Shortening the time for battlefield trauma care

NY Times:

In Iraq, wounded American troops are treated at a well-equipped field hospital within one hour, regardless of where they were fighting or how bad the battle.

In Afghanistan, with its rugged terrain, their comrades are not so fortunate. Some wounded troops there do not receive advanced trauma care for almost two hours, lessening the chances of survival and rapid recovery.

Now, Robert M. Gates, the defense secretary, is trying to address the imbalance, directing the military to send more helicopters and a fourth field hospital to Afghanistan to guarantee that wounded Americans in Afghanistan are treated within what the military calls “the golden hour.”

The order is Mr. Gates’s latest foray into a Pentagon bureaucracy that he has complained is sometimes too slow to respond to the needs of the troops. It comes as the Obama administration is preparing to double American forces in Afghanistan as part of a plan to battle Al Qaeda and the Taliban more effectively.

“In Iraq, our goal is to have a wounded soldier in a hospital in an hour,” Mr. Gates told Congress on Tuesday. “It’s closer to two hours in Afghanistan. And so what we’ve been working on the last few weeks is, how do we get that medevac standard in Afghanistan down to that ‘golden hour’ in Iraq?”

Mr. Gates has directed that the number of helicopters assigned to medical evacuation in Afghanistan be increased by about 25 percent. They will be drawn from Army, Air Force and Navy equipment, officials said. Some medical evacuation helicopters will be assigned to forward bases, closer to where troops may come into contact with adversaries, the officials said.

Mr. Gates has also directed that some of the helicopters set aside for search-and-rescue missions for downed pilots in Afghanistan be reconfigured and reassigned to medical evacuation. That represents a departure from military doctrine that calls for certain numbers of combat search-and-rescue teams to be on 24-hour call, but it was seen by Mr. Gates and his advisers an acceptable tradeoff.

“The question is, can you take a little risk there especially as we are going to have more and more forces sent to Afghanistan?” said Geoff Morrell, the Pentagon press secretary, who cited military statistics that no American jets or bombers had been shot down in Afghanistan in seven years.

As those new rules have been put in effect over recent weeks, the officials said, the average medical evacuation time in Afghanistan already has dropped to 71 minutes today from nearly two hours last year.

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This is a great example of Gates's leadership at the Defense Department. The Afghanistan operation has always suffered from a chronic shortage of choppers especially among the NATO troops. The risk on the search and rescue choppers seems minimal. The most likely craft to need their services is probably another chopper that gets caught in a hot LZ.

Most of the other aircraft fly above the range of the Taliban's anti aircraft capability and they do not need to make low level approaches for the most part because of precision ordnance. The one exception is the A-10 which is heavily armored. It is useful for strafing runs against enemy forces in contact with our forces.