Trauma registry aims to improve troops’ protection
By Scott Peterson; April 2004
The Christian Science Monitor

  FALLUJAH, IRAQ - For military medics, the lesson that matters most from Lt. Jeff Copeland's U.S. Marine convoy is not that it was ambushed three times by Iraqi insurgents on a single run. The key point for them: How and where were the two U.S. casualties wounded?
  A newly established U.S. Navy Combat Trauma Registry is charting casualty patterns in hopes of improving troop protection.
  Already, specific dangers for U.S. forces - roadside bombs and urban warfare - are prompting swift innovations.
  The military, for example, has rush-ordered thousands of Kevlar shoulder guards and blastproof sunglasses. The reason? Ask Copeland, a U.S. Navy combat medic officer from Gainesville, Fla., whose first taste of combat came two weeks ago. Two of his marines took shoulder injuries from bullets and shrapnel.
  "He's done, he's gone home - he can't shoot," Copeland said of one case. New Kevlar shoulder guards might have protected the marine and kept him on the battlefront.
  At Camp Fallujah, seven miles east of the city, new forms arrived this week that will allow surgeons to log details of injuries and answer questions about their cause, and armor used.
  Using a prototype form until now, U.S. Navy medical corpsmen at the Bravo Surgical Company here have detailed more than 190 trauma cases.
  The new forms can be filled out on computer; some medical officers nearer the front line will hold voice recorders.
  "All we have is this huge database from Vietnam that ... needs updating," said Navy Capt. Eric McDonald, chief surgeon for the 1st Marine Expeditionary Force.
  "We're trying to answer those questions -  which glasses are better, which armor, which vehicle is better - in a scientific way."
  There has been close cooperation between the Army and the Navy, which traditionally provides medical support for the marines.
  "If you watch Roman Legion movies, that is where we are getting to," said Navy Capt. John Siefert, a doctor from San Diego, Calif., referring to Kevlar shoulder guards and lower skirts on flak vests.
  Trauma centers in U.S. hospitals today are a direct outgrowth of Army medics coping with combat trauma in Vietnam. Improvements since that era - including forward surgical teams much closer to front-line action - have trimmed front-line death rates.
  In the 1991 Gulf War, ceramic armor plates were used only by Special Forces; today they are standard issue.
  Parallel to the budding Navy effort, the Army has been pursuing the first stages of its own trauma registry. Key innovations in Iraq, in fact, began over the winter, when the Army's 82nd Airborne controlled this area.
  It was Lt. Col. Kelly Bal, an orthopedic surgeon with the Army's 82nd Airborne, who first detected the pattern of wounds to exposed shoulders.
  Bal rigged a Kevlar groin protector from a typical armored vest to fit around the upper arm, McDonald said. A prototype saved a soldier. The Army quickly bought 6,000, some 2,000 of which are now being used by Marines. The Marines also have ordered 25,000 more shoulder protectors.
  A similar story surrounds the wide use Wiley--X sunglasses with ballistic lenses are  padded frames, and toughened goggles direct result of blast wounds to the eye from IEDs.
  "Ideally, we would travel in hermetically sealed bubbles ... but we don't drape ourselves in this stuff. Everything you add is a benefit, and has a cost," McDonald said Shoulder protectors may hamper a marksman and add a heat burden. Some ballistic glasses tend to fog in heat.
  Experts are also working on a better ear-plug that permits frequencies like voices while protecting against the noise of a near by grenade blast. Surgeons here also expect more coverage of neck and lower abdomen areas.
  "The future is mining that database," said McDonald, "to find the places where benefits fits outweigh risks."