thedrifter
10-01-06, 09:10 AM
Medical techniques keep soldiers in battle
The Norman Transcript
Editor’s notes: This is the first of a two part series. The second part will be published in Monday’s edition.
By Eric Reinagel
CNHI News Service
You hear the mortars going out, but you don’t know where they’ll land. This could be the last breath of your life.
Marine Lance Cpl. Bret McCauley of Kokomo, Ind., recalls crouching close to the ground, moving warily through a Sunni rebel neighborhood in Fallujah just before dusk.
He’d been in Iraq two weeks, he says, not enough time to fully absorb the treacherous uncertainty of the landscape and yet sufficient time to see the bloody reality of war.
It is March 26, 2004, and the sounds of combat are loud in McCauley’s ears as his infantry unit moves from house to house. Suddenly, a rocket-propelled grenade flies over his right shoulder, smashing into the building in front of him.
McCauley says he instinctively dived behind a cinder block structure cradling a propane tank and starts shooting at insurgents perched on a rooftop.
Before he can find a safer location, a bullet from an AK-47 rips through his left thigh. Then the gunfire stops.
“Who’s hit?” someone calls out. “Who’s hit?”
McCauley says he responds, “Dude, I’m hit!”
Blood drips from a jagged hole in his camouflage pants. He tries to get up but his left leg buckles. A corpsman tells him to stay down on the ground, and administers a shot of morphine.
McCauley says he is picked up and moved to a Humvee. The limp body of a fellow Marine who had bummed a cigarette only an hour earlier rests next to him. The Marine is dead, shot in the face, says McCauley, and “his blood covers me.”
They know where we are. This is where I’ll die. Not in this place. Not in this stinking place.
But the 23-year-old McCauley won’t die. The efficiency of modern military medicine whisks him off to a field hospital in Fallujah. Within minutes, doctors clean, medicate and suture his thigh injury and tell him he’s among the lucky. He’s suffered a flesh wound.
The doctors explain they can helicopter him to the main combat hospital in Baghdad for air transfer to the regional military hospital in Landstuhl, Germany, and more medical attention — if that’s what he wants. He will then return home to the United States within a day or two.
Or he can stay and rejoin his 1st Marine Division infantry unit in Fallujah when he’s feeling up to it. The choice is his. He will get a Purple Heart either way.
McCauley, who enlisted in the Marine Corps before graduating from Kokomo’s Taylor High School in 2001, elects to remain in the war zone. Marines are trained to be tough, he says, and you do your job just as long as you are able to do it.
McCauley thus becomes one of the 10,600-plus American soldiers in Iraq who have suffered injuries and yet were able to return to combat since the U.S. invasion in March of 2003.
“I just got here,” he recalls saying. “I watched my friend get killed. I’m not going to go home. I’m out for blood.”
His next encounter with the wounds of war will not be so fortunate. But McCauley says the swift, expert medical treatment he received for the bullet through his thigh was an example of the military’s new techniques for treating battlefield injuries.
There’s nothing to do but lay in bed, listen to Blink 182 on my Walkman and eat canned sardines and oysters sent in CARE packages.
Sgt. Maj. David Cahill, a Vietnam War medic and now an official at the U.S. Army Medical Center and School at Fort Sam Houston, Texas, says the military is returning more wounded soldiers to combat and saving more lives because of improved medical knowledge and faster response.
There are, he said, three primary causes for death in the first 10 minutes of a battlefield injury: bleeding, obstructed airways and collapsed lungs. He said the military teaches trauma skills to first responders so they can treat these conditions rapidly and effectively.
Combat medical packs, for example, contain special tourniquets and emergency trauma bandages with elastic pressure tails to stop external bleeding. They also carry a dressing called QuickClot that instantly stops the flow of blood, and a 14-gauge needle to open a two-way flow of air to the lungs.
That’s in addition to morphine, oxygen, IV lines and high-tech digital instruments that measure heart rate, blood pressure, respiration and other telltale signs of life or death. Some medics even carry portable heart-lung machines to supply oxygen.
“Simple little things,” said Maj. Gen. George W. Weightman, a medical doctor and the center’s commander. “But they address 90 percent of all the reasons people die in those first 10 minutes.”
Lifesaving statistics tell the story. Medical improvements have reduced to less than 10 percent the number of wounded American troops in Iraq who do not survive, according to the Pentagon.
