Have you been exposed to trauma in near or freezing conditions? Are there institutional courses or classes available that discuss this topic?

2021-04-16T01:58:51-04:00

25th ID in Alaska and Ft. Drum regularly send people through the Cold Weather Leader Course, and Mountaineering courses that aid those units in learning about TTPs and lessons learned from cold weather conflicts in the past and how to negotiate the terrain more effectively, reduce risk, and much more. Many of the references and lessons were taken from the Russo and Finnish war, several references to the documentary Fire and Ice https://www.youtube.com/watch?v=QBtSP_X7fog&list=PL0tVClD-FkQon3lAVx94LwBcPJW07uW1Q&index=2.

A large problem that remains with little focus is how to respond to trauma in cold weather. We talk about cold weather injuries all the time but there is very little in the way of courses or classes dedicated to treatment of trauma within near or freezing conditions. History, if unchanged, would show that if you experience severe trauma in these arctic conditions, you are guaranteed death. Is there any more information offered on the SOF side to address this issue? I have not come across any in either conventional or SOF in the communities I worked with.

Fire and Ice: The Winter War of Finland and Russia

2005 Documentary

Response by CPT Lawrence Cable made Apr 16 at 2021 8:08 AM

2021-04-16T08:08:01-04:00

I would suggest you look at mountaineering medicine and wilderness medicine sources for answers. My take is that the ability to maintain body temperature is the biggest concern, so if you have a wound that has profound blood loss, you are trying to deal with shock and maintain a non hypothermic body temperature, which would be difficult if rapid evacuation is unavailable. I taught Swiftwater Rescue for about a decade and have had to deal with hypothermia alone on rivers on a number of occasions where there were not any additional conditions involved. If the condition gets beyond the "umbles" stage, evacuation is required to a definitive care facility. Google "Medicine for Mountaineering" as a good place to start. Here are a number of Wilderness Medical Schools in the nation, from NOLS to WMI. They can be a good source too.

Response by SSG Paul Headlee made Apr 16 at 2021 9:08 AM

2021-04-16T09:08:08-04:00

Great question and I hope someone knowledgeable chimes in so I can learn more. All I can offer is that I routinely carried a "space blanket" (commercial name) in my ruck sack. Its just a sheet of mylar the size of a poncho liner. This was in case anyone took a dunk in freezing weather. Never needed it but I thought it couldn't hurt.

Response by SFC Randy Hellenbrand made Apr 16 at 2021 10:08 AM

2021-04-16T10:08:23-04:00

Avoiding hypothermia and the ability to evac are the 2 issues. We know how to treat our wounded, but cold weather is just a plain old--KILLER. So make sure you know how to get the individual warm. and keep them warm-FAST. (And yes, this is where you may have to do the two in one bag thing) So, your basic jobs are to perform first aide and to keep them warm till they are evacuated.

Now keeping your soldiers in good physical shape is biggest thing you can do to help them survive being wounded in extreme cold. There is a host of PREVENTATIVE things that go along with this and everyone of them is absolutely important, and if not strictly enforced, will hugely retard a individual's ability to resist trauma in cold weather operations. Oh, I usually count frost-bite as stupidity and NCO negligence; unless you accidently fell into water.

Here are a few of them, and trust me, they are just little common sense things and orders of discipline. Clean and dry clothes, enough hot food to eat as you need additional calories to survive in cold weather, buddy system, hygiene, enough decent sleep, the discipline to follow winter SOPs, and good moral. I will only give you one example and you will see how something small becomes something big; frozen clothes don't keep you warm and have you ever tried to get them off?? Nuff said.

I used to be in the 205th Artic Light and I'm coined. The book Frozen Hell by William R. Trotter is excellent. An Oldie but Goodie that I have is the US Army's Pamphlet No. 20-271 by Earl Ziemke, on German Northern Operations from WWII; printed June 1959. While at a higher level, it covers a lot of issues of large scale northern operations and you can see how it filters down to the individual unit. This is really a old but excellent read. Oh, and it's actually a hard cover book and not a paper pamphlet.

Response by SFC Private RallyPoint Member made Apr 16 at 2021 1:43 PM

2021-04-16T13:43:11-04:00

I appreciate the added response of mountain medicine and like courses but in my experience they still mostly just cover cold weather injuries (including hypothermia) and response to them but still treat them as separate issues from the trauma sustained.

What I haven't seen yet is any official guidance that teaches medical providers when it's time to deviate from the book answer (TC3 guidelines specifically) and understand that exposing the patient will kill them. Giving them cold fluids that have been in your bag will kill them, applying moist dressings will increase risk of hypothermia, etc.

I have not witnessed any official guidance that tells the first responder at what temperature to stop administering fluid, exposing patients, changing the items we apply directly to the skin, etc..

It's a common problem that I have run into when it is 40 degrees outside or even snow on the ground and these first responders are still cutting or ripping clothing off and seeing the TC3 guideline indications for fluid administration and pulling out a bag that has been in their dismounted pack for the movement that took 30+ minutes and not even thinking twice before giving it to a hypovolemic patient. They are hot from the movement and don't even comprehend that it is near or freezing outside where they are providing tactical medicine.

Response by SFC Casey O'Mally made Apr 16 at 2021 3:28 PM

2021-04-16T15:28:27-04:00

I spent 4+ years at Fort Drum. I would definitely classify those winters as traumatic.

Response by SPC Joshua Dawson made Apr 19 at 2021 10:19 PM

2021-04-19T22:19:13-04:00

So this is only talking about training scenarios? This is not something that would even be considered practical anymore because of the massive cost that would be associated with it and the fact that such expeditions would not be happening anymore because it is way safer and more cost effective to simply avoid those areas entirely when making troop movements. I have to confess I don't know much about the training aspect of it because most of my time was spent in combat zones but I do know about the budgeting aspect and trying to secure the necessary funds for training that would ultimately be deemed unnecessary would be almost impossible. I remember when I was teaching combat life saver classes to my unit that me and the other two guys teaching the class actually even had to secure our own supplies for teaching the class and even setup our own lesson plan and everything and that was training that the unit actually wanted to happen.