title: An assessment of the potential for reducing future combat deaths through medical technologies and training.
abstract: BACKGROUND
  We examined clinical records of combat casualties that died subsequent to reaching a medical treatment facility in an effort to determine whether new medical technologies or enhanced training might contribute to a reduction in combat deaths.
  
  
  METHODS
  Hospital records of 210 fatal combat casualties were independently reviewed by four surgeons. The surgeons assessed each fatality to determine whether it would be preventable if the trauma were sustained today and treated with currently available technology and training.
  
  
  RESULTS
  In 8% of the cases, the four surgeons independently agreed that the deaths would be possibly preventable if the same traumas were incurred today. In an additional 17% of the cases, three of the four surgeons judged the deaths to be possibly preventable today. Causes of death viewed as most likely to be salvageable today included hemorrhage, severe burns, pulmonary edema, and sepsis. The medical technologies most often mentioned to have a potentially lifesaving effect were ventilators/respirators, computed tomographic scanners, ultrasound, and antibiotics. Areas of training most often mentioned to have a potential impact on the salvageability of the trauma cases reviewed were damage control, ventilator management, liver packing, respiratory distress management, and burn management.
  
  
  CONCLUSIONS
  Surgeons reviewing records of past combat deaths indicated that reductions in the incidence of combat deaths through deployment of improved medical technologies and training is possible. Deployment of the noted technologies and proficiency in the cited training has the potential for reducing deaths by 8% to 25% when compared with the died-in-hospital incidence among casualties in the last sustained conflict.
authors.affiliation: Naval Health Research Center, San Diego, CA 92186-5122, USA.
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Blood
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Puyana
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Pitlyk
authors.forename: David B
authors.initials: DB
authors.lastname: Hoyt
authors.forename: H Scott
authors.initials: HS
authors.lastname: Bjerke
authors.forename: Julia
authors.initials: J
authors.lastname: Fridman
authors.forename: G Jay
authors.initials: GJ
authors.lastname: Walker
authors.forename: James M
authors.initials: JM
authors.lastname: Zouris
authors.forename: J
authors.initials: J
authors.lastname: Zhang
mesh_terms: D000328:Adult; D020811:Biomedical Technology; D002423:Cause of Death; D004632:Emergency Medical Services / Q000592:standards* / Q000639:trends; D005260:Female; D005544:Forecasting; D019538:Health Care Surveys; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D008887:Military Medicine / Q000193:education* / Q000639:trends*; D011336:Probability; D011787:Quality of Health Care; D012042:Registries; D016019:Survival Analysis; D014481:United States; D014857:Warfare; D014947:Wounds and Injuries / Q000401:mortality* / Q000628:therapy*