by James Glaser
November 16, 2005

Think about being in combat and your unit is hit, and you come upon a comrade who has been seriously wounded. What would you do for a sucking chest wound? Every time the wounded soldier tries to breath, his chest cavity fills with air through his wound and soon his lungs can't inflate, because that wound becomes a one way valve allowing air into the chest cavity. You need to get that pressure off, but how? Today, Army medics and Marine corpsman have a 14-gauge needle that they can push into that wounded soldier's thorax, and that allows the air in the chest cavity to escape, which allows the lungs to inflate. This field procedure gives the wounded trooper and the military medical doctors time, and when a trooper is wounded, buying time to get him or her to a field hospital is the number one priority.

Today in Iraq, the survival rate for wounded troops is at 90%. In the first Gulf War it was 80%. The care given by medics and corpsman immediately after a soldier is wounded has changed and that has saved many lives. In a report by Tom Philpott, for the Stars and Stripes Pacific Edition, that better medical training plus, "Better body armor, forward-deployed surgical teams, and swift medical evacuations are factors that have raised the survival rate."

The three worst things that can happen to a body-armored soldier who is wounded are blood loss from damaged limbs, sucking chest wounds, and restricted airways.

It has been found in Iraq that a tourniquet works well to stop the bleeding. In the past a tourniquet almost always meant amputation of the limb it was used on, but now combat surgeons are finding that stopping that blood flow from the limb is most important, and many lives are saved with their use.

When a soldier goes into shock after being wounded, his muscles can relax and his tongue may roll back to block his throat. Today's combat corpsman carries with him a soft rubber tube that he can insert in the wounded soldiers nose, and that tube will slide past the back of the tongue so that an air passage opens to the lungs. It is just in the last few years that the military has trained medics and corpsman to do this, and it has saved many lives.

Philpott's Stars and Stripes report states that 6% of the troops wounded in Iraq have lost a limb. With 15,500 wounded so far, that works out to 930 soldiers or Marines losing a limb or limbs. That 6 % figure is twice the rate of past wars and the increased number of lives saved contributes to that figure, and the fact that body armor leaves the limbs unprotected does too.

Without the advances in combat medical training and improved trauma care, the number of combat deaths (currently at 2,068) would be much higher. The large increase in limbs lost reflects the trade off in these life saving measures.