Insight into military care

01 July 2012

The extraordinary skill and co-ordination involved in treating Britain’s wounded military personnel has been set out in unprecedented detail in a new publication.

The article, authored by five Birmingham-based trauma and orthopaedic experts describes the lessons which have been learned since the invasion of Iraq in 2003.

It explains the development of new techniques to treat patients injured in blasts from improvised explosive devices (IEDs), including new tourniquets to stop catastrophic bleeding and field dressings impregnated with shellfish extract to stop bleeding faster.

It also describes the complex, life-changing decisions made by surgeons when deciding whether to amputate damaged limbs.

The article also looks at the introduction of the medical emergency response team (MERT), which is credited with saving many lives by bringing consultant-level doctors, paramedics and an emergency nurse to wounded personnel in the battlefield.

After initial surgery and stabilisation at Camp Bastion, all seriously wounded military personnel are evacuated to the Queen Elizabeth Hospital Birmingham for further treatment.

They are flown to Birmingham by the Aeromedical Evacuation Service, under the care of the Critical Care Air Support Team (CCAST).

This combination of NHS and military care for military personnel only began in 2001, and has also developed into a major success.

Wing Commander Jon Kendrew, a Consultant Orthopaedic Surgeon at QEHB and co-author of the article, says it shows how hard so many people have worked to develop a world class system for treating our wounded personnel.

“Since 2003 the way we treat these patients has evolved tremendously at every level.

That includes the team medics who provide the initial treatment, the MERT teams, those working at Camp Bastion, the CCAST personnel, our teams here at QEHB and of course the rehab unit at Headley Court.

“This article draws together many of those lessons, showing how much work has gone into developing our care of men and women who are serving their country so bravely.

” Wg Cdr Kendrew co-authored the article with Colonel John Clasper, Defence Professor in Orthopaedics, and fellow surgeons Miss Kate Brown, Major Hugo Guthriea and Major Arul Ramasamy.

QEHB is now home to the NIHR Surgical Reconstruction and Microbiology Research Centre, which is further examining these lessons to apply them to civilian trauma care in the NHS.

“Modern military surgery – Lessons from Iraq and Afghanistan” was published in the April edition of the Journal of Bone and Joint Surgery.