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Combat Casualty Care Research at the U.S. Army Institute of Surgical Research
  1. Dr D Baer, Director of Research1,
  2. MA Dubick, Task Area Manager2,
  3. JC Wenke3,
  4. KV Brown3,
  5. LL McGhee4,
  6. VA Convertino, USAISR5,
  7. LC Cancio, US Army Program Manager6,
  8. SE Wolf7 and
  9. LH Blackbourne, Commanding Officer8
  1. 1US Army Institute of Surgical Research (USAISR), 3400 Rawley E Chambers Ave San Antonio, Texas 78234 USA
  2. 2Damage Control Resuscitation USAISR
  3. 3Dept of Regenerative Medicine, USAISR
  4. 4Battlefield Pain Control Research Program, USAISR
  5. 5USAISR
  6. 6Combat Critical Care Engineering task area, USAISR & Clinical Professor of Surgery, University of Texas Health Science Center at San Antonio
  7. 7Chair in Burns and Trauma Professor and Vice Chairman for Research Department of Surgery University of Texas Health Science Center - San Antonio & Chief, Clinical Research USAISR
  8. 8USAISR
  1. US Army Institute of Surgical Research. 400 Rawley E Chambers Ave San Antonio, TX 78234, USA 210-916-4327 210-916-8522 David.Baer{at}amedd.army.mil

Abstract

The Institute of Surgical Research is the US Army’s lead research laboratory for improving the care of combat casualties. The Institute follows a rigorous process for analyzing patterns of injury and the burden of disease to determine where research can be conducted in order to positively impact care. These analyses led the ISR to focus research on: preventing death frombleeding; developing improved pain control techniques; developing improved vital signs analysis techniques; improving the treatment of extremity injuries; preventing burn injuries on the battlefield; and improving critical care for combat casualties. This process has resulted in numerous improvements in care on the battlefield. Highlights include development, fielding, and efficiency testing of tourniquets and improved dressings for bleeding control. Significant progress has also been made in the resuscitation of combat casualties using blood products instead of crystalloid or colloid solutions. Improvements in pain control include assessments of the effect of perioperative anaesthetics on the development of Post-Traumatic Stress Disorder [PTSD]. Novel vital signs analyses have been successful in identifying promising techniques which may improve the medic’s ability to accurately triage patients. Current research in extremity injuries has focused on optimizing the use of negative pressure wound therapy for contaminated wounds. Burn research has focused on improving personnel protective equipment and implementing continuous renal replacement therapy. This research program is soldier focused and addresses care from self aid and buddy aid through all echelons of care. Many of these advances have been adopted in civilian medical centres as well, benefiting not only the military trauma patient, but also the civilian trauma patient.

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