Thursday, December 17, 2009

Medevacs for troops get faster in Afghanistan

By Gregg Zoroya, USA TODAY

During the past year, the U.S. military reduced from 100 to 42 minutes the average time it takes for a badly wounded servicemember in Afghanistan to reach a hospital, even as the casualty rate tripled, according to military commanders.

Five new field hospitals were constructed to reduce flight distances, and the number of medical evacuation helicopters was tripled to 36 from 12, says Air Force Col. Warren Dorlac and Army Lt. Col. Kyle Burrow, who supervise medevac duties in Afghanistan.

Last January, Defense Secretary Robert Gates called for improved medevac times in Afghanistan. He complained before Congress that the standard in Iraq was to deliver a wounded soldier within an hour and this was not close to being matched in Afghanistan.

"The secretary didn't understand and wasn't willing to accept there being two different standards for those two theaters," says Pentagon spokesman Geoff Morrell. "To him, it just made no sense."

Although improved survival rates are the goal of faster patient delivery, field commanders are still calculating whether quicker times have saved lives, says Marine Corps Lt. Col. Joseph Kloppel, a spokesman for U.S. Central Command. A complicating factor, he says, is that survival is determined largely by wound severity, regardless of the travel time.

The military's leading medical advisory panel, the Defense Health Board, noted in August that most of the preventable combat deaths in Iraq and Afghanistan are servicemembers who bled to death, in many cases before reaching surgery.

Currently, 96% of wounded in Afghanistan survive wounds, compared with 95% in Iraq. The average medevac times for urgent cases in Iraq is 55 minutes, Kloppel says. So far, 855 U.S. troops have died serving in or near Afghanistan, according to the Pentagon, and more than 4,600 have been wounded.

President Obama is sending 30,000 additional U.S. servicemembers to Afghanistan, raising troop levels there to about 100,000 by summer. Kloppel says medevac resources will be added to meet the increased need.

The improved medical evacuation rates pertain only to the most dire wound or injury cases requiring "emergency, short-notice evacuation to save life, limb or eyesight, or to prevent complications that could lead to more serious illness or permanent disability," says Air Force Maj. John Redfield, a Central Command spokesman.

These "urgent" cases account for 5% of all medical evacuation missions, Redfield says. The vast majority of medevac missions are for transporting between facilities patients who are in better condition.

January was among the lightest casualty months of 2009, with only 37 urgent-care medical evacuation missions. And yet three out of four of those missions took well over a hour, according to statistics provided by U.S. Central Command. The average time was more than 1½ hours, statistics show.

By November, that average time had been cut to 42 minutes. During the busiest casualty months of July and August, with dozens of medical evacuations, more than 80% finished in less than an hour, the numbers show. As of last month, 90% finished in less than an hour.

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