An Assessment of the Potential for Reducing Future Combat Deaths through Medical Technologies and Training

Blood, Christopher G.; Puyana, Juan Carlos; Pitlyk, Paul J.; Hoyt, David B.; Bjerke, H. Scott; Fridman, Julia; Walker, G.; Zouris, James M.; Zhang, J.

doi:10.1097/00005373-200212000-00021

Cited by 27 publications

(8 citation statements)

References 8 publications

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“…(6) Of hospital deaths, 20% and 60% occurred within the first 2 and 12 hours respectively. (7) Deaths within the first 24 hours were overwhelmingly related to hemorrhage (87% of deaths), followed by sepsis and respiratory failure. (6, 8) While death from sepsis can occur quickly in unique patient populations including highly immunomodulated patients, neutropenic patients, and following splenenectomy, this study does state that sepsis deaths within the first 24 hours were in non-US civilians who had delayed hospital admission.…”

Section: Infection-related Mortalitymentioning

confidence: 99%

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Lessons of war

Blyth

Yun

Tribble³

et al. 2015

Journal of Trauma and Acute Care Surgery

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Summary In over a decade of war, numerous advancements have been made to improve overall combat-related mortality, but infectious complications remain a leading cause of both morbidity and mortality in combat-related injured personnel. Here we will attempt to compare the challenges and lessons of combat-related injuries and infections from the Vietnam War with those of OIF/OEF. Throughout the Vietnam War and OIF/OEF, there have been similar infection-related challenges faced in caring for combat-related trauma patients. Both conflicts reinforced the importance of rapid medical evacuation and definitive surgical management of war wounds. They revealed the constant evolution of infecting organisms and the challenge of increasing antimicrobial resistance. We have also seen that with decreased mortality of severely injured personnel new morbidities must be addressed. Using the foundation of fragmented research from the Vietnam War, previously successful models were assembled into joint service research institutions which have allowed these questions to be addressed. However, many questions regarding measures to reduce infectious complications in our combat-injured personnel remain unanswered. Continued research building on established knowledge is critical for continued improvements in the care of combat-related trauma patients.

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Section: Infection-related Mortalitymentioning

confidence: 99%

“…A retrospective review of 210 Vietnam casualties suffered by U.S. Marines revealed that 10 were related to “booby traps.”(7) The most frequently cited were punji sticks. These were sharpened bamboo sticks hidden with foliage.…”

Section: New Pathogens Associated With Various Mechanisms Of Injurymentioning

confidence: 99%

Lessons of war

Blyth

Yun

Tribble³

et al. 2015

Journal of Trauma and Acute Care Surgery

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“…Blood et al examined 210 in-hospital deaths in casualties who had sustained trauma in Vietnam and found eight of these fatalities (3.8%) were due to sepsis and judged that five of them would be preventable with modern therapies 1. Hodgetts et al examined all 76 operational deaths due to trauma in Iraq and Afghanistan over 1 year from 2006 to 2007 and did not find any deaths due to sepsis 2.…”

Section: Epidemiologymentioning

confidence: 99%

Sepsis management in the deployed field hospital

2013

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Sepsis, a syndrome caused by severe infection, affects a small proportion of military casualties but has a significant effect in increasing morbidity and mortality, including causing some preventable deaths. Casualties with abdominal trauma and those with significant tissue loss appear to be at a greater risk of sepsis. In this article, the diagnosis and management of sepsis in military casualties with reference to the Surviving Sepsis Campaign guidelines are examined. We discuss the management considerations specific to military casualties in the deployed setting and also discuss factors affecting evacuation by the UK Royal Air Force Critical Care Air Support Team.

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“…Retrospective studies of "preventable" deaths from both the Vietnam conflict and US Special forces deaths in the recent past [2,3] suggest a significant minority of around 4-6% of patients die from sepsis. The incidence of sepsis in other historical conflicts is not well defined [4], however there is some data from the more recent conflicts in Iraq and Afghanistan.…”

Section: Sepsis In Deployed Military Populationsmentioning

confidence: 99%

Focus on Sepsis and Intensive Care

Johnston

2009

J R Army Med Corps

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The Surviving Sepsis Campaign (SSC) Guidelines collate the evidence for managing sepsis. Most of the interventions suggested by the SSC guidelines are very relevant to military critical care, including rapid microbiologic investigation, early antibiotic administration and many aspects of early goal directed therapy. Other interventions may be more difficult to provide in remote theatres of operation where resources may be limited. This article discusses the application of the SSC guidelines to deployed military hospitals, with suggestions as to which interventions are feasible, and which may not be indicated.

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An Assessment of the Potential for Reducing Future Combat Deaths through Medical Technologies and Training

Cited by 27 publications

References 8 publications

Lessons of war

Lessons of war

Sepsis management in the deployed field hospital

Focus on Sepsis and Intensive Care

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