That’s the best survival rate of any U.S. war. In the Gulf War, 22 percent of injured U.S. soldiers died. The rate was 24 percent in the Vietnam War, and 30 percent during the Korean War and World War II.
Weightman, Cahill and others credit advances in combat casualty care to superior medical research, technology and training by the military. These factors, they said, have led to corpsmen, medics, nurses, doctors and the soldiers themselves providing critical medical assistance far forward on the battlefield.
Iraq’s compact geography and flat landscape also help. Rapid-response medevac crews can land by helicopter almost anywhere, lifting injured soldiers to one of four strategically located combat hospitals in less than an hour. The severely wounded are transferred to Germany for further treatment before they are sent to the Army’s Walter Reed Hospital in Washington, D.C., or the Naval Hospital in Bethesda, Md.
Pentagon medical officials said it can take as few as 36 hours to move an injured soldier from the battleground to a hospital bed in the United States, a speed unheard of in previous wars.
“Primary medical training during Vietnam was what we called sticks and rags,” said Cahill. “You put on a bandage or an IV. It wasn’t any advance trauma. The training we give now is more directed at trauma.”
Like a mosquito or fly that won’t go away, mortars fall again. Somewhere they are being launched. Somewhere they fall to earth in a violent collision.
Lance Cpl. McCauley is back with the 1st Marine Expeditionary Force in Fallujah in May of 2004, five weeks after he was shot by a Sunni sniper.
“I picked infantry because that’s what my idea of a Marine was,” he says. “You know, with a rifle, sleeping in the mud.”
Only Marines in this war sleep on bunks in the desert and wear body armor to shield their abdomen and upper chest, and Kevlar helmets to protect against head injuries. Arms, legs, armpits and neck are about all that’s exposed. That’s why the number of amputees in Iraq is twice that of previous wars.
It is now Sept. 6, 2004, and McCauley is assigned to a patrol in the heart of an insurgency stronghold just north of Fallujah. He mentally counts the days he has left in Iraq — “one month to go” — before jumping into the open bed of a supply truck.
Then, he recalls, out of nowhere a car loaded with explosives slams into the convoy, blowing him like a rag doll through the air. The car contained a 500-pound bomb, 250-mm artillery shells and makeshift shrapnel.
That’s the last thing McCauley says he remembers — until awaking from a coma two weeks later in Bethesda Naval Hospital back in the United States.
He is told that extraordinary medical care saved his life in an attack that killed seven fellow Marines and three members of the Iraqi National Guard. McCauley is one of four Marines who survived the attack. He also learns that a Navy corpsman found him unconscious, blood flowing from his mouth, ears and nose. The corpsman inserted a tube through McCauley’s nostril to prevent blockage of his airway, and placed a tourniquet under McCauley’s left armpit to stop the bleeding.
Within minutes, McCauley says, he’s stabilized at a combat field hospital and transferred to the Army’s main medical facility in Baghdad, where surgeons remove his spleen and a kidney. He’s then sent to the regional hospital in Germany for recovery from the operation, and a few days later, airlifted to Bethesda for treatment of these other injuries:
• Bruised liver and pancreas.
• Ruptured corneas in both eyes from heat and pressure.
• Deep lacerations in his right arm, buttocks and neck from shrapnel.
• Nearly severed left arm.
• Ruptured left ear drum; pinhole in right ear drum.
• Second-degree burns on most of his face and right arm.
• Tumor-like blood clot on his head that resembles a basketball.
• Chipped teeth.
McCauley says he never expected to find himself among the critically wounded and dependent on modern military medicine to keep him alive when he volunteered for deployment to Iraq in January of 2004.
He says he willingly gave up his assignment as a Marine security guard at Camp David, the presidential retreat in the Maryland woods outside Washington, for the adventure of combat duty in one of the most dangerous places in the world.
Yet he doesn’t regret his decision then or now. Marines, he says, are taught to sacrifice and to show courage and commitment.
“Everybody wants the experience (of war),” McCauley says. “I wanted to be the best.”
Coming in Part Two: Recovering from war’s psychological scars.
Eric Reinagel is a CNHI News Service Elite Reporting Fellowship recipient. He writes for The Meadville, Pa., Tribune. Danielle Rush, a reporter with the Kokomo, Ind., Tribune, also contributed to this story.
