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Surgeon general: Improving medevac times requires balancing act

By C. Todd Lopez

WASHINGTON (Jan. 29, 2010) -- Speeding up critical medical-evacuation times in Iraq and Afghanistan must be balanced against flight crew safety, said the Army's surgeon general.

Lt. Gen. Eric B. Schoomaker, also commander of the U.S. Army Medical Command, spoke Thursday to an audience of military medical professionals during the 2010 Military Health Systems conference, about the challenge of decreasing medevac response times.

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"Where to put our helicopters and all the support crews and the aircraft they fly is really a delicate balancing act, because it balances the risk of putting care providers and medevac crews at risk to the enemy and to the elements and balances that with the risk of loss of life, limb or eyesight, if the evacuation is excessively prolonged," Schoomaker said.

Now, Schoomaker said, the Joint Theater Trauma Registry and the Joint Theater Trauma System are engaged in an analysis of medevac times.

"This is an effort to minimize the evacuation time for casualties in a highly dispersed force which is subjected in Afghanistan to what has been described as the 'tyranny of terrain and weather,'" he said.

Schoomaker said the only way to fully understand the risks is to know the outcomes of the care provided to those servicemembers assisted by medevac teams, and to know based on injury type.

"We are analyzing this by injury type, across a very wide range of missions," he said.

The general also said that improving combat care for servicemembers in the field involves improvements in equipment, like recent advances in the Improved First Aid Kit fielded to Soldiers -- which now includes the combat application tourniquet, for instance.

Also important is the development of new tactics, techniques and procedures for Soldiers -- that means the capture and dissemination of knowledge about practices in the field.

"The key to improving combat casualty care is the use of knowledge, which is derived from sound science and good data," he said. "Much of what we have done to improve outcomes hasn't been material products. They've been the way we've done things, rather than just the materials we've applied to them."

Schoomaker said Army medicine is involved in continues process improvement, even as combat wages on in both Iraq and Afghanistan.

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