- The Washington Times - Friday, January 5, 2007

The killed-in-action rate in the Iraq-Afghanistan wars is half what it was in World War II and a third less than Vietnam and Desert Storm, according to internal Pentagon documents that say battlefield medical teams are doing a better job of stabilizing the wounded and getting them to doctors.

“We have better battlefield medicine,” Dr. William Winkenwerder Jr., assistant secretary of defense for health affairs, told The Washington Times yesterday. “We are reviving and resuscitating many, many more of our soldiers who would have died in previous conflicts.”

The improvement may be little solace to the families of the American troops who have died or been seriously wounded in Iraq and Afghanistan. The Pentagon, however, says it has put in place a first-rate system for saving life — and limb.

The briefing papers show the killed-in-action rate is 12.5 percent for the current wars compared with 25.3 percent for World War II and 18.6 percent for Vietnam/Desert Storm. Dr. Winkenwerder, a trained internist, said the rate is based on the number of combatants who died of wounds before reaching a treatment center. He said the standard has been the same for each war.

Dr. Winkenwerder ticked off a number of improvements. Medics now carry resuscitation gear. Each soldier and Marine, not just medics and Navy hospital corpsmen, are issued tourniquets to stop bleeding.

“We had anecdotal reports of service members who died, unfortunately, because there was no tourniquet available until the medic got there,” he said.

Medical teams have also worked on arriving at the scene of injuries, in most cases caused by a roadside improvised explosive device (IED).

“It used to be the ‘golden hour,’ ” he said. “Now we are trying to get down to the ‘platinum 15’ because what kills so many people is hemorrhage, massive hemorrhage.”

New ways of treating the wounded emerged with the creation in 2003 of the Joint Theater Trauma System (JTTS). It involves a constant “lessons learned” data analysis designed to come up with better tactical medicine

Until JTTS, for example, doctors were sometimes missing football-type concussions that occur in troops impacted by an IED.

Dr. Winkenwerder said the “few thousand” medical personnel in Iraq is the smallest in recent wars because many wounded and diseased personnel are flown out of the country to hospitals in Germany and the U.S.

From January 2005 to November, the military evacuated nearly 15,000 troops — 23 percent for battle injuries, 21 percent for nonbattle injuries and 56 percent for diseases. During that same span, the military treated 80,448 patients in theater.

The briefing charts, which were compiled in December for presentation to retired military analysts, also credit new technologies, such as improved body armor, ballistic eyewear and hearing protection. It cites better-armored Humvee vehicles and better detection of IEDs, which are responsible for 80 percent of the Army’s killed in action.

In the run-up to the Iraq invasion, the Pentagon failed to predict or prepare for the deadly insurgency that attacks military troops and civilians daily. Soldiers and Marines early on lacked armored Humvees that could blunt the force of IED blasts. The Army embarked on a crash program to produce armor kits for existing vehicles and to assemble armored Humvees from scratch.

The Pentagon also created a special unit, the Joint Improvised Explosive Device Defeat Organization, and gave it more than $2 billion to find technologies and tactics to find and defuse IEDs.

The internal Pentagon briefing comes as the U.S. military suffered 115 combat deaths in December, the most since November 2004 and the third deadliest month since the March 2003 invasion to oust Saddam Hussein. Total U.S. deaths yesterday stood at 3,005 for Iraq and 357 for Afghanistan.

The number of wounded has reached more than 23,000 in Iraq and Afghanistan. This includes 759 amputees: 497 who lost a leg, arm, hand or foot; and 262 who lost a finger, toe, or part of a hand or foot, the Pentagon says.

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