Ellie
The Norman Transcript
Editor’s notes: This is the first of a two part series. The second part will be published in Monday’s edition.
By Eric Reinagel
CNHI News Service
You hear the mortars going out, but you don’t know where they’ll land. This could be the last breath of your life.
Marine Lance Cpl. Bret McCauley of Kokomo, Ind., recalls crouching close to the ground, moving warily through a Sunni rebel neighborhood in Fallujah just before dusk.
He’d been in Iraq two weeks, he says, not enough time to fully absorb the treacherous uncertainty of the landscape and yet sufficient time to see the bloody reality of war.
It is March 26, 2004, and the sounds of combat are loud in McCauley’s ears as his infantry unit moves from house to house. Suddenly, a rocket-propelled grenade flies over his right shoulder, smashing into the building in front of him.
McCauley says he instinctively dived behind a cinder block structure cradling a propane tank and starts shooting at insurgents perched on a rooftop.
Before he can find a safer location, a bullet from an AK-47 rips through his left thigh. Then the gunfire stops.
“Who’s hit?” someone calls out. “Who’s hit?”
McCauley says he responds, “Dude, I’m hit!”
Blood drips from a jagged hole in his camouflage pants. He tries to get up but his left leg buckles. A corpsman tells him to stay down on the ground, and administers a shot of morphine.
McCauley says he is picked up and moved to a Humvee. The limp body of a fellow Marine who had bummed a cigarette only an hour earlier rests next to him. The Marine is dead, shot in the face, says McCauley, and “his blood covers me.”
They know where we are. This is where I’ll die. Not in this place. Not in this stinking place.
But the 23-year-old McCauley won’t die. The efficiency of modern military medicine whisks him off to a field hospital in Fallujah. Within minutes, doctors clean, medicate and suture his thigh injury and tell him he’s among the lucky. He’s suffered a flesh wound.
The doctors explain they can helicopter him to the main combat hospital in Baghdad for air transfer to the regional military hospital in Landstuhl, Germany, and more medical attention — if that’s what he wants. He will then return home to the United States within a day or two.
Or he can stay and rejoin his 1st Marine Division infantry unit in Fallujah when he’s feeling up to it. The choice is his. He will get a Purple Heart either way.
McCauley, who enlisted in the Marine Corps before graduating from Kokomo’s Taylor High School in 2001, elects to remain in the war zone. Marines are trained to be tough, he says, and you do your job just as long as you are able to do it.
McCauley thus becomes one of the 10,600-plus American soldiers in Iraq who have suffered injuries and yet were able to return to combat since the U.S. invasion in March of 2003.
“I just got here,” he recalls saying. “I watched my friend get killed. I’m not going to go home. I’m out for blood.”
His next encounter with the wounds of war will not be so fortunate. But McCauley says the swift, expert medical treatment he received for the bullet through his thigh was an example of the military’s new techniques for treating battlefield injuries.
There’s nothing to do but lay in bed, listen to Blink 182 on my Walkman and eat canned sardines and oysters sent in CARE packages.
Sgt. Maj. David Cahill, a Vietnam War medic and now an official at the U.S. Army Medical Center and School at Fort Sam Houston, Texas, says the military is returning more wounded soldiers to combat and saving more lives because of improved medical knowledge and faster response.
There are, he said, three primary causes for death in the first 10 minutes of a battlefield injury: bleeding, obstructed airways and collapsed lungs. He said the military teaches trauma skills to first responders so they can treat these conditions rapidly and effectively.
Combat medical packs, for example, contain special tourniquets and emergency trauma bandages with elastic pressure tails to stop external bleeding. They also carry a dressing called QuickClot that instantly stops the flow of blood, and a 14-gauge needle to open a two-way flow of air to the lungs.
That’s in addition to morphine, oxygen, IV lines and high-tech digital instruments that measure heart rate, blood pressure, respiration and other telltale signs of life or death. Some medics even carry portable heart-lung machines to supply oxygen.
“Simple little things,” said Maj. Gen. George W. Weightman, a medical doctor and the center’s commander. “But they address 90 percent of all the reasons people die in those first 10 minutes.”
Lifesaving statistics tell the story. Medical improvements have reduced to less than 10 percent the number of wounded American troops in Iraq who do not survive, according to the Pentagon.
