This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Rasmussen, T. E. Articles by Smith, D. L. Search for Related Content PubMed PubMed Citation Articles by Rasmussen, T. E. Articles by Smith, D. L. Social Bookmarking                   What's this?

Echelons of Care and the Management of Wartime Vascular Injury: A Report From the 332nd EMDG/Air Force Theater Hospital, Balad Air Base, Iraq

332nd Expeditionary Medical Group/Air Force Theater Hospital, Balad Air Base, Iraq, The Division of Vascular Surgery, Wilford Hall United States Air Force Medical Center, Lackland Air Force Base, Texas, The Norman M. Rich Department of Surgery, The Uniformed Services University of the Health Sciences, Bethesda, Maryland, todd.rasmussen{at}lackland.af.mil

W. Darrin Clouse, MD, Lt Colonel USAF MC

332nd Expeditionary Medical Group/Air Force Theater Hospital, Balad Air Base, Iraq, The Division of Vascular Surgery, Wilford Hall United States Air Force Medical Center, Lackland Air Force Base, Texas, The Norman M. Rich Department of Surgery, The Uniformed Services University of the Health Sciences, Bethesda, Maryland

Donald H. Jenkins, MD, Colonel USAF MC

332nd Expeditionary Medical Group/Air Force Theater Hospital, Balad Air Base, Iraq, The Division of Vascular Surgery, Wilford Hall United States Air Force Medical Center, Lackland Air Force Base, Texas, The Norman M. Rich Department of Surgery, The Uniformed Services University of the Health Sciences, Bethesda, Maryland

Michael A. Peck, MD, Major USAF MC

332nd Expeditionary Medical Group/Air Force Theater Hospital, Balad Air Base, Iraq, The Division of Vascular Surgery, Wilford Hall United States Air Force Medical Center, Lackland Air Force Base, Texas, The Norman M. Rich Department of Surgery, The Uniformed Services University of the Health Sciences, Bethesda, Maryland

Jonathan L. Eliason, MD, Major USAF MC

332nd Expeditionary Medical Group/Air Force Theater Hospital, Balad Air Base, Iraq, The Division of Vascular Surgery, Wilford Hall United States Air Force Medical Center, Lackland Air Force Base, Texas, The Norman M. Rich Department of Surgery, The Uniformed Services University of the Health Sciences, Bethesda, Maryland

David L. Smith, MD, Colonel USAF MC

332nd Expeditionary Medical Group/Air Force Theater Hospital, Balad Air Base, Iraq, The Division of Vascular Surgery, Wilford Hall United States Air Force Medical Center, Lackland Air Force Base, Texas, The Norman M. Rich Department of Surgery, The Uniformed Services University of the Health Sciences, Bethesda, Maryland

The objective of this report is to provide a contemporary in-theater account on the systematic management of wartime vascular injury. Included are strategies at each echelon of care that affect the treatment of these injuries. In addition, the aim of this report is to present a modern wartime vascular registry describing rates and distribution of injury in what is now a mature military conflict. A 15-month review (September 1, 2004 through December 1, 2005) from the central level III echelon facility in Iraq (332nd EMDG/Air Force Theater Hospital) presented by the in-theater Consultants for Vascular Surgery. During this period 13 460 casualties were treated at or evacuated through our location, 3096 (23%) with battle-related injuries. Vascular injuries comprised 6.6% (N = 209) of battle-related trauma in the following distribution: extremity 79% (n = 166), neck 13% (n = 27), thoracoabdominal 8% (n = 16). Three levels (formerly echelons) of care are active in theater each with strategies that affect vascular injury management: Level 1: use of commercial tourniquets; level 2: use of temporary vascular shunts as damage control adjuncts; and level 3: definitive repair of arterial and venous injuries in theater using autologous vein. Evacuation patterns and the position of the Air Force Theater Hospital have allowed the formation of a contemporary wartime vascular registry. The rate of vascular injury appears increased compared to that of Vietnam with extremity injuries most prevalent. Effective strategies are in place at each of 3 levels of care that affect the management of vascular injury.

Key Words: vascular injury • battle-related injury • war injuries • vascular registry

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				V. Y. Sohn, Z. M. Arthurs, G. S. Herbert, A. C. Beekley, and J. A. Sebesta Demographics, Treatment, and Early Outcomes in Penetrating Vascular Combat Trauma Arch Surg, August 1, 2008; 143(8): 783 - 787. [Abstract] [Full Text] [PDF]