ReviewThe combat experience of military surgical assets in Iraq and Afghanistan: a historical review
Section snippets
The historical evolution of military surgical assets: the Forward Surgical Team and the Combat Support Hospital
Although medical technicians and litter bearers frequently were encountered at the battlefront in the later 19th century, physicians still were not to be found except in the rear. With the start of the first technically modern conflict in 1914 (World War I), however, practitioners came to realize that the initial distance between combat wounded and military surgeons was detrimental to outcomes and survival.1, 3, 4 As a result, some surgeons began to advocate for small, mobile, military
The role of combat surgical assets in the evacuation chain
The US military presently operates a 5-tiered evacuation system capable of rapidly transporting injured service members from the field of battle to military treatment facilities within the continental United States (CONUS).7 Reminiscent of Letterman's integrated military medical treatment chain, the current echelons of care system allows soldiers to simultaneously receive care as they are transported through successive levels, ultimately to arrive at a major military installation in Washington,
Composition of FST and CSH units
According to doctrine, the Army FST and similar units in the Navy and Air Force are composed of 20 soldiers, typically 10 officers and 10 enlisted.8 Physicians assigned to an FST include 3 general surgeons and 1 orthopedic surgeon, with 1 of the 4 serving as the commander. Other individuals comprising the unit include a critical care nurse/head nurse, an operating room (OR) nurse, 2 nurse anesthetists, an emergency room (ER) nurse, 3 vocational nurses, 3 surgical technicians, and 3 combat
The combat experience of FSTs and CSHs in Operations Enduring and Iraqi Freedom
At the time of the terrorist attack on the World Trade Center, relatively few military medical assets were on a war-footing and ready to deploy in a short period. Within 6 weeks of the September 11 attacks, US forces were invading Afghanistan in an effort to oust the Taliban government. Two FSTs, the 274th and 250th, were deployed as the medical assets in support of the combat effort.2, 5, 6, 18 The 250th FST initially was located in Oman and then moved to Kandahar Airfield once that site was
Prospects for the future
The United States presently is engaged in the longest sustained period of conflict in its history. If the medical histories of prior wars are any indication, the dedicated compendium describing the military medical experience in the Global War on Terror will not be completed for 1 to 2 decades after the conflagration has ended. In the meantime, we are left with the individual reports of echelon II2, 5, 6, 13, 14, 15, 18, 19, 20, 21 and III16, 17, 22, 23, 24, 25, 26 facilities to appreciate the
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Cited by (30)
Combat medical support
2017, Medical Journal Armed Forces IndiaSurgical challenges in a new theater of modern warfare: The French role 2 in Gao, Mali
2016, InjuryCitation Excerpt :Regarding African conflicts, Pons et al. reported in 1996 that more than 315 surgical procedures were carried out over 2 months during Operation Turquoise in Rwanda, following the ethnic conflict between the Hutus and the Tutsis [15]. Therefore, surgical activity during the conflicts of the second half of the 20th century is reported to be much higher than the surgical activity at Roles 2 in Iraq or Afghanistan [16–22]. During the first months of Operation Enduring Freedom from October 2001 to April 2002, the 250th Forward Surgical Team (FST) carried out 68 surgical procedures on 50 patients [20] and the 274th FST carried out 103 surgical procedures [19].
French surgical experience in the Role 3 Medical Treatment Facility of KaIA (Kabul International Airport, Afghanistan): The place of the orthopedic surgery
2014, Orthopaedics and Traumatology: Surgery and ResearchCitation Excerpt :Because of asymmetric warfare, both military (NATO and Afghan National Army [ANA]) and civilian patients were managed. MAP and scheduled surgeries represented more than half of Role 3 facility [2–8] activity, which is specific to these structures, unlike Role 2 facilities which manage military and civilian Afghan patients in two out of three cases [4] with 70% of emergency procedures, providing emergency surgical management of the wounded before they are evacuated to Role 3 facilities. They are mobile, close to combat zones and their goal is to stabilize the wounded based on the principles of damage control surgery by controlling hemorrhage, which is the primary cause of death in combat, and infection [9–11].
French surgical experience in the role 3 medical treatment facility of KaIA (Kabul International Airport, Afghanistan): The place of the orthopedic surgery
2014, Revue de Chirurgie Orthopedique et TraumatologiqueThe surgical legacies of Hawkeye Pierce
2013, Journal of the American College of SurgeonsEn route critical care transfer from a role 2 to a Role 3 medical treatment facility in Afghanistan
2018, Critical Care Nurse
The author is an employee of the US Federal Government and the US Army. The opinions or assertions contained herein are the private views of the author and are not to be construed as official or reflecting the views of William Beaumont Army Medical Center, the Department of Defense, US Army, or US government.
There are no conflicts of interest to disclose.