US Army Two-Surgeon Teams Operating in Remote Afghanistan - An Evaluation of Split-Based Forward Surgical Team Operations

Abstract

Background: United States Army Forward Surgical Teams (FSTs) consist of twenty personnel and are the Army's smallest surgical units. Currently, they provide the majority of resuscitative surgical care for combat casualties in Afghanistan where the mission of the FST has been further extended to include split-based operations. The effectiveness of these 10-person teams is unknown and outcome data has not been previously reported in the literature. This article evaluates the effectiveness of one split FST during a 14-month period in remote Afghanistan. Methods: The primary endpoint was died of wounds (DOW) outcomes among United States Forces, Coalition Afghani Forces, and local national citizens. Mortality was evaluated separately for patients who received a blood transfusion. Secondary endpoints of the study included number of blood products transfused, Injury Severity Score (ISS), and mechanism of injury. Results: Seven hundred sixty-one patients were treated and 327 patients underwent an immediate surgery. The average ISS was 12.05, and the DOW percentage was 2.36%. There were 61 patients with an ISS of greater than 24 (mortality 23.0%), and 47 patients with an ISS of 16 to 24 (mortality 2.13%). Nine of 121 patients transfused (7.4%) died. A total of 27 patients required massive blood transfusion and on average received 12.6 units of fresh frozen plasma and 18.2 units of packed red blood cell (ratio 1:1.49). Seven of 27 patients who received massive blood transfusion (25.9%) died. Conclusions: Small two-surgeon surgical teams can achieve acceptable DOW rates when compared with other larger surgical units currently operating in the Global War on Terror.

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Document Details

Document Type
Technical Report
Publication Date
Apr 01, 2009
Accession Number
ADA627521

Entities

People

  • Brian J. Eastridge
  • Daniel R. Cronk
  • Jason Edens
  • Jason Windsor
  • John B Holcomb
  • Lorne H Blackbourne
  • Shawn C. Nessen
  • Todd R. Little

Organizations

  • United States Army Institute of Surgical Research

Tags

Communities of Interest

  • Biomedical

DTIC Thesaurus Topics

  • Body Regions
  • Bone Fractures
  • Burns
  • Debridement
  • Disability Administration
  • Health Services
  • Medical Personnel
  • Patient Care
  • Surgery
  • Therapy
  • Veins
  • Wounds And Injuries

Fields of Study

  • Medicine

Readers

  • Joint Military Operations and Doctrine.
  • Military and Counterinsurgency Studies.
  • Trauma Surgery or Emergency Medicine.