plasma
Developed by the United States during World War II, freeze dried plasma has since fallen out of use.
However, the French Armed Forces still uses it extensively. We see tremendous potential for this product and are conducting clinical trials of two dried plasma products under the auspices of the Food and Drug Administration and the Army’s Medical Research and Materiel Command. Hopefully we will soon be able to add this to the life-saving medications currently available on our aircrafts and ambulances.
The transition from purely military use of these medical advances to civilian use happens even more quickly than ever nowadays. I believe that several of our military medical initiatives have the potential to save lives in our cities and towns just as they do in the dusty villages of Afghanistan.
I hope everyone recognizes the tremendous work that goes on daily in Afghanistan and around the world by the dedicated health care personnel of the Military Health System. I am honored to have had the opportunity to be a part of health care in Afghanistan and will continue to work on joint global initiatives to advance medical care in the military and beyond.
Three cheers, and as we say in the Army medical department, “Serving to Heal … Honored to Serve!”
Brig. Gen. Norvell Coots, Army Assistant Surgeon for Force Projection
Editor's note: This article was posted Oct. 7 on the health.mil website.