Military medical care and lessons for the home front

AMA Leader Commentary. By William G. Plested III, MD, March 19, 2007.

AMA LEADER COMMENTARY

A few words about current events in medical practice

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A message to all physicians from AMA President William G. Plested III, MD.

I have just returned from an outstanding trip and am anxious to share my experiences with you. Gerald Harmon, MD, soon to be installed as the president of the South Carolina Medical Assn. in addition to running a busy private practice, is also a major general in the U.S. Air National Guard. He serves as assistant to the surgeon general of the Air Force and is his principal adviser on Air National Guard medical service matters.

One of the critical assignments of the guard is aeromedical evacuation of injured patients. Improved combat casualty treatment represents a remarkable achievement for today's Army, Navy and Air Force medical services. Because of planning, training and outstanding coordination, today's service physicians and medical teams have recorded the lowest lethality rates in the history of armed conflict. In World War II the lethality rate was 30%; in Viet Nam, 24%. But in the Iraq war, the rate is currently 9%.

This dramatic reduction in lethality rates is a combination of a number of factors that J. Edward Hill, MD, immediate past president of the AMA, and I had the opportunity to review on a visit to Ramstein Air Base, Landstuhl Regional Medical Center and Spangdahlem Air Base, all located in Germany. At each facility, we had thorough presentations about their specific mission and contribution to the continuity of care that is given to our sick and wounded soldiers.

That care begins with first aid measures that are self-administered or administered by a buddy or medic. Airway maintenance and control of hemorrhage are the immediate goals. First aid is followed by immediate transfer by ground or helicopter to a forward surgical facility. Here, as throughout, the speed of intervention is paramount.