WarDocs - The Military Medicine Podcast

Understanding the Intricacies of Military Trauma Care and Combat Casualty Mortality Analysis- COL(R) Russ S. Kotwal, MD, MPH


Listen Later

Military Medicine & WarDocs present: "Insights and Take-Home Messages from the Author"

Article Title: United States Military Fatalities During Operation Inherent Resolve and Operation Freedom’s Sentinel

Military Medicine, Volume 188, Issue 9-10, September/October 2023, Pages 3045–3056

Link to Article: https://academic.oup.com/milmed/article/188/9-10/3045/6584429

Episode Summary:

      Join us as retired Army Colonel Dr. Russ Kotwal takes us through the complexities of analyzing military fatalities in combat operations discussing his recent article in Military Medicine. Drawing from his extensive experience and in-depth research, Dr. Kotwal breaks down how changes in military missions, resources, and roles of engagement over time can influence the outcome of these operations. You'll gain valuable insights into the significance of mortality reviews from previous major military operations in guiding injury prevention and future combat casualty care efforts. Also, we take time to clarify important terms such as 'DNBI' and 'Battle Injury', and their relevance to cause of death.

     In our discussion, we venture into the realm of military medical terminology used to define battle injuries and casualties. Listen in as we fully define terms like killed in action, died of wounds, injury survivability, and death preventability. To help you understand these terms and their meanings better, we explore the Joint Trauma System lexicon, an indispensable tool in military trauma care.

     Don't miss out as we dissect the case fatality rate for battle injuries in the context of combat casualty care. We look at data from World War II, Vietnam, Afghanistan, and Iraq, and draw comparisons between OIR and OFS. We also touch on the role of the Joint Trauma System and the Department of Defense Trauma Registry and their potential impact on the case fatality rate in large-scale combat operations. Our discussion extends to the examination of autopsy reports and the implications they carry for garrison care and the readiness of the medical force. Join us in this enlightening exploration of military trauma mortality and injury severity.

 

Episode Chapters:

(0:00:00) - Analyzing Military Fatalities in Combat Operations

Dr. Kotwal discusses military missions, resources, mortality reviews, DNBI and Battle Injury, and injury prevention for combat casualty care.

 

(0:05:29) - Military Trauma Care Medical Terms

We discuss military battle injuries, casualties, KIA/DOW, survivability, death preventability, and the joint trauma lexicon.

 

(0:21:07) - Analyzing Case Fatality Rates and Lessons

We compare case fatality rates of battle injuries in WW2, Vietnam, Afghanistan and Iraq, examining the Joint Trauma System, DoD Trauma Registry, and autopsy reports.

 

(0:30:22) - Military Trauma Mortality and Injury Severity

Hemorrhage, injury severity scores, blast and gunshot wounds, and future Mortality analysis projects are discussed.

**CORRECTION**-  The Army Air Corps vignette discussed at 37:55 in the podcast occurred in 1943.

 

Take Home Messages:

  1. Understanding military missions, resources, and roles of engagement is crucial in analyzing the outcomes of combat operations and informing future casualty care efforts.
  • The terms 'DNBI' and 'Battle Injury' play a key role in understanding the cause of death in combat scenarios.
  • Military medical terminology such as 'killed in action', 'died of wounds', 'injury survivability', and 'death preventability' are critical in the analysis of military trauma care.
  • The Joint Trauma Lexicon is an invaluable tool that helps in understanding complex military medical terms and their meanings.
  • The case fatality rate for battle injuries has varied across different combat operations such as World War II, Vietnam, Afghanistan, and Iraq.
  • The Joint Trauma System and the Department of Defense Trauma Registry have significantly impacted case fatality rates in large-scale combat operations.
  • Autopsy reports play a critical role in understanding the prevalence of certain diseases and conditions in the military and can have implications for garrison care and the readiness of the medical force.
  • The role of hemorrhage in military trauma mortality reviews, the use of injury severity scores, and the development of new metrics are all important factors in the analysis of military trauma mortality.
  • There is a need for more research into the impact of underlying illnesses such as atherosclerosis on military service members, including better pre and post-deployment screening and prophylactic medical therapy.
  • Studying cases deemed survivable and potentially preventable can lead to important lessons in both prevention and care, helping improve outcomes in future combat operations.
  • Episode Keywords:

