Army unit shows UK med students life-saving battlefield techniques

By JIM WARREN | Lexington Herald-Leader | Published: December 5, 2012

LEXINGTON, Ky. — Surgeons on the old TV show "MASH" operated at breakneck speed to save wounded soldiers during the Korean War, but their pace would seem leisurely compared to that of a modern U.S. Army Forward Surgical Team.

Operating near frontline combat positions, these mobile teams can rapidly treat critically wounded soldiers, literally pulling them back from death's door in many cases, and move them on to higher level treatment facilities in as little as three hours.

"Thanks to that kind of speed, badly wounded soldiers in Afghanistan can be back on their feet in as little as two months, even if they are on prosthetic legs," says Capt. Melanie Bowman, a U.S. Army flight trauma nurse who'll be serving in a Forward Surgical Team in Afghanistan next summer.

On Tuesday, Bowman and some other soldiers visited the University of Kentucky, where they set up a life-size model of a Forward Surgical Team, or FST, in the second-floor atrium of UK's Biomedical Biological Sciences Research Building.

The visit was part of an Army recruiting program to give college medical and nursing students an opportunity to see the equipment and life-saving battlefield techniques used by Forward Surgical Teams.

Bowman says serving in an Army FST, doing operations in what the army calls "austere environments," is ideal training for doctors coming out of medical school who want careers in emergency medicine.

By the way, Bowman says that operating in an "austere environment" could mean just about any kind of battlefield shelter, from a peasant shack to a tent or a cave.

The Army created Forward Surgical Teams in the 1990s, about the time it was phasing out Mobile Army Surgical Hospital units like the fictional 4077th MASH from the classic TV show.

An FST typically has 20 staffers, including four surgeons, various nurses and anesthetists, surgical technicians and medics.

Surprisingly, FSTs were little used in the Iraq War because Iraq's flat terrain allowed wounded soldiers to be flown to hospitals in minutes. But that's seldom possible in Afghanistan's high mountains. In fact, Bowman says it's almost impossible.

A wounded soldier who already has lost large amounts of blood and fluids could die of hypothermia on long high-altitude, sub-zero helicopter flights before reaching a hospital, she said.

In contrast, a Forward Surgical Team can provide life-saving treatment on the spot, thanks to portable, sophisticated modern medical equipment.

For example, Bowman said, teams carry their own electrical generators, portable ultrasound equipment to help doctors locate internal injuries, and even facilities allowing direct donor-to-patient whole blood transfusions when needed.

Thanks to such advances, soldiers in earlier wars, suffering from what would have been life-threatening injuries then, not only survive today but can return to duty, Bowman said.

"It's amazing," she said.

Bowman, a 12-year army veteran, predicts that life-saving lessons which Forward Surgical Teams are learning in Afghanistan inevitably will find their way into use in hospital emergency rooms in the U.S.

"It's a process that has gone on in every war we've ever had," she said. "But never so much as in this one."



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