Skip to main content

Military Health System

How Military Medicine Is Preparing for the Next Conflict

Image of As the Pentagon prepares today’s force for a “near-peer” fight against a large military adversary, the Military Health System is challenged to provide life-saving support for large-scale and dispersed operations. . Army medics assigned to the South Carolina Army National Guard, conduct combat medical training during a sensory deprivation exercise at McCrady Training Center, Eastover, South Carolina Aug. 16, 2018. The medics are finishing a 12-day sustainment course so they remain proficient in their skills providing care to a casualty from the point of injury to the evacuation site in a combat area. ( Sgt. Jorge Intriago, South Carolina National Guard)

Recommended Content:

Health Readiness & Combat Support | Health Care Technology | Education & Training | Medical Education and Training Campus

During the wars in Iraq and Afghanistan, military medical teams were well positioned on the battlefield to support the "golden hour" response – the ability to get wounded warfighters off the battlefield and delivered to the care of a full-scale military hospital within about an hour.

And that was a realistic goal given that the U.S. military had total air superiority and maintained top-tier trauma centers in-country. Wounded troops were rarely very far from the life-saving care they needed.

But the next conflict might be very different.

As the Pentagon prepares today's force for a "near-peer" fight against a large military adversary, the Military Health System is challenged to provide life-saving support for large-scale and dispersed operations. That's especially true for the medics supporting troops on the front lines.

Imagine a wounded Marine stranded on a remote Pacific island. The highest level of care available might be an independent duty corpsman. Evacuation to a higher level of care might take several days. For military medics, this scenario requires a new kind of training, new equipment, and a new approach to casualty care.

"We're worried about future casualties because those distances [to hospitals] are so great," said Air Force Col. Stacy Shackelford, chief of the Joint Trauma System (JTS), Joint Base San Antonio, Texas.

In the future, a lack of U.S. air superiority and vast distances could prohibit quick evacuations.

Those conditions likely mean that the "golden hour" handoff to a surgical team will not be possible, Shackelford warned.

The golden hour is the critical time window for trauma patients to receive a series of life-saving interventions – starting at the point of injury and transitioning to handoff to a surgical team. Moving patients quickly through that process is essential to saving lives and improving outcomes.

If wounded warriors are unable to get that care within the golden hour window of time, service medics, Special Operations medics, and independent duty corpsmen will "need a lot of skills, such as in administering pain medications, long-term pain control, airway management, and nursing skills like changing dressings, even things like rolling the patient," Shackelford said.

A near-peer conflict in the Pacific could leave injured warfighters near front lines for days. "Africa would be the same type of issue when we would have overland transport versus water evacuation," Shackelford said.

"All of those situations make us think that we may need to hold patients at lower levels of care, where you're going to have medics taking care of patients for days, including patients that need surgery. Not being able to get to a surgeon means having to stabilize those patients for longer periods of time at lower levels of care," she explained.

The mission of JTS, part of Defense Health Agency, is to improve outcomes for combat casualties from the strategic level down to the scene of conflict through evidence-driven performance improvement. Under the DHA, the JTS also has expanded the data capture and collection capabilities of its DOD Trauma Registry with the addition of special injury registries.

Preparing for the Next Fight

Medics' training is changing dramatically in advance of possible future near-peer conflicts.

To meet this challenge, medics' skills are being upgraded from the very start of their training, and the entire DHA is developing or reworking tactics and stratagems to reflect the new reality.

"We expect that with large-scale combat operations, every echelon of medical care will need to be better prepared to treat large numbers of casualties with limited resources," said Army Col. Johnny Paul, who is the department chair for the Army Combat Medic Specialist Training Program at the San Antonio Medical Education and Training Campus located at Fort Sam Houston.

For example, Paul said, you may get whole blood transfusions through donations to the Armed Services Blood Program or from "walking blood banks," i.e., combat buddies who can donate fresh blood via direct transfusion.

Medics are now receiving newer, advanced training, instilling in them potential life-saving skills and methods. Paul said that includes:

  • Use of whole blood
  • Operating a walking blood bank
  • Telemedicine
  • Bladder catheterization
  • Ventilator management
  • Airway management
  • Prolonged casualty monitoring to include nutrition and nursing care

Army Medic Training

To address these needs, the Combat Medic Specialist Training Program (CMSTP) has developed an Introduction to Delayed Evacuation Care component to its capstone 72-hour combat field training exercise.

The goal is to expose the Army's point-of-care medical personnel – the "68 Whiskey" Combat Medic Specialists – to the principles of prolonged field care. The 68W are assigned to the Army Medical Center of Excellence at Joint Base-San Antonio.

The first class of 275 medics who took the prolonged care course graduated in August 2021, and its medics are trained to transfuse blood on the frontlines. That is a skill that medics have traditionally learned only later in their careers.

