Speed, technology have reduced mortality among U.S. troops

I found an article on Yahoo! that discusses how technological advances are helping to save the lives of wounded US troops. I found it interesting, but it does make me wonder. How many more soldiers are coming back as amputees than in prior wars.

That is, in the past if a soldier lost an arm/leg in the field they frequently died as a result of their wounds. Now we are able to save many of them. I wonder what the percentages look like.

Speed, technology and advancements in armor have made the battlefield in Iraq one of the most survivable in the history of warfare:

- A new blood-clotting powder for major bleeds has proved so effective that it's being issued for medical kits.

- U.S. forces in the field are heavily populated with combat lifesavers, soldiers with training comparable to emergency paramedics back home.

- A fleet of aircraft - including helicopters and cargo planes - is on call to rush casualties to medical care.

- Physicians with advanced skills, such as neurosurgery and cardiology, practice in field hospitals.

- In extreme cases, patients are flown to the storied military medical center in Landstuhl, Germany, within hours of their injuries, in airborne intensive-care units.

After two years, the U.S. death toll is rising toward 1,700, far lower than the 3,000-plus deaths estimated for the initial invasion.

Body armor saves lives, but explosions still leave hideous injuries.

Army Maj. Kendra Whyatt of Greenwood, Miss., sees the devastation of improvised bombs and blasts, the amputations of mangled limbs.

"We are a living, true testament that our soldiers are still in harm's way," said Whyatt, a veteran of Desert Storm, the 1991 U.S.-led offensive against Iraq. "The war is over but the battle continues."

"This kind of stuff is new to this war," Maj. Charles Campbell of San Antonio said of the medical advances. "The most significant improvement is the critical specialists close to the battlefield."

Campbell is an Air Force cardiologist who often practices his craft in the cold, noisy belly of a C-141 that's racing to Landstuhl from Camp Anaconda at two-thirds the speed of sound.

When fighting is fierce, helicopters hover over Anaconda's tent hospital, waiting to discharge their casualties, then hastening off for more.

"We're in the middle of 16 emergencies and our radiology equipment is busted," Lt. Col. Marilyn Arnold said by way of introduction. "It's a typical hospital."

Typical perhaps in its unpredictability, but atypical in most other respects.

Situated in this desert garrison of 23,000, about 60 miles north of Baghdad, Anaconda's hospital is 60,000 square feet of modern medical care dressed in tan canvas.

It has intensive care units, three operating rooms, two CT scanners, recovery wards and a chapel.

Specialties include neurosurgery, urology, psychiatry. A dozen operations a day is routine. A baby has even been delivered here.

Anaconda is also the main center for transfer to Germany. The staff here treats U.S. troops and contractors, Iraqi military and Iraqi citizens caught up in the nation's violent spiral.

"World-class medicine is being practiced here," Arnold said. "Just last night they hooked someone up to a machine that's not even approved for use in the U.S.

"He's still alive this morning."

The feet of the soldier - the victim of a bomb - already had been amputated, and he lay unconscious amid a retinue of specialists. The concussion bruised his lungs, which were bleeding into themselves, making respiration all but impossible.

As he was deemed too unstable to fly to Landstuhl, Landstuhl came to him.

A medical team flew in with a German invention called a Novalung, which takes blood from the leg artery, oxygenates it and returns it to the circulatory system, breathing for the patient without using the lungs.

"Thirty-six hours after he was injured, we were putting the lung in," said Lt. Col Mark Ivey of Grand Haven, Mich., a doctor with the Army National Guard.

The U.S FDA has given Landstuhl physicians conditional permission to use the Novalung in acute cases. It's a landmark moment in American medical history. No matter how it ends, the soldier's case will be written in medical journals.

"If something like this happened in the States, we couldn't offer it," said Col. Bedford Boylston, an Army reservist from Ashland, Ky., who teaches at Marshall University in Huntington, W.Va.

It's only the second time the device has been tried. Weeks earlier, a Marine who'd been wounded by a roadside bomb was struggling to breathe at Anaconda. Doctors at Landstuhl rushed the Novalung, the size of a small suitcase, to the Air Force, which put it aboard a massive C-17 cargo plane and flew it to Anaconda.

That flight cost tens of thousands of dollars.

That Marine lived.

"We will use every tool in the box for these guys," said Air Force Col. Russ Turner of Florence, Ala.

The commander of the Anaconda hospital said its level of skill was comparable to such medical centers as Johns Hopkins or Massachusetts General.

Former patients won't argue, especially the soldier who arrived with a piece of shrapnel lodged behind his heart, one of the hardest places to operate.

"This would be a fatal case in most hospitals in the United States. This would be a fatal injury almost anywhere else," Turner said.

"But they got the shrapnel out. And the soldier went home."

Body armor, with its woven super-fibers and ceramic plates, is Turner's ally in the field.

"Before, it used to be shrapnel that killed people," he said. "Now it's all orthopedic extremity injury. The vests: a very good investment."

Speed of evacuation also distinguishes military medicine in Iraq.

"These young men and women will get injured in Fallujah one day and be in Germany two days later," Turner said. "We can take people critically injured and get them to care. It's just amazing."

"What we've changed is what we're comfortable flying with," said Air Force Lt. Col. Kirk Milhoan, explaining how advances in technology allow critically ill patients to be airlifted to specialty care. Ventilators and other critical equipment are now compact enough to fly.

"This allows them to get to a clean hospital outside a tent, usually in 36 to 48 hours."

Modern lifesaving techniques have reduced mortality dramatically among U.S. troops in Iraq over previous wars.

WAR / KILLED IN ACTION / LETHALITY OF WOUNDS

Revolutionary War / 4,435 / 42 percent

Civil War (Union Force) / 140,414 / 33 percent

World War I / 53,402 / 21 percent

World War II / 291,557 / 30 percent

Korean War / 33,741 / 25 percent

Vietnam / 47,424 / 24 percent

Desert Storm / 147 / 24 percent

Operation Iraqi Freedom / 1,665 / 10 percent

Authoritative statistics on Confederate forces aren't available.

As of June 1; comprises killed in action, natural and accidental deaths.