Posted: April 5, 2017 2:58 PM

Innovative Response, New Technologies Will Be Key to Survivability in Future Combat

By EVAMARIE SOCHA, Seapower Special Correspondent

NATIONAL HARBOR, Md. — Military medicine is beaming with an all-time high 97 percent combat survival rate. But future conditions likely will make for a battle theater that calls for innovative response using technology and medicine in new ways and unusual settings, according to Navy and Marine medical officers who spoke April 5 during the “Human Factors: How to Improve Combat Survivability” panel at the Sea-Air-Space Exposition.

Training enlisted and commissioned personnel — from corpsmen to doctors to expeditionary care — is the most important goal, they said.  

The panelists spoke of the latest advancements, training and research that will lead the service to care for the wounded in a future theater that likely is not to be as accommodating as the latest American forces faced over the past 15 years.

Immediate casualty recovery, damage control surgery in the “golden hour” right after injury, an abundance of air medical evacuation and well-trained medical corpsmen and staff all played into that record survival rate, said Navy Surgeon General Vice Adm. C. Forrest Faison III. But situations also never overwhelmed staff or supplies to make triage necessary.

“It’s evident we may not have that advantage in the future,” he said.

To that end, Navy medicine will focus on training and preparation of medical readiness for personnel and equipment, he said. For instance, Faison called the hospital corpsman the most important person in the field, but most do not get their first real patients until active duty, having trained on simulators and in controlled environments.

Programs now exist with Los Angeles County and Cook County in Chicago, for instance, where the corpsman work in emergency rooms to treat patients with invasive injuries, such as from vehicle accidents or gunfire, as they’d see in battle.

Getting these patients stabilized, treated and either home or to more care translates into the valued agility that translates to combat survival, Faison said.

From the water, the last 25 years have seen power projected from the sea, said Rear Adm. Cathal O’Connor, commander of Expeditionary Strike Group Three.

“The evidence is clear this is a time of great power competition,” he said, and with the number of missions today, strike group ships are everywhere.

Therefore, a need exists to enhance surgical response aboard. Casualties affect ship operations, and keeping operations flow while responding to wounded is critical, he said, making surgical suite tactical training an important part of future medicine.

Rear Adm. Tina Davidson agreed.

“Navy medicine is out there imbedded with the fleet,” said the director of medical resources, plans and policy. The best lessons they learn come from real-life events.

Rear Adm. Stephen Pachuta, director of health services for the Marine Corps, said he sees a need for more surgical medicine on shore, and field medical training battalions are at work on this, especially for that all-important corpsman training.

Transporting and using real blood are among advancements, he said. It’s complicated because blood must be kept cold and can be heavy, be using it to resuscitate in the field is optimal. Finding ways to do that are among innovations he seeks.

Another one is using drones to deliver automated care to field wounded or even transporting them out.

“Those innovations will drive the survival rate in the future,” Pachuta said.

Speaking to the research and development to make all these goals possible, Rear Adm. Colin Chinn, director of research, development and acquisition for the Defense Health Agency (DHA), talked about some projects under his agency’s preview.

DHA, which came to be in 2013, operates with a research, development, test and evaluation budget of about $2 billion, the bulk of which goes to basic and applied sciences. Advanced trauma training technologies, using simulations and virtual reality, aid in readiness, he said.

About 90 percent of preventable death, injury or trauma comes from controlling hemorrhage, for instance. So blood products, hemorrhage containment, pain management and wound infection are of interest.

Major hemorrhage in the upper chest, abdomen or pelvis are especially dangerous; expandable injected foams to stop that bleeding while the patient is transported to care is among possible and promising technologies, Chinn said. So are advances in patient movement and en-route care.

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