Air Force reservists lead trauma care advances

  • Published
  • By Lt. Col. Bob Thompson
  • 332nd Air Expeditionary Wing Public Affairs
BALAD AIR BASE, Iraq (AFPN) --  As coalition forces fight to help Iraq transition to democracy, Air Force surgeons here are fighting to save lives with new surgical knowledge that may benefit military and civilian medical care for years to come.

Finishing his third tour in combat, Air Force reservist Col. (Dr.) Jay A. Johannigman has performed surgery on about 900 patients, saving hundreds of lives.

"In every major conflict, military trauma surgeons have pushed the envelope," he said. "It's been a long time since Vietnam. The military medic has re-emerged as a leader and innovator, leaning forward and taking home important medical lessons."

When Colonel Johannigman returns to his civilian job as the director of trauma at Cincinnati's University Hospital in Ohio, he'll take with him three significant surgical lessons for his civilian counterparts.

"Throughout the theater, doctors use 'shunts' -- a plastic tube -- as a quick repair to bridge together the two ends of a torn blood vessel," he said. "That is unheard of in the states."

Also, he said combat has proven to him the importance of using tourniquets.

"Out here, every Soldier carries a tourniquet in his medical kit," he said. "This has clearly saved the lives of numerous Soldiers who have come through here. It remains a harsh combat statistic that 10 percent of our combat casualties bleed to death from wounds to the arms or legs. Tourniquets can prevent this."

He said that he will push the civilian medical community to make sure all paramedics back home carry tourniquets to stop excessive bleeding.

The third lesson is the value of using whole blood when replenishing a wounded service member whose own supply has dipped dangerously low.

"This is a lesson we've had to relearn," he said. "Whole blood is a tremendous asset which provides all the components necessary to stop bleeding and carry oxygen for the injured patients."

He said combat surgeons often rely on "the walking blood bank" of co-workers and fellow military troops who donate blood which is immediately transfused into a wounded patient.

Continuing Colonel Johannigman's work as vice commander of the Air Force Theater hospital is fellow reservist Col. Mike Yaszemski who helped fine tune aeromedical evacuation procedures as the mobilization assistant to the Air Mobility Command surgeon general.

"The No. 1 advancement I've seen during this conflict is en-route care," Colonel Yaszemski said. "In Vietnam, from the time of injury till the patient was able to get back to the states averaged 43 days. Today, we're getting wounded troops back to the states oftentimes within 48 to 72 hours."

"When an urgent trauma patient is being transported, (his or her) condition can go bad in a heartbeat," said the spine surgeon from the Mayo Clinic, Rochester, Minn. "Now we have critical care air transport teams that are like an intensive care unit in the sky."

As part of an annual workshop, the colonel streamlined what the airborne medics carry, trimming their equipment from 750 to 550 pounds. Also, he ensured that each of the teams, consisting of a flight surgeon, flight nurse, respiratory therapist and medical technician, follow the same duty and crew-rest standards that other aircrew use.

Sixty percent of the aeromedical evacuation mission is done by Air Force Reserve Command. Since the beginning of operations Enduring Freedom and Iraqi Freedom, the Air Force has transported thousands of patients and only one has died en route, a Soldier with unsurvivable burns.

"When we build the critical care air transport teams, we ask, 'What would we like onboard the aircraft if we were a very sick troop lying on a stretcher?'" Colonel Yaszemski said.

The Air Force Theater Hospital averages about 750 patients a month. According to records, about 96 percent of the trauma patients treated here survive to move on to the next stage of care. This is the best rate in military medical history.

"I'll always remember the young Marine who came here on Father's Day and required 248 pints of blood and three operations on his first day with us," Colonel Johannigman said. "The team effort of our medics was successful in helping this wounded hero make it back alive to the states where he continues to recover from his wounds.

"It is a unique privilege to care for these military men and women," he said. "We strive to give the very best care to everyone that comes to our door."