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Medical Corps brings advanced care to front line
By YAAKOV LAPPIN
12/26/2012
As part of preparations for multi-arena conflict, IDF Medical Corps has drawn lessons from US techniques.
 
Soldiers carried a badly wounded soldier on a stretcher to a field hospital, where a senior doctor and advanced medical equipment were waiting.

“He lost his leg in an IED attack. We’re stemming the bleeding and providing him with an infusion plasma,” a source explained, as the medical staff ran through the motions.

It was only a drill, carried out by the IDF Medical Corps at its headquarters in Tzrifin on Wednesday, but the exercise revealed some major changes washing over the organization as it prepares itself for a multi-front conflict.

The reforms, many of them informed by improvements in US military battlefield care, are centered on the placing of top surgeons and doctors – some of whom head hospital departments in civilian life – together with medics, and advanced medical equipment, right near the front line of a battle.

This, the IDF says, will maximize the chances of survival for badly wounded soldiers, who would otherwise likely die en route to hospitals.

The idea of replacing evacuations with state-of-the-art medical treatment on the scene has also seen the IDF become the first military to offer out-of-hospital plasma transfusions to soldiers suffering from heavy bleeding.

The drill reflected the fact that the IDF has been facing more powerful explosives along the Gaza border in recent months.

“We’re seeing more and more limbs being lost,” the medical corps source said.

Chief Medical Officer Brig.- Gen. Dr. Yitzhak Kreiss said the new frontline medical presence would be made up of two levels. “First, there will be a Medical Company, providing advanced intensive care,” he explained. “The company must be placed in a forward position.”

Backing up the medical company is a team of surgeons, who will set up a mobile surgery unit and carry out complex treatment alongside the intensive care unit.

“They have to be set up close enough to the battlefield, but not so close that they won’t be able to work,” Kreiss said.

In the drill, surgeons performed stomach surgery on a paratrooper who was badly wounded by an explosive attack. “He would not have lived through an evacuation to hospital,” Kreiss explained.

Going forward, ordinary combat soldiers will receive a first aid kit complete with arterial tourniquets to stem bleeding and ballistic glasses to protect eyes from shrapnel.

“We’re turning the soldiers into combat life-savers,” the source said.

Unit medics will be equipped with a blood clotting drug, a finger oxygen monitor measuring both pulse and blood oxygen levels, and dried plasma packs for transfusion – an improvement on the older salt and water transfusions carried out in the field.

Medics will also have candies packed with the powerful anti-pain compound, pentamine.

Serious bleeding causes some 80 percent of battlefield casualties among cases of preventable deaths, research has found.

The medical corps is studying the success of US military medical care, which has managed to bring down the casualty rate among injured soldiers to single-digit figures. Currently, the IDF loses some 15% of critically injured soldiers, most of them soon after the wounds are suffered, while the US Army Rangers have brought down their casualty rates to between 6% and 7%.

“We went to the Americans and asked them, ‘How did you do this?’” the source said.

The answer helped shape reforms in the medical corps’ capabilities in the fields of trauma care, tactical medicine (involving the training of doctors to use radios and deploy to the correct locations), ballistic protection for soldiers, and evacuations.

The IDF has recently signed an agreement with the British Army to share information on treatment of shock injuries, an area in which the UK has made progress due to its battlefield experience in Afghanistan.

As part of the changes, by next year, every combat battalion will have its own in-house doctor.
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