The Telegraph
Since 1st March, 1999
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Fighters of death in ‘golden hour’

Kuwait, March 28: They call it the “golden hour” — that crucial window during which medical personnel hustle to stop bleeding, control breathing and save the lives of American troops wounded on the sandy battlefields of Iraq.

Speed in delivering medical care to the wounded can mean the difference between life and death — excessive bleeding causes about half of all battlefield deaths. Ever since the Persian Gulf War, the US military has been developing ways to improve battlefield survival, and the result is high-tech equipment and revised medical tactics.

In the Iraqi desert, the military is equipped with bandages made from shrimp shells that can stop bleeding within minutes, special tourniquets that troops in the battlefield can apply to themselves using just one hand and hand-held ultra-sound devices to detect internal bleeding.

The US Army has added roving surgical units that travel with the troops. The units complement more traditional combat support hospitals (called CSH or CASH units), which can house close to 300 beds. Time is their enemy, and their mission is to get as close to the front as possible.

Col. James Gilman, a doctor who is the US army’s acting assistant surgeon general for force projection, says the surgical units are each composed of 20 to 25 medical personnel — general surgeons, orthopaedic surgeons, anaesthesiologists and nurses.

“It’s treatment in the first hour that makes the difference,” Gilman said. “There are a lot of severe injuries that will result in death if treatment is not available.”

For that reason, Gilman said, the surgical units are highly mobile: “It takes a few trucks, they set up and tear down quickly.”

Gilman said the surgical units — used experimentally in the 1991 Persian Gulf War — provide resuscitation, stabilisation and life-saving procedures. Once stabilised, the wounded are transported to field hospitals set up in available buildings or in tents.

“In general, in every place where people are fighting, they will have access to this kind of treatment,” Gilman said. “Including enemy PoWs.”

Armoured personnel carriers resembling tanks without guns, M-113As, carry the medical officers. Gilman also noted that improvements have been made to the Black Hawk helicopters that transport the wounded from the field to hospitals; they’re now equipped with more medical equipment — oxygen, gurneys, bandages, decontamination suits — and are better outfitted for frequent communication.

“If you go back and look at the winners of the congressional Medal of Honour, medics are very well represented,” Gilman said. Gilman said medics, who formerly received most of their training in a hospital, are now being trained as emergency medical technicians.

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