9 out of 10 soldiers survive

http://story.news.yahoo.com/news?tmpl=stor...viving_soldiers

For every American soldier killed in Iraq (news - web sites), nine others have been wounded and survived — the highest rate of any war in U.S. history. It isn't that their injuries were less serious, a new report says. In fact, some young soldiers and Marines have had faces, arms and legs blown off and are now returning home badly maimed.

AP Photo

But they have survived thanks, in part, to armor-like vests and fast treatment from doctors on the move with surgical kits in backpacks.

"This is unprecedented. People who lose not just one but two or three extremities are people who just have not survived in the past," said Dr. Atul Gawande, a surgeon at Brigham and Women's Hospital in Boston who researched military medicine and wrote about it in Thursday's New England Journal of Medicine (news - web sites).

The journal also published a five-page spread of 21 military photographs that graphically depict the horrific injuries and conditions under which these modern-day MASH surgeons operate.

"We thought a lot about it," said the journal's editor, Dr. Jeffrey Drazen, and ultimately decided the pictures told an important story.

"This war is producing unique injuries — less lethal but more traumatic," he said.

In one traumatic case, Gawande tells of an airman who lost both legs, his right hand and part of his face. "How he and others like him will be able to live and function remains an open question," Gawande writes.

Kevlar helmets and vests are one reason for the high survival rate.

"The critical core, your chest and your abdomen, are protected," said Dr. George Peoples, a Walter Reed Army Medical Center surgeon who served in Iraq and Afghanistan (news - web sites). "Parodixically, what we've seen is devastating extremity injuries because people are surviving wounds they otherwise wouldn't have."

By mid-November, 10,369 American troops had been wounded in battle in Afghanistan or Iraq, and 1,004 had died — a survival rate of roughly 90 percent. In the Vietnam War, one in four wounded died, virtually all of them before they could reach MASH units some distance from the fighting.

Today in Iraq, real-life Hawkeyes and B.J. Hunnicuts have stripped trauma surgery to its most basic level, carrying "mini-hospitals" in six Humvees and field operating kits in five backpacks so they can move with troops and do surgery on the spot.

"Within an hour, we drop the tents and set up the OR tables, and we can pretty much start operating immediately," said Peoples, whose photographs are in the medical journal.

He's now at Walter Reed in Washington which has treated 150 amputees from the Iraq war. American military hospitals collectively have had 200 amputees from Iraq and Afghanistan, three of them triple amputees.

The record survival rates in Iraq have been achieved with an astonishingly small number of general surgeons. The entire Army has only about 120 on active duty and a similar number in the reserves. Of these, only 30 to 50 are in Iraq, plus 10 to 15 orthopedic surgeons, to care for 130,000 to 150,000 troops, Gawande reports.

That's fewer than the 80 general and orthopedic surgeons on staff at two Boston hospitals — Brigham and Massachusetts General.

"It's a very tight supply," Gawande said of the surgeons in Iraq. "They're now also burdened with civilian Iraqis seeking their help because the U.S. has taken over many Iraqi hospitals."

Virginia Stephanakis, a spokeswoman for the Army Surgeon General's Office, said Gawande had done excellent research and that his figures on casualties jibe with those on Department of Defense (news - web sites) Web sites, though she wouldn't confirm the number of surgeons in Iraq.

Gawande and others also credit nurses, anesthetists, helicopter pilots, other transport staff and an entire rethinking of the combat medicine system for soldiers' survival.

The strategy is damage control, not definitive repair. Field doctors limit surgery to two hours or less, often leaving temporary closures and even plastic bags over wounds, and send soldiers to one of several combat support hospitals in Iraq with services like labs and X-rays.

"We basically work to save life over limb," said Navy Capt. Kenneth Kelleher, chief of the surgical company at the chief U.S. Marine base near Fallujah. "No frills, nothing complicated. If the injury is not going to be salvageable, we do a rapid amputation, and there have been a fair number of those."

If soldiers are shipped to a combat support hospital, the maximum stay is three days. If more advanced care is needed, they're sent to hospitals in Landstuhl, Germany, or Kuwait or Spain. If care will be needed for a month or more, they're whisked directly to Walter Reed or Brooke Army Medical Center in San Antonio.

"The average time from battlefield to arrival in the United States is now less than four days. In Vietnam, it was 45 days," Gawande writes.

John Greenwood, a historian with the Army Surgeon General's office, said the new strategy has made a big difference in survival.

"Historically, the key change has been the ability to move the wounded man to definitive surgical care," he said.

Field surgeons moving with troops is the first step. Peoples traveled 1,100 miles throughout southern Iraq and into Baghdad, doing only what was absolutely necessary to save a life and shipping patients out.

