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Medical Corps training, improved technologies saved lives in Gaza
By JUDY SIEGEL-ITZKOVICH
08/20/2014
DF surgeon-general Brig.- Gen. Prof. Yitzhak Kreiss disclosed the innovations on Tuesday at the one-day annual Israel Medical Conference in Jerusalem.
 
Many soldiers’ lives were saved and suffering reduced by new technologies used on the battlefield – from freeze-dried plasma reconstituted with water, self-applied tourniquets and pain-relieving lollipops.

IDF surgeon-general Brig.- Gen. Prof. Yitzhak Kreiss and one of his staff doctors disclosed the innovations on Tuesday at the one-day annual Israel Medical Conference organized by the Hadassah Medical Organization held in Jerusalem.

Attended by some 1,000 members of the general public, other sponsors included the capital’s Shaare Zedek Medical Center, Haifa’s Bnei Zion Medical Center, the International Fellowship of Christians and Jews and others.

Kreiss, who is due to leave the IDF next year, said that three years ago his office introduced a program called Shomer Ahi (My Brother’s Keeper) to reduce deaths on the battlefield and which was fully implemented in Operation Protective Edge.

“We didn’t know we were going into this operation, but we were ready. It wasn’t an easy battle, with 64 fighters dead and hundreds wounded. It will take months to analyze the results of the project to save lives and minimize injuries,” he said.

A major difference between the current military operation and previous ones in Gaza and other battlefields was that IDF doctors and paramedics were on the scene within seconds or minutes to treat the wounded, instead of lesser-trained medics.

In addition, all soldiers on the front were supplied with special tourniquets that can be applied by a wounded-but-conscious soldier immediately after an incident, to reduce or halt the amount of bleeding. All regular and reserve soldiers in battle were supplied with personal tourniquets, Kreiss said.

The IDF learned from other armies abroad and civilian medical institutions how to improve treatment of the wounded, he continued. In Operation Protective Edge, the IDF was the first army in the world to use freeze-dried plasma to improve the chances of survival of soldiers wounded in battle.

There was access to hemostatic dressings to stop arterial bleeding too, and reduce bleeding from deep, penetrating injuries, bullet wounds and lacerations.

When medics were not immediately available, wounded fighters’ fellow soldiers had been trained to use lifesaving equipment on the spot, said Kreiss. He commended the selected hospitals around the country who performed excellently in treating the wounded.

Capt. Dr. Sammy Gendler of the IDF Medical Corps, said that many battlefield deaths could be prevented if treated immediately.

If there were direct hits, wounds to major blood vessels and significant head injuries that could not be operated on in the field, a soldier must be evacuated speedily to a hospital.

But casualties with compressible (i.e. pressure of the hand) and even non-compressible wounds could be saved with the proper care during the fighting, he said.

Gendler said that one-quarter to one-third of battle injured could be saved. He added that usually, those who don’t survive, die immediately or within the first hour after being wounded.

“If they are still alive two hours later, they will probably survive.

In Israel’s previous wars, most died within minutes, up to an hour.”

Plasma used on the battlefield used to be frozen and difficult to use; freeze-drying makes it as simple as mixing a cold drink.

The original blood is collected from large numbers of healthy soldiers, checked more than once for infectious disease and then freeze-dried and packed.

“During the Gaza operation, we used it on over 150 wounded soldiers.”

In addition to giving fighters self-applied tourniquets, instant plasma, speedy evacuation and better preventive equipment saved lives, he said.

It is vital to relieve the pain of wounded soldiers, not only to prevent post-traumatic stress disorder and chronic pain later but to improve recovery from physical wounds, said Gendler.

Thus candy on a stick containing fentanyl – a potent, synthetic opioid analgesic with a rapid onset and short duration of action, was given to all conscious wounded soldiers even before they were evacuated, the captain explained. “They are as good as injected morphine,” though much easier to use.

Among the gear were Smith goggles to cover the eyes and prevent shrapnel injuries.

“There were goggles before but they were hard to use, so many soldiers didn’t use them.

The new type looks good – even sexy – so they are willing to wear them. In addition, there are lighter helmets so they are not a burden on the heads of soldiers,” Gendler said. In the future, the IDF hopes to develop light helmets that protect against shrapnel and bullets.

Another technology being tested on pigs is foam to stem the bleeding of internal wounds. In the future, electric currents could be used to stop hemorrhaging and even synthetic blood could be developed, he said.

Another possibility to reduce deaths was preconditioning soldiers before being wounded. It has been shown in heart surgery that stopping the oxygen supply momentarily can make the heart used to ischemia so it can survive the lack of oxygen.

“It works on pigs; someday, maybe in a decade, it could be used on soldiers going to battle,” suggested Gendler.

The medical conference was the first to be held after the Hadassah Medical Organization’s deep financial crisis. Acting director-general Prof. Tamar Peretz-Yablonski said that stages of its painful recovery program were proceeding.

A full feature on the conference will appear on August 31.
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