    Military Trauma Care, Mortality Reviews, Combat Operations, DNBI, BI, Killed in Action, Died of Wounds, Injury Survivability, Death Preventability, Joint Trauma Lexicon, Case Fatality Rate, World War II, Vietnam, Afghanistan, Iraq, OIR, OFS, Joint Trauma System, Department of Defense Trauma Registry, Autopsy Reports, Garrison Care, Medical Force Readiness, Hemorrhage, Injury Severity Scores, Blast Wounds, Gunshot Wounds, Survivability, Prevention

    Hashtags:

    #MilitaryTraumaCare #CombatCasualtyAnalysis #MilitaryMedicine #InjurySurvivability #DeathPreventability #CaseFatalityRate #MilitaryMissions #JointTraumaSystem #WarCasualtyInsights

     

    Honoring the Legacy and Preserving the History of Military Medicine

    The WarDocs Mission is to honor the legacy, preserve the oral history, and showcase career opportunities, unique expeditionary experiences, and achievements of Military Medicine. We foster patriotism and pride in Who we are, What we do, and, most importantly, How we serve Our Patients, the DoD, and Our Nation.

     

    Find out more and join Team WarDocs at https://www.wardocspodcast.com/

    Check our list of previous guest episodes at https://www.wardocspodcast.com/episodes

    Listen to the “What We Are For” Episode 47. https://bit.ly/3r87Afm

    WarDocs- The Military Medicine Podcast is a Non-Profit, Tax-exempt-501(c)(3) Veteran Run Organization run by volunteers. All donations are tax-deductible and go to honoring and preserving the history, experiences, successes, and lessons learned in Military Medicine. A tax receipt will be sent to you.

    WARDOCS documents the experiences, contributions, and innovations of all military medicine Services, ranks, and Corps who are affectionately called "Docs" as a sign of respect, trust, and confidence on and off the battlefield, demonstrating dedication to the medical care of fellow comrades in arms.

     

      Follow Us on Social Media

    Twitter: @wardocspodcast

    Facebook: WarDocs Podcast

    Instagram: @wardocspodcast

    LinkedIn: WarDocs-The Military Medicine Podcast

    ...more
    View all episodesView all episodes
    Download on the App Store

    WarDocs - The Military Medicine PodcastBy Doug Soderdahl, Wayne Causey, Kevin Kniery

    • 5
    • 5
    • 5
    • 5
    • 5

    5

    145 ratings


    More shows like WarDocs - The Military Medicine Podcast

    View all
    EMCrit FOAM Feed by Scott D. Weingart, MD FCCM

    EMCrit FOAM Feed

    1,869 Listeners

    Emergency Medicine Cases by Dr. Anton Helman

    Emergency Medicine Cases

    536 Listeners

    The FlightBridgeED Podcast by Long Pause Media | FlightBridgeED

    The FlightBridgeED Podcast

    391 Listeners

    Behind The Knife: The Surgery Podcast by Behind The Knife: The Surgery Podcast

    Behind The Knife: The Surgery Podcast

    1,306 Listeners

    Jocko Podcast by Jocko DEFCOR Network

    Jocko Podcast

    30,736 Listeners

    Mentors for Military Podcast by aka Mentors4Mil

    Mentors for Military Podcast

    443 Listeners

    Modern War Institute by Modern War Institute at West Point

    Modern War Institute

    765 Listeners

    Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast by Jed Wolpaw

    Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

    1,473 Listeners

    Heavy Lies the Helmet by Mike Boone, Dan Rauh, & Dr. Amanda Humphries

    Heavy Lies the Helmet

    262 Listeners

    The Spear by Modern War Institute at West Point

    The Spear

    610 Listeners

    Critical Care Scenarios by Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM

    Critical Care Scenarios

    251 Listeners

    The Team House by dee takos

    The Team House

    1,665 Listeners

    From The Green Notebook by Joe Byerly

    From The Green Notebook

    369 Listeners

    The Jack Carr Channel by Jack Carr

    The Jack Carr Channel

    2,870 Listeners

    Critical Care Time by Critical Care Time Podcast

    Critical Care Time

    236 Listeners