Saving lives: simulations promise better training for combat medics.

• Author: Wagner, Breanne
• Position: TRAINING AND SIMULATIONS

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As improvised explosive devices continue to claim lives and maim troops, a new market has emerged for medical simulations to train combat medics.

"What's driving the need for training is the way we're fighting today," said retired Army Lt. Col. Nick Guerra, now deputy director and program manager at Computer Sciences Corp.

IED attacks are resulting in traumatic injuries that require more complex medical care than in previous wars. While more soldiers are surviving devastating attacks in Iraq and Afghanistan because they are equipped with heavier armor, they are also subject to more debilitating wounds such as multiple amputations and blindness, said Claudia Johnston, associate vice president at Texas A&M University at Corpus Christi, and creator of a Navy medical simulation project. Military armor vests protect the trunk of the body, leaving the head, legs and arms exposed. Soldiers are coping with "wound patterns we have not seen before," Johnston said.

Young medics and doctors who are unable to see and treat IED or blast-related wounds during traditional medical training face a steep and difficult learning curve in combat.

In the civilian world, doctors have the luxury of the "golden hour," which means it typically takes one hour from the time a patient calls 911 to the point of surgery. But in theater, medics have a shortened timeline for mitigating injuries. Since soldiers can be held in triage for up to 24 hours, what a medic does in the first 10 minutes is critical to the rate of survivability, Guerra asserted. Those minutes could delineate the difference between life and death, in large part because of the severity of IED wounds, he added.

"When there's an IED, there's always a concern about bleeding to death."

Guerra said that there have been cases of soldiers dying from non-lethal injuries because there wasn't enough emphasis on controlling bleeding. Traditional medical education concentrates first on clearing a patient's airway. But in combat, new lessons have been learned. "If the blood coagulation properties are not taken care of and the patient bleeds to death, the other parts don't really matter," he said.

Adding to the complexity of addressing traumatic wounds are the harsh conditions in theater. The emphasis today is on "care under fire," where medics have to defend against enemy fire before they can begin to treat the wounded, Guerra said. Hostile fire and inclement weather, such as high winds that...