He said he tried to ignore personal danger, like the time his medical team was sent to an evacuated air base in southern Iraq.

"At least, we thought it was evacuated," he said. In fact, Iraqi soldiers were still being routed out. The medical team was told to pick any of the bombed-out buildings to use as a makeshift hospital. After finishing one surgery, he walked outside and noticed big red X's on all the other buildings warning against entry.

By sheer luck, he said, "we had chosen the only one that hadn't been booby-trapped."

As for the soldiers he took pictures of, he had this to say:

"Every person depicted in those photos survived."

i wonder how many of these people wish they were dead missing a leg or two half your face, etc, its a new generation of fucked up vets.

I saw something about this on the news the other night.

What kind of quality of life are these guys gonna have? It'd be nice if you had the option of signing something that basically said if I sustain QOL threatening injuries...let me go.

I'd never want to live like that.

Hey symbols.... come over to walter reed with me one time. You will trip out.

But yeah I'm hearing numbers more like 20,000 wounded.... it's fucking out of control.

I'm actually surprised how positive many of these amputees are. Some of them have a better attitude than I do.

how many civilians survive those remaining 9 troops?

So who here is willing to roll a 10-sided die for that chance to die for a mistake?

[insert obvious D&D joke]

That article tells me that Americans are dying in an ignorant, illegal, and totally unnecessary war. This is exactly what you hear about on the news.

One in ten is too much. The problems with this war are so fucking obvious. Too easy.

This war is crazy, if the situation with medical care was like wars in the past we'd have tons more casualties.

Originally posted by Nekro@Dec 8 2004, 09:29 PM

This war is crazy, if the situation with medical care was like wars in the past we'd have tons more casualties.

Quoted post

I've been saying this since people first started coming back as parapalegics and missing half their heads and shit. This is vietnam in disguise.

Not to sound like a hippy, but ALL WAR IS CRAZY!

Fuck Bush.

Fuck Cheney.

Fuck Everything.

Originally posted by <KEY3>+Dec 8 2004, 06:48 PM--><div class='quotetop'>QUOTE (<KEY3> - Dec 8 2004, 06:48 PM)</div><div class='quotemain'>how many civilians survive those remaining 9 troops?

Quoted post

[/b]

yeah i am kinda wondering that myself, i mean they dont keep track of iraqi casulties i wonder how many iraqis cant ever work again because they have no hands, no legs, half thier face, this war is fucked we all have known it i just dont understand how the majority of the country doesnt know it yet.

<!--QuoteBegin-Poop Man Bob@Dec 8 2004, 08:21 PM

So who here is willing to roll a 10-sided die for that chance to die for a mistake?

[insert obvious D&D joke]

well with my boots of missle weapon evasion and my dexterity of 19 i fell pretty good about rolling that die. oh yeah dont forget my gloves of stripping which when used give me a 4 in 10 chance of distracting the enemy so nanoc the erotic will take those chances any day.

Last I heard :

1015 troops KIA

9,800 troops Injured

When bush was at camp pendleton giving his speech

He said that 2000 insurgents were killed

thats little more then a 2/1 ratio...

that aint winning shit , considering we have a multi-billion dollar military

and there using junk I couldn't even sale at Pennslyvania Gun show

^He meant just in Fallujah 2000 insurgents (actually its around 1,200).

theres no accurate way of knowing how many insurgents were killed, same as there is no way of knowing who is an insurgent and who isn't.

They were sayin on the rado yesterday that figures weren't available for Iraqi deaths and injuries, because US troops have been instructed to prevent journalists from entering hospitals and counting corpses....

I know the US goverment does keep track of kills..

I friend of mine just came home from "door knocking in bagdad" His whole unit carry disposable cameras issued by the goverment in order for them to have a photographic record of there kills for UN... ( weird shit huh ?)

horrible.

The saddest and most disturbing part is that there's no end in sight for all of this.

I'm not just talking about missing half a face... I'm talking about troops missing half their skulls and brains and living.... missing all four limbs and living (quadrapalegics).... troops who have mesh screens to hold their guts in....

And the US body count is more like 2000 with 20000 injured.

As for the iraq body count.... who really knows?

Here is a guesstimate:

http://www.iraqbodycount.net/

quadriplegia is paralysis of the limbs, not missing them. i forget what the term is for that.

i think i would probably rather be dead than only have half a face. it's not an issue of vanity, it's an issue of natural order. people weren't meant to survive stuff like that.

