GOV/MIL No guaranteed ‘golden hour’ for Marines headed into the next big fight - Marine Corps Times

Housecarl

On TB every waking moment
That this sort of article is getting the light of day should be seen as a real warning...

For links see article source.....
Posted for fair use.....
https://www.marinecorpstimes.com/ne...r-for-marines-headed-into-the-next-big-fight/

No guaranteed ‘golden hour’ for Marines headed into the next big fight

By: Shawn Snow  
6 hours ago

A lifesaving Defense Department policy that whisks wounded troops off the battlefield to lifesaving care within the first hour of injury is a luxury Marines may not have headed into the next big fight.

The policy is credited with a near 98 percent survival rate, Rear Adm. Colin G. Chinn, Joint Staff surgeon, told audience members at a Navy medical symposium held at Marine Corps Base Quantico, Virginia, on Wednesday.

But as the U.S. is facing more capable adversaries, it’s a promise the Defense Department no longer believes it can keep.

“The last 15 years of war we pretty much adapted to the operational environment and dominated it,” Chinn said. “We are not going to have all the advantages we have now.”

Chairman of the Joint Chiefs, Gen. Joseph Dunford, relayed his concerns about the ‘golden rule’ last week to Chinn, the admiral said.

The ‘golden hour’ policy was put in place by then-Secretary of Defense Robert Gates in 2009 in an effort to stem the tide of increasing battlefield casualties. It was a promise by the DoD to surge medical assets and rotary wing support to the battlefields of Iraq and Afghanistan to save the lives of troops wounded in action.

For the past 15 years the U.S. military has dominated the battlefield, allowing U.S. forces to set the time and space for hostilities. U.S. forces controlled the terrain, and were afforded the ability to move medical assets when and where they wanted.

“But in a future fight that may not be the case,” Chinn said. “We need to be ready now. You fight tonight with what you have.”

Rising adversaries like Russia, China and North Korea are investing heavily in new missile technology and advanced weapon systems to contest the U.S. in hot spots and choke points around the globe.

In the next big war, the Corps is going to have to “fight to get to the fight,” Gen. Robert B. Neller, the commandant of the Marine Corps, has said.

Ensuring proper medical care for U.S. troops and Marines in this environment is an issue the Joint Chiefs are taking seriously: “We’ve been focusing on the Korea question the last several months,” Chinn said.

Senior U.S. military leaders are working to find and identify current gaps in medical planning and capabilities before the next big fight breaks out.

“Our potential problem is air lift capacity, in certain scenarios we are not going to have enough capacity and so as opposed to right now, we are going to have to hold onto those patients much longer,” Chinn said.

There are other problems too ― medical gear isn’t always uniform across the services.

A Marine wounded on the battlefield and patched up by a Navy doc on the ground may find his medical equipment isn’t interoperable with the Army or Air Force as he’s moved through different echelons of care.

“We need to solve that problem,” Chinn said.
 

night driver

ESFP adrift in INTJ sea
Crowley's "Trauma Golden Hour" mantra has been pretty much trashed by folks in the biz over the past 20ish years. It is hardly the hard end point for emergency care that it started out as (and HE wrote it as a sales tool for his (ahem HIS) Maryland ShockTrauma facility.

The Pros I have had the pleasure of playing with have pointed out that the 60 minutes to definitive care standard is nice, but we have kind of sliced and diced definitive care so much, with some of it noe coming to you in the street/squad, some coming in the chopper if you are SERIOUSLY compromised, some being in the trauma bay and some waiting upstairs or down the hall in the surgical theater, that 60 minutes standard is pretty much a dying relic.
For some injuries, definitive care needs to be a whole lot closer than 60 minutes, and for other similar appearing injuries, you have time, given current prehospital standards of care...

Devil Docs (Green Side Corpsmen...corpsmen assigned to Marine units) aer STILL going to work their magic, and do what they can, it's just now there may NOT BE a CASH on the end of a short chopper ride, OR there may not be a CASEVAC chopper nearby to GIVE that short ride.


I have no doubt that Devil DOCs will improvise, adapt, and overcome this new landscape.
 

Dozdoats

On TB every waking moment
medical gear isn’t always uniform across the services

NIH - not invented here - raises its ugly head yet again. This is shortsighted and stupid and should have been fixed decades ago - but here we still are. Stuck on stupid.
 

