1. 14 BIRMINGHAM POST THURSDAY, JUNE 11, 2015
NEWS
H
uge steps forward at a Bir-
mingham hospital have led
to much better survival
rates for soldiers who have suffered
terrible injuries in Iraq and Af-
ghanistan.
The study, which has just been
published in the Journal of Trauma,
highlighted work at the Royal Cen-
tre for Defence Medicine, which is
based at the Queen Elizabeth Hos-
pital. But the report warned it was
important to take action to ensure
the expertise and lessons learned
was not lost now the two major con-
flicts had ended.
In the decade to 2012 there were
2,792 UK Military casualties, sus-
taining 14,252 separate injuries – of
which 608 died.
Around 70 per cent of all injuries
came from explosions – and the
report found over the ten years
there was a marked improvement
in survival rates.
Improvements in care meant
that, over the course of the decade,
an estimated 265 casualties
survived injuries that
would have been
judged likely to be
fatal at the start of
the conflicts.
It found that 572
casualties sur-
vived despite
injuries classed
by the NHS as
“life-threatening”,
while 38 casual-
ties survived
with injures
classed
as “unsurvivable”. Three-quarters of
combat casualties were due to
explosive weapons, which is con-
sistent with most of the major wars
of the last century.
The evolution of a complex
response package, beginning on the
battlefield, including emergency
surgery in Camp Bastion, Afghani-
stan, and finally in Birmingham,
was attributed to improvements in
survival rates.
The study by Navy surgeons and
an academic at the University of
Birmingham has been described as
the fullest examination of battle-
field casualties released by a Nato
member after a war.
Primary author of the study, Sur-
geon Lieutenant Commander
Jowan Penn-Barwell RN said:
“While both the UK military and our
American colleagues always believed
that survival rates had improved,
this is the first time that it has been
demonstrated scientifically.
“This study is the most detailed
analysis of combat casualties ever
released on either side of the Atlan-
tic and is the first to definitively
prove that the huge efforts to
advance and improve the care of
our wounded have been
enormously effective.
“It is important to rec-
ognise that this work
describes the efforts of
thousands of people,
from the patrol medics
out on the ground, to
the vast range of sur-
geons, physicians, nurs-
es, therapists and scien-
tists in both the Defence
Medical Services and the
NHS, and most impor-
tantly the sacrifice of the
2,792 casualties, including
the 608 who died in service
during this decade.”
The report found that
returning patients to a
single treatment facility
was an important factor,
with the expertise con-
centrated in one area.
It said: “Manage-
ment of trauma in
deployed UK Military
medical facilities is
both consultant led and consultant
delivered. With the high tempo and
unpredictability of military opera-
tions during the last decade, con-
sultants have gained experience
across multiple previous deploy-
ments.
“This knowledge is further con-
solidated by the cyclical predeploy-
ment training system through
which clinicians returning from
deployment instruct their col-
leagues about to deploy via the
bespoke Military Operational Sur-
gical Training (MOST) course run
with the assistance of the Royal
College of Surgeons of England
since 2007.
“This team-based training
involves rehearsing damage-con-
trol resuscitation and surgical
techniques on cadaveric material
and third-generation simulation
mannequins with the complete
team of surgeons, anaesthetists,
emergency physicians, and theatre
staff using current equipment and
protocols.”
The report said it was vital to
ensure, for the good of future sol-
diers, that the expertise is kept.
It said: “It is possible that
improvements in UK military trau-
ma system performance achieved
during the last ten years might be
lost at the cessation of hostilities.
“The associated decreased expo-
sure to severe combat trauma may
result in a loss of some of the gains
in survival demonstrated by this
study in the initial phases of subse-
quent conflicts.”
And Lt Com Penn-Barwell
added: “While it is hard to pin-
point individual treatments or
techniques that have led to the
improvements in survival rates, we
have examined every facet of our
practice and worked hard to refine
and improve it.
“We have done this again and
again. And we have worked hard
with our NHS colleagues to dis-
seminate these vital, life-saving les-
sons. It is now of the utmost impor-
tance that these advances are
maintained in order to care for cas-
ualties during any future conflict
and to the continued benefit of
civilian healthcare.”
Major gains in trauma
care ‘must not be lost’
Ben Hurst
Staff Reporter
ben.hurst@trinitymirror.com
A military amputee in the trauma ward at the Queen Elizabeth Hospital, right, during the recent Afghan conflict. Below, Lt Com Jowan Penn-Barwell>>
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