Page 85 - Journal of Special Operations Medicine - Spring 2016

role of trauma in many important and serious cardiac events the Advancement of Science and served at the Office of Na-
which was an important step from an epidemiological point of val Research, managing biomedical research and development
view. Dr Ismailov was a recipient of the Dean's Endowment programs. She has also served as a programmatic reviewer
Scholarship, a finalist for the Student Research Achievement for the US Department of Defense Congressionally Directed
Award Competition at the 47th Annual Biophysical Society Medical Research Program. In 2009, Dr Lytle joined AVIAN
Meeting, and featured student in Public Health, the official LLC as their Science and Technology Division Director and
magazine of Graduate School of Public Health University of went on to become a director of Business Development and
Pittsburgh. His publications appeared in such prestigious sci- chair of AVIAN’s Science and Technology Center of Excel-
entific journals as American Heart Journal, Annals of Neu- lence. In 2009, she was awarded the Chief of Naval Research
rology, Journal of Trauma, Alzheimer Disease & Associated Gold Coin for her contributions to the US Naval Science and
Disorders, and others. He currently heads the nonprofit Com- Technology Strategic Plan. In 2012, Dr Lytle was awarded the
plex Mechanisms of Disease, Aging and Trauma Research Commander Naval Air Forces Force Surgeon Gold Coin for
Foundation in Glendale, CO. E-mail: dr.ismailov@cmdat.org. her efforts associated with their hypoxia mitigation program.
She is currently a Director at the Pacific Northwest Research
Dr Lytle earned her PhD in interdisciplinary neuroscience Institute (www.pnri.org), Seattle, Washington.
from Georgetown University Medical Center in Washing-
ton DC. In 2007, she was awarded a National Defense and Keywords: high altitude; traumatic brain injury; Editorials;
Global Security Fellowship with the American Association for Posttraumatic headache

program to train Army Flight Medics to the Paramedic
Power to the People level. But, in reality, both initiatives were mere catch-up
moves to align Army Medic training with a far more ad-
by Steven Schauer, DO; Cord Cunningham, MD; vanced and effective civilian trauma standard. With the
Robert DeLorenzo, MD experience of the two recent wars and a pause in the ac-
tion allowing for retraining and refitting, now is the time
for the Army and the entire military medical establish-
ou are about to start golf season with a limited bud- ment to lead, and not lag, in combat casualty training.
get to get you through the summer. Where do you
Ysink your budget: a new driver, a new putter, or les- At a strength of approximately 20,000, the 68W Com-
sons from the clubhouse professional? Like a misguided bat Medic military occupational specialty (MOS) is the
golfer who repeatedly seeks the panacea of yet another second largest MOS in the Army and the largest group
piece of fancy equipment that will achieve Jack Nicholas– of battlefield medical providers. The literature has
like performance, the military medical establishment side- shown both the significant level of preventable deaths
steps better training in the hope of a technology solution that occur in the prehospital setting before reaching the
to the challenges of far-forward combat casualty care. 1 fixed facility, as well as a clearly demonstrable improve-
ment in mortality with the properly trained prehospital
Since 1990, the US Army Medical and Materials Com- providers. However, the 68W advancement model is
8,9
mand has executed more than $9.6 billion in appro- starkly contrasted with the rest of the Soldiers they serve
priations, much of which is in search of a supposed next to in combat.
2
technology game changer. This elusive device or drug
would save lives, replacing Combat Medic skills with The 11-MOS (infantry) and 18-MOS (Special Forces)
technology. Despite repeated calls for more than a quar- series Soldiers make up the considerable percentage
ter of a century, a proportional amount of resources has Warfighters where advancement in combat skills is req-
not been aligned with training. Aside from some phar- uisite for advancement in rank. The 11- and 18-MOS
3–6
maceutical agents, there is no equipment in the Medic’s Soldiers must seek schools and MOS-related advanced
aid bag that was not there several decades ago. Even training as well as noncommissioned officer (NCO) ed-
with the addition of drugs to that aid bag, recent data ucation system classes to move up in rank.
demonstrate poor adherence to Tactical Combat Casu-
alty Care-recommended use; lack of training with these The 68W training model is disappointingly different.
agents is almost certainly a contributing factor. 7 The average Soldier entering basic training is 20.7 years
old, rapidly moving from basic training through 16
To be sure, two important advances in combat medical weeks of advanced individual training, where they are
training must be highlighted: the Army 68W revolution trained to a skill level roughly equivalent to that of the
spearheaded at the turn of the century and the more recent civilian advanced emergency medical technician (AEMT;

Editorials 69