Paul said the addition of prolonged casualty care training puts a different focus on the advanced knowledge and skill sets students will need to learn in class. That's a big change from previous combat medic courses, which focused on the treatment of casualties at the point of injury, with the assumption that a patient would soon be evacuated.

A new training program for all medics, known as Tactical Combat Casualty Care (TCCC), became operational on Dec. 15, 2021. The curriculum includes training for Care Under Fire, Tactical Field Care, and Tactical Evacuation Care.

TCCC guidelines are the blueprint for combat care at the frontlines for all branches of service. They are updated continually with best clinical practices.

The courses for prolonged casualty care include airway management, acute traumatic wound care, analgesia and sedation management, burn wounds, and crush injuries.

Some of the TCCC curriculum is given to first responders in all services in case there is no medic or corpsmen immediately available.

"This additional training will result in a higher level EMT [Emergency Medical Technician] certification for graduates," Paul said. That "will directly translate to more advanced medical credentials for combat medics."

Currently, medics are on a national certification registry at the Basic EMT level. The new curriculum will upgrade that certification to Advanced EMT. "These certifications are nationally recognized," Paul noted.

Battlefield Medicine

The Navy and Marine Corps are also preparing corpsmen for prolonged casualty care and for crisis situations that might require healthy Marines to donate blood on the battlefield to help treat injuries.

On the battlefield, Combat Life Saver-trained Marines are an essential asset in stopping preventable deaths before a corpsman is available.

However, the skills learned in CLS aren't only relevant to the battlefield. The principles of CLS can be applied across a range of medical emergencies, Marine Corps officials said. Clearing an airway, mitigating blood loss, and splinting a potentially fatal bone fracture are some of the skills taught during CLS.

Lt. Gen. Robert Miller, Air Force Surgeon General, testified recently at a Senate appropriations hearing where he emphasized the importance of preparing today for tomorrow's battlespace.

"Future conflicts may see medics needing to hold and treat patients in deployed settings for longer periods than in the past," said Miller. "We are actively evaluating how our teams can remain agile and leverage technology to provide Trusted Care…anytime, anywhere."

You also may be interested in...

I Am Navy Medicine - and Certified Registered Nurse Anesthetist - Lt. Jason Balazs

Article Around MHS
1/27/2023
Military medical personnel administers ultrasound on patient.

National Certified Registered Nurse Anesthetist (CRNA) Week is January 22-28, 2023. Learn why CRNAs like Lt. Jason Balazs use extraordinary precision and focus to support critical mission readiness and their impact on this profession's long history and enduring record of patient safety.

Recommended Content:

Health Readiness & Combat Support

Eyes on Vision Readiness

Article Around MHS
1/27/2023
Military personnel gets eye exam

Good eyesight is often take for granted, but vision impairment can be the difference between mission success and mission failure. Find out what's happening on Joint Base Anacostia-Bolling so airmen in the National Capital Region remain sharply focused on their U.S. Air Force missions.

Recommended Content:

Vision and Hearing Loss Prevention | Vision Center of Excellence | Health Readiness & Combat Support

U.S. Army Medical Laboratory Forges Relationship with Australian Defence Force Institute

Article Around MHS
1/25/2023
Military personnel in medical laoratory

American soldiers from the 1st Area Medical Laboratory were hosted by their counterparts at the Australian Defence Force Malaria and Infectious Disease Institute in Brisbane, Australia. Find out what was discussed at this meeting to strengthen critical relationships, save lives, and enable both sides' mission readiness.

Recommended Content:

Building Partner Capacity and Interoperability | Health Readiness & Combat Support | Research & Innovation

Medical Training Made a Priority During Deployment

Article Around MHS
1/24/2023
Military medical personnel demonstrating a surgical technique

Working in a Role III hospital center overseas, the bulk of the work consists of routine medical care for soldiers, coalition forces, and contractors, addressing a multitude of symptoms, including headaches, muscle pain, cold-like symptoms, upset stomachs. To do this, training is made a high priority, offering multiple training opportunities for every level in the hospital.

Recommended Content:

Education & Training | Army Reserve

959th Medical Group Airmen at BAMC Receive Distinguished Awards

Article Around MHS
1/18/2023
U.S. Army Col. Renee Matos speaks at ceremony

The New Year’s revelry may be over; however, with a host of local and national awards, the 959th Medical Group still has cause to celebrate. Several 959th Airmen assigned to Brooke Army Medical Center were recognized recently for their selfless service, professionalism, and clinical expertise, both at home and overseas.

Recommended Content:

Health Readiness & Combat Support

Fleet Readiness Center East Enhances Emergency Preparedness with Training in CPR, Defibrillator, and First Aid

Article Around MHS
1/12/2023
Military medical personnel practicing CPR

When it comes to providing first aid and initial care during an emergency, every second counts in the matter of life and death. That's why this training program at Fleet Readiness Center East aims to equip its workforce with lifesaving skills and training to respond quickly and effectively to emergencies.

