By Carrie McLeroy, Soldiers MagazineJune 30, 2008
Recently re-deployed Soldiers are noting that the first 10 minutes after a Soldier is wounded are critical in saving his life. Those precious minutes are known as "the platinum 10."
Today's asymmetrical warfare and the injuries Soldiers have sustained in Iraq and Afghanistan have forced the Army to rethink its approach to combat medicine to better contend with the current and emerging challenges Soldiers face.
The transformation is beginning in basic training, said Col. Kevin A. Shwedo, deputy commander of Fort Jackson, S.C. All five basic-training bases, which train up to 180,000 Soldiers from all components annually, have added 7.5 hours of Combat Lifesaver Skills to their current medical training and now complete all requirements or certification.
"Sergeants major out of theater loved the idea," Shwedo said. "They loved that Soldiers would be walking out of basic training with the fundamental skills they could build on to perform mission-essential tasks."
The skills learned in CLS instruction train Soldiers to administer immediate medical care in theater until the wounded can be transported, or a medic or doctor arrives.
Since Oct. 1, 2007, every Soldier must learn to perform advanced first aid and such potentially lifesaving procedures as CPR, controlling bleeding and starting an IV before they can graduate from basic training. While new Soldiers have always received first-aid training, Shwedo said the IV and other portions are new and are and intended to stress recruits by simulating the conditions they could encounter in combat, he said.
The combat lifesaver skills training puts Soldiers into an artificially stressful environment that Shwedo believes helps ready them for the stresses of combat.
"We have induced a different kind of stress on the Soldier, through a different training methodology," Shwedo said. "The training is relevant to today's fight, and is conducted in a way that the Soldier can't tune things out because he must stay focused."
Shwedo conjured the image of a newly trained, 17-to-24 year-old inserting an IV into his buddy's arm, knowing that his buddy would be doing the same to him later.
While it doesn't replicate a combat scenario with life-or-death consequences, Shwedo said the stress is very real.
Before the introduction of the combat lifesaver skills package in basic training, the Army required that only 20 percent of a unit's members be lifesaver qualified through a four-day, 40-hour course.
This condensed version covers each essential task and teaches every new Soldier how to save a life. Each Soldier now receives more than 27 total hours of medical training. Only marksmanship and physical training have more time devoted to them.
There were initial concerns that the basic-training graduation rate would decline as a result of the new requirements. Shwedo said that has not been the case.
"No Soldier has yet failed to graduate because he failed to pass the combat lifesaver skills portion," he said. "All our graduates are combat-lifesaver qualified."
The drill sergeants, who are combat lifesaver certified, are the primary instructors, Shwedo said. There is also a medic on site to provide assistance if necessary.
Although every Soldier who has finished basic training or officer candidate training since October 2007 is combat-lifesaver certified, Shwedo said the majority of Soldiers in the operational Army haven't yet received the training. Although it's offered at virtually every installation, frequent and multiple deployments have prevented many Soldiers from receiving it.
Shwedo is hopeful that the entire Army will be combat lifesaver certified by 2011.
"The most critical element that has come from this is the confidence these Soldiers have when they complete the certification process," he said. "They know that they have the basic skills to make a difference when confronted with a life-or-death situation. They are capable of stabilizing a patient until he can be moved or more medical support arrives."
Dr. (Col.) Steven Braverman, chief of the Clinical Services Division and deputy director for Health Policy and Services, Army Medical Command, said the training is working in concert with other improvements to provide invaluable gains in combat medical treatment.
"The enhanced training of our combat medics and combat lifesavers is certainly impacting the enhanced survivability of our combat wounded," Braverman said. "Improved training, coupled with the forward deployment of our forward surgical teams and other medical assets, faster medical evacuations to higher echelons of care, and the rapid application of lessons learned all play a key role in our high survival rates."