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EMS House of DeFrance http://www.emshouse.com Peripheral Med Courtesy the EMS House of DeFrance http://www.defrance.org Pinned down under enemy fire with an injured buddy - his leg blown off, his face a mass of blood - a soldier should first squeeze in behind the wounded man, allowing his body to absorb the incoming bullets, then yank a tourniquet onto the bleeding stump. When there is a lull in the firing, he should drag his buddy to cover, jam a rubber tube down his nose and turn him on his side so he won't choke. That's the new first-aid curriculum being taught to all the Army's basic recruits, a sobering but realistic new requirement the Army thinks could save about 10 percent of the soldiers who die in battle. Over two years in Iraq, the most common causes of death among the combat fatalities have been bleeding from arms or legs that have been smashed or explosively amputated, and bleeding or choking from serious facial wounds. Improved body armor, worn by all deployed U.S. troops, helps protect soldiers' torsos from the gunshot wounds that were the primary causes of death in past conflicts, Army medical officers said. The new training, and a new first-aid kit the Army will distribute, are the first improvements in basic Army combat medicine since the Korean War. Today, most soldiers still carry a 1950s-style pressure bandage issued in a compass pouch, and tourniquets that require a nearby stick to crank tight - a nonissue accessory not readily available in the desert. "You can't help a guy breathe or treat somebody whose leg is blown off with that stuff," said Donald Parsons, a retired Special Forces medic who is a senior official in the Army's combat medic training program at Fort Sam Houston in San Antonio. Soldiers in Iraq and Afghanistan often operate out beyond the immediate reach of combat medics. In a design that dates to the Cold War, when large units were trained to fight in formation, one Army medic is commonly assigned per infantry platoon of 40 to 60 men. But platoons often split into squads, which operate independently on patrol or in guarding convoys. "The nearest combat medic may be 30 minutes away, but if you have a partial amputation, you have about 10 minutes to stop the bleeding," said Col. Greg Jolissaint, the Army's top medical trainer. "You can't wait for the medic to show up." Until the new training began this month, Army recruits were taught a laborious step-by-step process to determine the extent of a soldier's wounds. Now, trainees are instructed to focus only on bleeding and choking problems. The newly designed tourniquet comes with a metal rod to torque it tight. The new first-aid kit also holds a rubber tube that "you insert in what's left of his nose that opens the airway to the back of the throat, allowing him to breathe on his own," Jolissaint said in an interview. Most important, he said, "We are teaching them to do all this while they are taking fire on the battlefield: Your foot patrol is under attack, your buddy has gone down, you are taking rounds, what do you do? The first thing is not to become a casualty yourself." Each of the Army's 80,000 recruits will get the training this year, practicing on realistic manikins and on fellow soldiers writhing in agony from faked wounds. With simple actions to control bleeding and clear the breathing passage of wounded soldiers, "we can probably save 10 percent of the people who've been dying on the battlefield in Afghanistan and Iraq," Jolissaint said. In a separate effort, the Army has trained tens of thousands of soldiers in basic trauma med icine, teaching them how to give injections and treat sucking chest wounds, skills that go well beyond the new training for recruits. The intent is to have every second soldier trained as a "combat life saver" to fill in before a medic arrives. "I've got 60 combat life savers trained out of 83 soldiers in the company," said Capt. Brian Thornton, who commands an engineer company of the Rhode Island National Guard that is headed to Iraq this summer. But not every combat life saver gets the well-stocked combat life saver medical kit, Thornton said. Each nine-man squad gets only one. A larger problem is that in a firefight, soldiers trained as combat life savers are expected to fight, not to stop to treat the wounded. "His primary focus is a life- taker, not a life-saver," Parsons said. The
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