Chain of survival

  • Published
  • By Lt. Col. Paul Nelson
  • 92nd Aeromedical Dental Squadron
On my last deployment, I had the privilege of talking to a lot of Americans coming out of Afghanistan. Many had been there several times and saw combat with significant casualties. It is always humbling for medics to hear a big reason our guys were willing to go and do the mission in harm's way was they knew the United States would take care of them if they were ever wounded. 

Unlike our adversaries, past or present, Americans have always had a commitment to doing the most for those who protect our freedom. Up until the past 20 years, whether World War II or Desert Storm, when an American was wounded on the battlefield, their chance of dying remained remarkably constant - a bit over 30 percent. Here's a recent good news story from the AOR: in the past 10 years the "died of wounds" rate has plummeted to less than 10 percent. Translated to real people, that means there are over 10,000 American wounded warriors who are alive today because of American combat medical care. 

Here's how it works: when an American is wounded, they get immediate stabilization aimed at stopping the airway, breathing and circulation issues that kill rapidly. These initial acts require simple skills from the Airman's Manual and the equipment found in the combat first aid kit. Medics will arrive within a few minutes (sooner if they are embedded) to accomplish further field treatment and transport their patients to a forward surgical facility. They may move again to a larger place, such as the Air Force hospital at Balad, for some of the most advanced surgical care in the world. Another statistic: if an American has a pulse when they get to Balad, they have a 99 percent chance of surviving. You will not find a better save rate at any other trauma hospital in the world! Finally, the stabilized member is returned to duty or transported out of theater using aeromedical evacuation - frequently in a flying Intensive Care Unit manned by specialist Total Force Airmen flying in an aircraft of opportunity and refueled by tankers from Fairchild. 

Warriors usually remember combat and the trauma of being wounded. The next several minutes are often a blur, but they usually recount the flurry of activity that got them to the hospital, and then going to sleep under anesthesia (all within the "golden hour" of trauma surgery). When they awake, they may be in Balad, Walter Reed or Wilford Hall, and surrounded by Americans who care. These same warriors are now returning to the battlefield after rehabilitation to fight another day, or returning to their families to start a new life. 

Amazing what a team effort this "chain of survival" is! From the home station here at Fairchild to the AOR; from the cardiac surgeon to the logistics planner; every Air Force medic has played a part of this chain to save Americans who would have been dead in any other war. The medical chain starts with training - from Self Aid Buddy Care to the most advanced combat life saver courses. Combat medical care is Total Force - it has no boundaries between Active, Guard or Reserve, or between Army, Navy, Marine or Air Force. Aeromedical evacuation is a Mobility Air Force core competency, and tankers from Fairchild provide the Global Reach to make it all happen. 

Finally, and most importantly: this remarkable chain of survival starts with you. Self Aid and Buddy Care works, and the life you save in combat may be your Wingman's, or even your own. Before you deploy, train on your Airman's manual and combat first aid equipment, and remember that when deployed, every Medic is an Airman first, and every Airman is a Medic when called upon.