Everyone just like to talks about physical injuries. Example my cousin has been a marine for almost ten years. He has fought all over the world from colombia to bosnia to sudan etc...... He has been shot or stabbed multiple times with no real physical scarring. He is so mentally scarred that he had to send his wife and kid away far away from him. He said that he would wake up in the middle of the night and pace the house with a weapon looking for a killlllllllllllllll!!!!!!!!! :huh2:

Originally posted by villain@Dec 21 2004, 12:00 AM

And the US body count is more like 2000 with 20000 injured.

 

Quoted post

where did you get these figures?

the first iraq war II amputee is being redeployed in a few months

homebuoy wants to go back.

he lost his foot, got a new one, and has rehabbed his way to snowboarding.

saw this shit on dan rather or something last night.

:huh2:

More crazy military drama?

Besides the military regularly passing the buck to the VA on the benefits issue, now some who are injured are kept until they are considered "fit for duty" and then returned. I know a guy who was shot three times and lost 25% of a lung and has lowered mobility in one arm and they declared him "fit for duty".... pretty wild stuff going on.

Originally posted by symbols@Dec 21 2004, 09:22 PM

the first iraq war II amputee is being redeployed in a few months

 

homebuoy wants to go back.

he lost his foot, got a new one, and has rehabbed his way to snowboarding.

 

saw this shit on dan rather or something last night.

 

:huh2:

Quoted post

fucking nutcase, i hope this guy ends up in a bed on life support not able to move totured by the familes of the civillians he killed.

fuck anyone who wants to go over there, fuck anyone who supports this "war"

http://www.thememoryhole.org/war/wounded/gallery.htm

New England Journal of Medicine photos mentioned above.

article accompaning the NEJM photos

here you can see photos of injured soldiers. it seems like a lot of them are missing legs and feet. i'm guessing it's mostly from under-armored hummers running over roadside bombs.

As horrible as these wounds are, and as upsetting as the numbers are, it's still very light casualties. The U.S. loses over 10,000 people to alcohol deaths EVERY YEAR. WE lose 440,000 people to tobacco EVERY YEAR. We have an HIV infection rate of over 44,000 A MONTH. (Which is really not too bad---in South Africa TWENTY PERCENT of the adult population is HIV positive.) We lose 20,000 to 40,000 killed in car wrecks EVERY YEAR.

I agree the injuries are horrible. And yes, without the forward-deployed surgical teams, the death rate would be much higher. But in terms of past wars, the war in Iraq has been very inexpensive, in terms of combat casualties. The psychiatric cases of PTSD are high in Iraq, compared to past wars, because a great deal of the fighting takes place in built-up urban areas, and the fighting is often house-to-house. This type of combat is very hard on the troops, worse than open battlefield engagements.

But compared to WWII or the Korean War, it's not too bad.

The reason it's so debilitating on the armed forces is that there is no draft. The Marines are still having NO PROBLEM whatsoever meeting their recruitment quotas. It's the National Guard, where people kind of expected to serve twenty years doing very little and then get a pension, where recruiting is way slow. The "college money" recruitments are way down, but there are still plenty of people joining the Army. I went to a friend's 18-year-old son's good-bye party last Saturday. He joined the Army, and is off to Fort Bragg, I think.

Bottom line: Do not join the Army or the Marines unless you want to be a combat soldier.

jonny got his gun

Originally posted by Armenhammer+Dec 21 2004, 07:40 PM--><div class='quotetop'>QUOTE (Armenhammer - Dec 21 2004, 07:40 PM)</div><div class='quotemain'><!--QuoteBegin-villain@Dec 21 2004, 12:00 AM

And the US body count is more like 2000 with 20000 injured.

 

Quoted post

where did you get these figures?

[/b]

Well I'm in the army. I talk to people at the largest military hospital. This is what they say.

And yes Kabar casualty levels are light compared to past wars, but the WIA to KIA ratio is alot higher. And for troop strength levels, it's just as detrimental.

20,000 wounded in 2 years does not seem like alot on the global scale, but we must remember there are only about 1 million people in the military total... most in the army which is about 500,000 people. National Guard and Reserves are well over half the U.S. Army. Certainly retention in National Guard and Reserves is down, and as far as I know, retention in Active Duty units is not so hot either. The activation of several thousand IRR soldiers is evidence of the strain on our forces. And that is not the only sign. There are career soldiers getting out without even completing retirement requirements. I suspect that once the IRR is exhausted we will see a draft.... especially if this idiot stays in office.

It would seem as though you are trying to diminish the sacrifice of the troops with your facts and figures.... while however accurate, they are irrelevent to todays military which is near breaking point. Guard and Reserve are being used like Active duty which they are not supposed to be and not even recieving equal benefits.

Stop loss is also evidence of the strain. Stop loss is a regular occurance now.

It's just a matter of time.... in this war of attrition.