Recommended Content:

Education & Training | Emergency Preparedness and Response

Injured Fort Bliss K-9 Handler Makes Inspiring Return to Duty

Article Around MHS
1/10/2023
Military personnel with K9

A military working dog handler assigned to the 93rd Military Police battalion survives a horrific motorcycle crash with a speeding pickup driver, but his prognosis was grim. Find out how dedication, motivation, and his sweet connection with a K-9 got U.S. Army Spc. Cade Brown back on the road to recovery.

Recommended Content:

Warrior Care | Health Readiness & Combat Support

Theater Medical Command Experiment Focuses on Large-Scale Combat Operations, Future Operating Environment

Article Around MHS
1/6/2023
Military medical personnel at Fort Sam Houston

The Medical Capability Integration Directorate hosted its culminating limited objective experiment for calendar year 2022. See how the Theater Medical Command (TMC) Experiment will affect large-scale combat operations and prioritize limited Army Health System capabilities and how the TMC will support future operating environments.

Recommended Content:

Health Readiness & Combat Support

Air Force Research Laboratory Launches Wearable Biomolecular Sensors Program

Article Around MHS
12/29/2022
Military personnel demonstrating a wearable human performance monitoring device

It's like an aircraft's "black box" - that Soldiers wear. Learn about the research collaboration that will literally "arm" warfighters with a sensor to track their well-being during critical missions, predicting performance and health issues before they occur.

Recommended Content:

Research & Innovation | Health Care Technology

U.S. Army's Non-Commissioned Officer of the Year is Proof Army Medicine is Army Strong

Article Around MHS
12/28/2022
Military personnel performs tactical combat exercise.

He's the first Army medicine soldier to be named the U.S. Army’s Noncommissioned Officer of the Year. Find out what - and who - motivated U.S. Army Sgt. Garrett Paulson toward earning this honorable distinction, in his own words.

Recommended Content:

U.S. Army Medical Center of Excellence | Education & Training

Tele-Critical Care Brings New Capability to Womack Army Medical Center

Article Around MHS
12/27/2022
Military medical personnel demonstrating new tele-critical care medicine

This groundbreaking new tool gives critically ill patients access to 24/7 monitoring by deploying medical experts who can get them help immediately. See how it works, and why military medical experts are calling it the fail-safe mechanism that cannot be underestimated.

Recommended Content:

Telehealth Program | Health Care Technology | Research & Innovation

New “mCurriculum” Launched to Help Surgeons Worldwide Sharpen Skills, Improve Clinical Readiness

Article Around MHS
12/23/2022
Military personnel holding new device developed by USU

Imagine surgeons honing their skills using their smartphone, tablet, or computer. Thanks to a collaboration between the Uniformed Services University, the American College of Surgeons, the Military Health System Strategic Partnership American College of Surgeons, and the University of California, Davis, it's happening. See how this groundbreaking "mCurriculum" is helping surgeons around the globe save lives.

Recommended Content:

Uniformed Services University of the Health Sciences | Education & Training | Health Care Technology

New Work Group Looks at Preventive Health Measures for Service Members

Article Around MHS
12/9/2022
U.S. Army Brig. Gen. Christopher Mohan

The U.S. Coast Guard is now prioritizing a review of health-related data to determine how to reduce illness and injuries within the workforce. This shift is prompted by a policy update within the Coast Guard Medical Manual COMDTINST 6000.7, as well as the new Population Health Optimization Work Group that will impact members, civilians, dependents, and retirees.

Recommended Content:

Health Readiness & Combat Support | Medical and Dental Preventive Care Fitness

Project Crimson 22 experiments with New Medical Technology for the Battlefield

Article Around MHS
11/25/2022
Military personnel carry items from medical supply drone Project Crimson

When the packages hit the ground, medical warriors scramble to retrieve critical supplies. See how an unmanned medical supply aircraft helps military personnel preserve lives in battlefield emergencies.

Recommended Content:

Building Partner Capacity and Interoperability | Education & Training

Soldiers Learn Nuances of Basic Life Support

Article Around MHS
11/16/2022
Military medical personnel in life support class

U.S. Army Reserve soldiers from the 801st field hospital learned the nuances of providing care to adults, pregnant women, children and infants when they attended the basic life support class on Nov. 7.

Recommended Content:

Education & Training
<< < 1 2 3 4 5 > >> 
Showing results 1 - 15 Page 1 of 5
Refine your search
Last Updated: July 20, 2022
Follow us on Instagram Follow us on LinkedIn Follow us on Facebook Follow us on Twitter Follow us on YouTube Sign up on GovDelivery