AFMC surgeon general: joint medical teams saving lives Published May 16, 2008 By Chuck Paone 66th Air Base Wing Public Affairs HANSCOM AIR FORCE BASE, Mass. (AFPN) -- The Air Force offers one of the best medical services in the world, Brig. Gen. (Dr.) Richard A. Hersack said May 15 during his visit here. General Hersack, who became the Air Force Materiel Command surgeon general last fall, said he couldn't be more proud of the medical workers in the command and throughout the Air Force Medical Service. At the same time, he was quick to point out that they're part of a larger joint team. "The Air Force Medical Service is all about supporting the joint force," he said, noting in particular the work done to provide trauma care to warfighters wounded in theater. "We could not do what we do with the theater-level hospital care, the trauma surgery and the critical care transport, where our air-evac units get folks home as survivors, without those front line combat medics: the Army and Navy corpsmen who work at the point of injury. They're the ones who are stopping the killing process at the scene." This very often keeps even severely wounded victims alive for transport to far-forward surgery, he said, where Army, Navy and Air Force doctors work side-by-side to provide "damage control surgery." This in turn buys additional time to get patients to a theater hospital like those in Balad or Bagram, General Hersack said. There, second phases of surgery stabilize patients so they can be transported "half-way around the planet." "This is truly a remarkable system," he said, indicating that the U.S. is "routinely getting casualties home within three days of injury." In contrast, the process took three weeks during Vietnam. Even as recently as Desert Storm, the average was 10 days. The overall results are "absolutely stupendous," the general said. And that is not simply a subjective conclusion. The medical profession uses something called the injury severity score, which measures, among other things, the degree of injury to the trauma victims' vital organs and various regions of the body. "It's actually fairly predictive of survival," General Hersack said. "And what we've found is, where the injury severity score numbers would normally cause you to expect four fatalities, instead we are only seeing one fatality and three survivors, a huge improvement in survival." This astonishing survival-rate increase has meant hundreds, perhaps thousands, of combat troops' lives have been saved, the general said. But what's more, follow-on studies are now showing that military trauma care professionals are achieving identically dramatic fatality reductions at home. "That means they're bringing these skills back with them and getting the same results for people who suffer non-combat-related traumas," he said. Since assuming his job at the command, General Hersack has been traveling to AFMC's various bases to visit with his medical professionals. Along the way he's noted some very positive trends. "Morale's high and our people are engaged," he said. He spoke of the balance between their need to prepare for and perform in deployed operations and to provide top-notch direct care at home. "I'm seeing tremendous initiative and effort at every level," he said. He expressed admiration for the way in which medical staffs have embraced Air Force Smart Operations for the 21st Century, or AFSO 21, concepts. "Any of us, myself included, who lived through some of the previous initiatives, like (Total Quality Management), tended to be skeptical initially, but there really are some relatively simple things that can be done to make a huge difference in terms of how efficiently we deliver care." He also lauded exchange programs like the one the 66th Medical Group at Hanscom has with a local Veterans' Administration hospital in West Roxbury, Mass. Through the program, nurses and medical technicians gain, or simply renew, valuable hands-on treatment skills they don't routinely practice at the on-base clinic. "These programs are absolutely critical," the general said. "They don't start too many IVs here; they don't do a lot of complex dressings here. As a result, our people really need the chance to go out and do this type of work, and they clearly love doing it." The experience helps these professionals remain prepared for deployment, which is a huge plus, the general said. But it also makes them better day-to-day practitioners. "The more clinically current we stay, the better the care we're able to provide right here on base," he said. General Hersack said such programs are sprouting up across the Air Force, and they are making a real difference. He commended the medical professionals who participate in them and all of the team members he's come to observe while in command positions, including his current role as command surgeon. "The number one trend I've noted is that we have really superb people out there," he said. Comment on this story (comments may be published on Air Force Link) View the comments/letters page