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 The drill allows high-speed insertion of a needle directly into a
bone's marrow to give a patient intravenous fluids when life-saving
seconds count, said Elliott, a lieutenant with the Montgomery
County, Maryland, Fire and Rescue Service.
"The needle sits on there and you basically drill it right into the
bone. It's much easier and quicker," Elliott, who is also a 30-year
Navy corpsman, said as he demonstrated in the back of the ambulance.
The needle drill is among a raft of products and techniques learned
on battlegrounds in Iraq and Afghanistan that have transformed how
U.S. doctors and emergency personnel back home help trauma patients
survive life-threatening injuries.
Modern tourniquets that can be applied with one hand and have
attached turning devices are replacing the makeshift handkerchiefs
and stick or belt of past decades.
Clamps, needle drills and wound gauze impregnated with
blood-clotting agents have been developed commercially from the hard
lessons learned from more than a decade of fighting, trauma
treatment experts say.
Improved transfusions and airway tubes, a focus on stopping blood
loss, and training to coordinate and improve care from injury site
to operating room have also been critical to the new approach in
emergency medicine in U.S. streets and hospitals.
"All of this together has massively increased survivability and
pretty much all of them have been brought into the civilian
ambulance population," said Dr. Howard Mell, a spokesman for the
American College of Emergency Physicians.
LESSONS OF WAR
Many U.S. agencies have adopted the military's Tactic Combat
Casualty Care protocol, while a bill moving through Congress would
allow more former military medics to move into civilian emergency
jobs by streamlining requirements for veterans who already have
extensive training. There are no numbers readily available for how
many veteran medics have already transferred their skills to
civilian life.
About 35 million people are treated in the United States each year
for traumatic injuries, such as those cause by gunshots and car
accidents. Trauma is the leading cause of death for Americans under
44, according to the Trauma Center Association of America.
The techniques brought home since the Sept. 11, 2001, attacks on the
United States are a reflection of the historic low in combat deaths
in Iraq and Afghanistan.
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Only about 10 percent of casualties in Iraq and Afghanistan were
killed in action, with 90 percent wounded, according to Pentagon
data. During World War Two, battle deaths made up 30 percent of U.S.
casualties.
Before 9/11, the normal practice in U.S. emergency care was first to
clear the airway, make sure the victim was breathing and then deal
with bleeding.
But with the biggest number of wounded in the two recent conflicts
coming from homemade bombs that blew off arms and legs, the emphasis
switched to stopping bleeding.
"What difference does it make if we're oxygenating the patient if
the blood is squirting out on the ground?" said Caleb Causey, a
former Army combat medic and owner of Lone Star Medics, a training
company in Arlington, Texas.
The Boston Marathon bombing in April 2013, which killed three people
and wounded 264, became a grisly showcase for the stop-the-bleeding
protocol.
Tourniquets, sometimes improvised, stanched heavy bleeding from
wounds to victims' feet and lower legs caused when the nail-filled
pressure-cooker bombs exploded at ground level. All of the victims
who made it to a hospital survived.
"From two wars on two fronts over a dozen years, we've learned a lot
of what's worked and what's not worked," said Causey.
(Reporting by Ian Simpson; Editing by Jill Serjeant and Dan Grebler)
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