The “golden hour” marks the most critical period for combat casualties. Wound data and casualty rates indicate that 90 percent die within that first hour if they do not receive advanced trauma life support. The aim of military medicine on today’s battlefield is to provide lifesaving support within that time frame, and this focus has significantly increased survival rates among soldiers wounded in Iraq compared with other wars.
In addition to providing immediate combat health support, keeping the force healthy through preventive measures and lessons learned from the past is vital to the mission. Historically, non-battle injuries and illnesses have had a far more devastating effect on force readiness than battlefield losses. Consider trench foot during the Great War, when the British alone suffered an estimated 20,000 casualties from the infection, many resulting in gangrene and amputation.
Dehydration in arid environments like the Persian Gulf, the stress of deploying to another part of the world and doing dangerous work for sustained periods of time can adversely affect a unit’s effectiveness. U.S. Army Master Sgt. Robert Greenlief serves in operations for the 3rd Medical Command in Baghdad, which provides medical support for all of Iraq, and discussed these issues in a recent interview.
Greenlief grew up in Pinellas Park and attended Dixie Hollins High School. He has fond memories of the area and has family there and throughout Florida. Based out of Fort Gillem, Ga., and deployed on his first combat tour to Baghdad, he called Tribune correspondent MyLinh Shattan to talk about the importance of the medical mission in Iraq.
Tell us about your assignment. I am a combat medic, a nationally registered emergency medical technician and a licensed practical nurse. I help develop the plan for missions that we have in the theater. If a unit needs medical coverage for a particular mission, they contact us. It’s a big staffing process and a lot of teamwork.
As a master sergeant, I’m more on the planning side, and I don’t get out on the missions as much anymore. Traditionally a medic can function anywhere from in a garrison hospital environment to side by side with an infantryman on the front line. So a medic is a pretty versatile soldier today and can deploy just about anywhere with any type of unit.
Give us a picture of the medical support role. Just look at the stats today. Soldiers today are receiving the best medical care anywhere of any force, of any wars past. You have many illnesses and injuries that sometimes were not even combat-related and would take soldiers out of the field in astronomical numbers. Today, with the medical care that we have, the preventative medicine we do now … is what’s really brought down the numbers of non-battle injuries.
With battle injuries, the improved gear, wearing their body armor, has increased their chances of survival. And our medics are so much more advanced now that they can provide on-the-spot care. Our evacuation system gets soldiers out of the field quicker, so that “golden hour” comes into play there. All those factors, we’ve got a real good percentage of survivability if a soldier is injured.
What’s the “golden hour”? They say in the medical field: the platinum 15 minutes, then the golden hour. If you get a soldier stabilized and in a health care facility, their chances of survival dramatically increase. After that, their chances of survival go down. That’s kind of the rule of thumb in our medical practice.
Tell us about non-battle injuries and how that affects the readiness of units. Using “Lessons Learned,” a program that the Army has, we take into consideration what we’ve done in the past, what’s worked and what’s not worked. We analyze that and come up with a better course of action. Things we do now that weren’t done in the past have mitigated those type of injuries. Things such as issuing anti-fungal foot powder, changing socks a couple times of day if you’re road marching. Flu shots. Somebody with the flu taking them out of the picture two, three days can affect a unit, especially when the flu starts sweeping through a unit.
Safety is a big thing that the military has eyes on, everything from backing up a vehicle to wearing protective eyewear.
What problems are unique to Baghdad and Iraq? You can dehydrate quickly here. Unless you’re living in a desert, you’re not accustomed to the climate. The Army issues the best equipment to carry our water. Once again, preventive medicine – they inspect water to make sure it’s drinkable and meets standards. For the most part, your body does acclimate to the weather. They do allow time and don’t push us so hard first coming out the gate.
Are the hospitals in tents or hard structures? And do they treat American soldiers, or coalition forces, Iraqis also? We have combat support hospitals throughout theater. They’re teamed up with specialties. We have head/neck specialties, thoracic surgeon, CAT-scan capabilities, just like a regular hospital you have in the States.
We have teams that go out and support the national police. We have teams that support coalition forces. Our hospitals treat American soldiers, but we do see coalition forces and Iraqi national people. We have medical rules of engagement. Those are what give the hospitals the guidance on who they can treat and not treat.
Some hospitals are hard facilities; some are mixed. We can set up in a tent, but some have taken over a hard type of facility. As we’re here, we have a phrase – “You always improve your foxhole.” Not knowing an actual end date, we just do continuous improvement.
What do you want to tell the public? We appreciate all the support for the soldiers. And the media will sometimes ask us questions like, “What do you think about the president’s comments?” We can’t follow the media every day here because of the communications. And I hope they take that in consideration, that we’re not tracking everything that happens back there.
What was the reaction to the ruling on Saddam? We’re the same as everyone else. What’s going to happen? We’re not sure. I do know the Iraqi people were celebrating. What does that mean for us? It’s kind of hard to tell.
Tribune correspondent MyLinh Shattan can be reached at firstname.lastname@example.org.