YESTERDAY AND TOMORROW BETWEEN
USAMRMC’s Combat Casualty Care Research Program pursues evolving medicine for an evolving battlefield.
by Col. Michael R. Davis, Lt. Col. David S. Johnston and Mr. Ramin A. Khalili
I
t wasn’t that long ago when the concept of the future— this time beyond time, this collection of years on the horizon somewhere—was just that, a simple concept. But as we move from Operation Iraqi Freedom (OIF) and
Operation Enduring Freedom (OEF) onto a newer and more complex version of the battlefield, the future is beginning to look increasingly familiar—more and more like a direct reflec- tion of the past.
Given that a more confined and condensed combat zone will likely be the norm for future conflicts, we can no longer afford to operate as a strictly reactive medical force, simply waiting to respond to geopolitical changes and technological advances. Instead, we must build upon what we know right now, refining our tools and tactics along the way.
Tis is how you stay ready. Tis is how you save lives. Tis is how you win.
With that mindset, it seems appropriate to explore the ways that we at the U.S. Army Medical Research and Materiel Com- mand (USAMRMC) Combat Casualty Care Research Program (CCCRP) are continuing to modernize in the face of global instability and potential military intervention—all with a focus on sustainment of the modern warfighter.
BLOOD: THE BATTLEFIELD NECESSITY Modernizing can mean looking to the past to revitalize highly effective—but often lost—treatments, and blood products offer the perfect example. During the recent “throwback” efforts to modernize (during OIF and OEF) via the use of whole blood instead of crystalloid and other synthetic products, new advances in blood technology have been greatly accelerated. Of these advancements, freeze-dried plasma (FDP) remains the most potent tool because it can be brought to the Soldier on the battlefield instead of requiring evacuation to a medical facility. Te benefits of FDP—which is essentially a bloodlike substance minus the red blood cells—are many, but chiefly include its por- tability, its lengthy shelf life and the fact that it can be quickly reconstituted with sterile water at any time. While all special operations units deployed to war zones now carry FDP kits as a matter of protocol, approval for wider use by the U.S. Food and Drug Administration (FDA) is likely several months away. Full-throttle production is shortly behind that approval and dependent upon blood collection efforts.
Meanwhile, the FDA has been an important partner in likewise advancing cold-store platelet technology, a method in which platelets are removed from donor blood, stored at refrigera- tor temperature and then inserted back into the patient to aid clotting and to help minimize blood loss. Tose efforts, which in 2015 resulted in a landmark extension of platelet shelf life
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