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ARLINGTON, Va. — From pain control to more effective ways to prevent infections, military medical personnel are moving quickly to apply lessons from wounded servicemembers in Iraq and Afghanistan to solutions to improve their care, Air Force trauma experts said Thursday.

“When we identify a problem, we quickly come up with a way to try and fix it,” said Air Force Lt. Col. Warren Dorlac, chief of trauma surgery and critical care at Landstuhl Regional Medical Center in Germany.

As a result, “the guys being injured now are being cared for very differently than their buddies who were injured two years ago,” Dorlac told Pentagon reporters during a roundtable on the military’s aeromedical and critical-care transport system.

One significant medical advance now being used to help wounded servicemembers is the use of a device called the Stryker PainPump, a disposable pump that continuously delivers a controlled amount of pain medication to an injured area.

Instead of using drugs such as morphine, which affects the entire body and can cause mental confusion and a reduced heart rate, military doctors in facilities in Iraq and Afghanistan or aboard aircraft can use a catheter, or small tube, to link the pain pump directly to the damaged nerves.

The pain pumps are in use in civilian hospital settings, but until the Iraq and Afghanistan wars the device had never been used by the military during medical evacuation flights, Dorlac said.

“We’ve pushed this thing very far forward,” Dorlac said.

Using the pump on medevac flights has proved to be especially important for patients with fractures, which are aggravated by the vibrations of the airframe, Dorlac said.

“These patients, no matter how [carefully] you move them in the air, they’re going to have pain,” Dorlac said. “So coming up with some novel ways to take care of their pain is what it’s all about.”

Not all of the innovations adopted by medical personnel are cutting edge.

A particularly simple change as a result of lessons learned is the use of special blankets to keep patients warm as they are transported aboard helicopters from the battlefield to the first level of trauma care, a combat support facility, Dorlac said.

Another modification has been the use of foam pads to prevent patients on respirators from developing painful pressure sores on their bodies as a result of lying on their backs for long periods of time, according to Air Force Maj. Francis Schlosser, a critical care nurse with the Air Mobility Command’s 43rd Aeromedical Evacuation Squadron.

“I would say within a couple of days [from the time the problem was identified] we were able to work [a solution] through the system and start adding that preventive measure,” Schlosser said.

The foam pads are now carried by all trauma teams on all medical flights, Schlosser said, “and we’re seeing a marked decrease in the amount of patients” with pressure sores as they move through the evacuation system.

In the year that he has cared for “hundreds of patients” as a trauma surgeon at Landstuhl, Dorlac said, “I have not had a single patient arrive with a pressure ulcer, and some of those patients have been in a forward hospital … for a prolonged period of time.”


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