Reasonable Rascal

Veteran Member
The Death of the Golden Hour and the Return of the Future Guerrilla Hospital - from the Joint Special operations Univeristy.

https://prolongedfieldcare.files.wo...a-hospital-col-ret-warner-d-rocky-farr-md.pdf

Just so happens I have that on my hard drive. Part of the Gigabytes of medical stuff I have. Okay, there is some prepper stuff in there also. But I can seriously come up with at least 4 Gigs worth in just medical alone. Been doing up thumb drives for the author team so we have a head start on the next edition, and they are coming in at around 5 Gigs each. Lots of research material.

RR
 

Ractivist

Pride comes before the fall.....Pride month ended.
The Death of the Golden Hour and the Return of the Future Guerrilla Hospital - from the Joint Special operations Univeristy.

https://prolongedfieldcare.files.wo...a-hospital-col-ret-warner-d-rocky-farr-md.pdf

Just so happens I have that on my hard drive. Part of the Gigabytes of medical stuff I have. Okay, there is some prepper stuff in there also. But I can seriously come up with at least 4 Gigs worth in just medical alone. Been doing up thumb drives for the author team so we have a head start on the next edition, and they are coming in at around 5 Gigs each. Lots of research material.

RR
Has anyone ever compiled a video series of basic operations? Basic compound bone fractures being set...stuff like that in video form? Seems if the worlds gonna go boom, something of that nature might have value.
 

night driver

ESFP adrift in INTJ sea
Download Rascal's book (yes all 700 pages of it +/-)

Look through it and decide whether your hardcopy needs to have full color illustrations or B&W and then buy one.


B&W is economical (no not cheap but then again 600-700 pgs IS a lot of print). Color, ummm, not so much.

BUT with it in hard copy form you don't have to find some kind of non-electric player when in the back shed guerrilla OR.
 

Reasonable Rascal

Veteran Member
Hard to find video of stuff like that. Patient confidentiality and all that. Best I have ever personally seen are video'ed lectures. Otherwise the best you can find are short clips weaved into training films heavily dependent upon a commentator.

RR
 

ShadowMan

Designated Grumpy Old Fart
...Devil Docs (Green Side Corpsmen...corpsmen assigned to Marine units) are STILL going to work their magic, and do what they can, it's just now there may NOT BE a CASH on the end of a short chopper ride, OR there may not be a CASEVAC chopper nearby to GIVE that short ride.

I have no doubt that Devil DOCs will improvise, adapt, and overcome this new landscape.

As a retired combat veteran Devil Doc IDC (Independent Duty Corpsman) x 22 years I can tell you from first hand experience that if you aren't killed out right in combat a lot can be one to keep you alive by just following the simple ABC's. Keep the Airway open, Keep them Breathing, Protect the Circulation.

I have seen people that should have lived, die and people that should have died, live. I think the single biggest impact once the three primary ABC's are dealt with is the mindset of both the patient and provider. The patient has to fight to survive and the provider has to fight to keep them alive, but if the patient gives up, it's almost impossible to save them. Attitude IS EVERYTHING!
 

Doc1

Has No Life - Lives on TB
Absurd

From a military - though not medical - perspective, I think claiming to, in a real war, guarantee anything in 60 minutes is absurd. It may be a goal to aspire to, but every contingency should be explored (and hopefully ready) if it's not attained.

Best regards
Doc
 

Doomer Doug

TB Fanatic
I am a US Army trained medic, back in 1973, and I have to say you need to understand something. The "golden hour," was an IDEAL that depended on a whole bunch of things. The "golden hour," IS TOTALLY DEPENDENT ON THE ABILITY TO LAND A HELICOPTER, LOAD IT, AND THEN FLY OUT. This simple fact has always defined combat medical care. The theory is the combat medic, on the ground, in the field, does the first treatment, analysis. The goal is to keep things from getting worse, and to stabilize the medical situation. You then get the wounded out of the field, and back to either a major field clinic, or a MASH, mobile army surgical hospital, where a DOCTOR can look at him.

So, what this article is really doing is simply admitting what I knew way back in 1973. IF YOU HAVE ZERO AIR SUPERIORITY YOU HAVE NO MEDEVAC ABILITY. Further, with the rise of the shoulder fired manpads, YOU CAN NEVER HAVE AIR SUPERIORITY.

I think this article is merely a case of them finally admitting what we knew 40 years ago. It is also an admission all future landing zones are going to be hot.
 
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