Military trauma system in Afghanistan: lessons for civil systems?
OBJECTIVE
This review focuses on development and maturation of the tactical evacuation and en route care capabilities of the military trauma system in Afghanistan and discusses hard-learned lessons that may have enduring relevance to civilian trauma systems.


RESULTS
Implementation of an evidence-based, data-driven performance improvement programme in the tactical evacuation and en route care elements of the military trauma system in Afghanistan has delivered measured improvements in casualty care outcomes.


CONCLUSIONS
Transfer of the lessons learned in the military trauma system operating in Afghanistan to civilian trauma systems with a comparable burden of prolonged evacuation times may be realized in improved patient outcomes in these systems.
aUS Army Institute of Surgical Research, Joint Base San Antonio, Fort Sam Houston b59th Medical Wing, Joint Base San Antonio, Texas cThe Norman M. Rich Department of Surgery, The Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA dAcademic Department Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham eAcademic Unit of Surgery, Glasgow Royal Infirmary, Glasgow, UK. The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the US Department of the Department of Defense or UK Ministry of Defence.
Jeffrey A
JA
Bailey
Jonathan J
JJ
Morrison
Todd E
TE
Rasmussen
D055826:Afghan Campaign 2001-; D000346:Afghanistan; D019985:Benchmarking; D003299:Cooperative Behavior; D003422:Critical Care / Q000458:organization & administration / Q000639:trends; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D008887:Military Medicine / Q000458:organization & administration / Q000639:trends; D008889:Military Personnel; D009936:Organizational Innovation; D011379:Prognosis; D013997:Time Factors; D014187:Transportation of Patients / Q000458:organization & administration* / Q000639:trends; D014194:Traumatology / Q000639:trends; D014481:United States; D014947:Wounds and Injuries / Q000628:therapy*