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 M Rhee, Carlos Brown, Stacy Brethauer, Thomas Nelson, Nalan Narine, Bruce Baker, H. R. Bohman

Research output: Contribution to journalArticle

50 Scopus citations

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
Volume60
Issue number6
DOIs
StatePublished - Jun 2006
Externally publishedYes

    Fingerprint

ASJC Scopus subject areas

  • Surgery

Cite this

Chambers, L. W., Green, D. J., Gillingham, B. L., Sample, K., Rhee, P. M., Brown, C., Brethauer, S., Nelson, T., Narine, N., Baker, B., & Bohman, H. R. (2006). 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. Journal of Trauma, 60(6), 1155-1161. https://doi.org/10.1097/01.ta.0000220340.91356.7e