Combat Casualty Care in an Air Force Theater Hospital: Perspectives of Recently Deployed Cardiothoracic Surgeons

Current military operations have generated a large number of casualties and have led to the establishment of the first Air Force Theater Hospital since Vietnam. Located at Balad Airbase, Iraq, this hospital is a busy trauma center. Thoracic injuries are relatively infrequent but highly lethal. The cardiothoracic surgeon is uniquely trained to provide sophisticated surgical management to some of the most severely injured patients. The operative experiences of four recently deployed cardiothoracic surgeons are described. Mortality from combat injury in this conflict is lower than in prior wars. Body armor may prevent some fatal injuries. Several features of military medical care process are helping to improve our outcomes—specifically, the development of a trauma care system modeled on successful civilian centers, the expanded use of damage control concepts, and utilization of early transportation out of the theater of operations using Critical Care Air Transport Teams (CCATT).