The experience of the US Marine Corps' surgical shock trauma platoon with 417 operative combat casualties during a 12 month period of operation Iraqi freedom

Lowell W. Chambers, D. J. Green, Bruce L. Gillingham, Kenneth Sample, Peter Rhee, Carlos Brown, Stacy Brethauer, Thomas Nelson, Nalan Narine, Bruce Baker, H. R. Bohman

Research output: Contribution to journalArticle

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Abstract

Background: The Forward Resuscitative Surgical System (FRSS) is a small, mobile trauma surgical unit designed to support modern US Marine Corps combat operations. The experience of two co-located FRSS teams during 1 year of service in Operation Iraqi Freedom is reviewed to evaluate the system's efficacy. Methods: Between March 1, 2004, and February 28, 2005, two FRSS teams and a shock trauma platoon were co-located in a unit designated the Surgical Shock Trauma Platoon (SSTP). Data concerning patient care before and during treatment at the SSTP was maintained prospectively. Prospective determination of outcomes was obtained by e-mail correspondence with surgeons caring for the patients at higher echelons. The Los Angeles County medical center (LAC) trauma registry was queried to obtain a comparable data-base with which to compare outcomes. Results: During the year reviewed there were 895 trauma admissions to the SSTP. Excluding 25 patients pulseless on arrival and 291 minimally injured patients, 559 of 579 (97%) combat casualties survived; 417 casualties underwent 981 operative procedures in the two SSTP operating shelters. There were 79 operative patients with a mean injury severity score of 26 (range, 16-59) and mean revised trauma score of 6.963 (range, 4.21-7.841) who had sustained severe injuries. Ten (12.7%) of these casualties died while 43 of 337 (12.8%) deaths were seen with comparable cases treated at LAC. Conclusions: Small task-oriented surgical units are capable of providing effective trauma surgical care to combat casualties. Further experience is needed to better delineate the balance between early, forward-based surgical intervention and more prolonged initial casualty evacuation to reach more robust surgical facilities.

Original languageEnglish (US)
Pages (from-to)1155-1161
Number of pages7
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume60
Issue number6
DOIs
StatePublished - Jun 2006

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2003-2011 Iraq War
Surgical Shock
Military Personnel
Wounds and Injuries
Trauma Centers
Injury Severity Score
Los Angeles
Operative Surgical Procedures

ASJC Scopus subject areas

  • Surgery

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The experience of the US Marine Corps' surgical shock trauma platoon with 417 operative combat casualties during a 12 month period of operation Iraqi freedom. / Chambers, Lowell W.; Green, D. J.; Gillingham, Bruce L.; Sample, Kenneth; Rhee, Peter; Brown, Carlos; Brethauer, Stacy; Nelson, Thomas; Narine, Nalan; Baker, Bruce; Bohman, H. R.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 60, No. 6, 06.2006, p. 1155-1161.

Research output: Contribution to journalArticle

Chambers, Lowell W. ; Green, D. J. ; Gillingham, Bruce L. ; Sample, Kenneth ; Rhee, Peter ; Brown, Carlos ; Brethauer, Stacy ; Nelson, Thomas ; Narine, Nalan ; Baker, Bruce ; Bohman, H. R. / The experience of the US Marine Corps' surgical shock trauma platoon with 417 operative combat casualties during a 12 month period of operation Iraqi freedom. In: Journal of Trauma - Injury, Infection and Critical Care. 2006 ; Vol. 60, No. 6. pp. 1155-1161.
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abstract = "Background: The Forward Resuscitative Surgical System (FRSS) is a small, mobile trauma surgical unit designed to support modern US Marine Corps combat operations. The experience of two co-located FRSS teams during 1 year of service in Operation Iraqi Freedom is reviewed to evaluate the system's efficacy. Methods: Between March 1, 2004, and February 28, 2005, two FRSS teams and a shock trauma platoon were co-located in a unit designated the Surgical Shock Trauma Platoon (SSTP). Data concerning patient care before and during treatment at the SSTP was maintained prospectively. Prospective determination of outcomes was obtained by e-mail correspondence with surgeons caring for the patients at higher echelons. The Los Angeles County medical center (LAC) trauma registry was queried to obtain a comparable data-base with which to compare outcomes. Results: During the year reviewed there were 895 trauma admissions to the SSTP. Excluding 25 patients pulseless on arrival and 291 minimally injured patients, 559 of 579 (97{\%}) combat casualties survived; 417 casualties underwent 981 operative procedures in the two SSTP operating shelters. There were 79 operative patients with a mean injury severity score of 26 (range, 16-59) and mean revised trauma score of 6.963 (range, 4.21-7.841) who had sustained severe injuries. Ten (12.7{\%}) of these casualties died while 43 of 337 (12.8{\%}) deaths were seen with comparable cases treated at LAC. Conclusions: Small task-oriented surgical units are capable of providing effective trauma surgical care to combat casualties. Further experience is needed to better delineate the balance between early, forward-based surgical intervention and more prolonged initial casualty evacuation to reach more robust surgical facilities.",
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AU - Sample, Kenneth

AU - Rhee, Peter

AU - Brown, Carlos

AU - Brethauer, Stacy

AU - Nelson, Thomas

AU - Narine, Nalan

AU - Baker, Bruce

AU - Bohman, H. R.

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