That’s the best survival rate of any U.S. war. In the Gulf War, 22 percent of injured U.S. soldiers died. The rate was 24 percent in the Vietnam War, and 30 percent during the Korean War and World War II.
Weightman, Cahill and others credit advances in combat casualty care to superior medical research, technology and training by the military. These factors, they said, have led to corpsmen, medics, nurses, doctors and the soldiers themselves providing critical medical assistance far forward on the battlefield.
Iraq’s compact geography and flat landscape also help. Rapid-response medevac crews can land by helicopter almost anywhere, lifting injured soldiers to one of four strategically located combat hospitals in less than an hour. The severely wounded are transferred to Germany for further treatment before they are sent to the Army’s Walter Reed Hospital in Washington, D.C., or the Naval Hospital in Bethesda, Md.
Pentagon medical officials said it can take as few as 36 hours to move an injured soldier from the battleground to a hospital bed in the United States, a speed unheard of in previous wars.
“Primary medical training during Vietnam was what we called sticks and rags,” said Cahill. “You put on a bandage or an IV. It wasn’t any advance trauma. The training we give now is more directed at trauma.”
Like a mosquito or fly that won’t go away, mortars fall again. Somewhere they are being launched. Somewhere they fall to earth in a violent collision.
Lance Cpl. McCauley is back with the 1st Marine Expeditionary Force in Fallujah in May of 2004, five weeks after he was shot by a Sunni sniper.
“I picked infantry because that’s what my idea of a Marine was,” he says. “You know, with a rifle, sleeping in the mud.”
Only Marines in this war sleep on bunks in the desert and wear body armor to shield their abdomen and upper chest, and Kevlar helmets to protect against head injuries. Arms, legs, armpits and neck are about all that’s exposed. That’s why the number of amputees in Iraq is twice that of previous wars.
It is now Sept. 6, 2004, and McCauley is assigned to a patrol in the heart of an insurgency stronghold just north of Fallujah. He mentally counts the days he has left in Iraq — “one month to go” — before jumping into the open bed of a supply truck.
Then, he recalls, out of nowhere a car loaded with explosives slams into the convoy, blowing him like a rag doll through the air. The car contained a 500-pound bomb, 250-mm artillery shells and makeshift shrapnel.
That’s the last thing McCauley says he remembers — until awaking from a coma two weeks later in Bethesda Naval Hospital back in the United States.
He is told that extraordinary medical care saved his life in an attack that killed seven fellow Marines and three members of the Iraqi National Guard. McCauley is one of four Marines who survived the attack. He also learns that a Navy corpsman found him unconscious, blood flowing from his mouth, ears and nose. The corpsman inserted a tube through McCauley’s nostril to prevent blockage of his airway, and placed a tourniquet under McCauley’s left armpit to stop the bleeding.
Within minutes, McCauley says, he’s stabilized at a combat field hospital and transferred to the Army’s main medical facility in Baghdad, where surgeons remove his spleen and a kidney. He’s then sent to the regional hospital in Germany for recovery from the operation, and a few days later, airlifted to Bethesda for treatment of these other injuries:
• Bruised liver and pancreas.
• Ruptured corneas in both eyes from heat and pressure.
• Deep lacerations in his right arm, buttocks and neck from shrapnel.
• Nearly severed left arm.
• Ruptured left ear drum; pinhole in right ear drum.
• Second-degree burns on most of his face and right arm.
• Tumor-like blood clot on his head that resembles a basketball.
• Chipped teeth.
McCauley says he never expected to find himself among the critically wounded and dependent on modern military medicine to keep him alive when he volunteered for deployment to Iraq in January of 2004.
He says he willingly gave up his assignment as a Marine security guard at Camp David, the presidential retreat in the Maryland woods outside Washington, for the adventure of combat duty in one of the most dangerous places in the world.
Yet he doesn’t regret his decision then or now. Marines, he says, are taught to sacrifice and to show courage and commitment.
“Everybody wants the experience (of war),” McCauley says. “I wanted to be the best.”
Coming in Part Two: Recovering from war’s psychological scars.
Eric Reinagel is a CNHI News Service Elite Reporting Fellowship recipient. He writes for The Meadville, Pa., Tribune. Danielle Rush, a reporter with the Kokomo, Ind., Tribune, also contributed to this story.
Ellie