Mobile surgical teams are critical to battlefield care

Mobile surgical teams that follow troops into the field are becoming increasingly important to combat medicine, the Air Force surgeon general said Tuesday.

Lt. Gen. Dr. Mark Ediger said the eight-person teams are more mobile than field hospitals and don’t require the same extensive set-up.

“We have mobile surgical teams, the U.S. Air Force does, in North Africa now that actually move and relocate as the [military] operations occur,” he said at a breakfast hosted by the Air Force Association. “That’s a quite different scenario from what we were used to seeing in Iraq and Afghanistan. That has really required that we evolve our capabilities to be able to have surgical teams that can move with the operation, set up in locations of opportunity, and provide that kind of life-saving stabilization.”

U.S. and allied troops are involved in counter-terrorism operations in Africa, but the huge size of the continent and relatively few number of troops on the ground makes the mobile surgical teams more suited to the operations than a stationary field hospital, Ediger said.

He pointed to an incident in May when a French soldier took two bullets to the chest and was taken to one of the mobile surgical teams.

“They administered anesthesia, they operated, they stabilized,” Ediger said. “That sounds like a somewhat familiar scenario and story. What’s different about that story is that the U.S. Air Force surgical team that operated on that soldier was not located at a hospital. They had set up a make-shift operating room in a building of opportunity.”

The soldier, in fact, didn’t see the inside of a hospital until he got back to Europe, Ediger said.

Paired with the mobile surgical teams, military doctors have to be prepared to treat patients in mid-flight on the way to more advanced medical facilities.

“They are now moving patients who have yet to see their first hospital,” Ediger said. “Whereas in Iraq and Afghanistan it would be stabilize and then move to [U.S. military hospitals in] Germany, we now have a requirement to pick up patients that perhaps have not seen a hospital yet and continue the stabilization operations, providing more care and intervention as we fly. So we are actively engaged in the process of evolving the way we organize, train and equip our medical teams to do that.”

That increased ability to move patients quickly and stabilize them on the go has “made a big difference in terms of good outcomes for the wounded forces,” Ediger said.

With the mobile surgical teams on the ground, the Air Force is bolstering its medical instruction at San Antonio and the School of Aerospace Medicine at Wright-Patterson Air Force Base in Dayton, Ohio.

“We are in the process of putting together what we call an ‘austere surgical team training course,’ ” Ediger said. “We develop new training so that they are able to identify a site, set up a surgical location, but also so that they are prepared to be able to move and relocate with the operational force as required.”

The teams are also starting to see more specialists join their ranks.

“As we have gained experience over the last 15, almost 16 years of war, our medical capabilities that we have applied in a deployed environment have changed considerably,” the surgeon general said. “When I came into the Air Force, the doctrine was that we would never deploy or use a neurosurgeon or vascular surgeon or specialist like that in a field hospital. We didn’t think there was anything they could do in their skill set in a field setting. But today they are actually integral and a key part of what we do.”

Having specialized care so close to troops has allowed many saved lives and limbs, he added.

“We have a lightweight, modular capability that can come in with minimal airlift and get a surgical stabilization and a small hospital capacity on the ground operating within hours,” Ediger said.

So what’s the next big challenge? Better blood replacements for transfusions that don’t require large pieces of equipment to store.

“The ability to store and maintain blood products in a challenging environment is a significant focus for our research,” Ediger said, adding that the goal is to “develop blood products that don’t require refrigeration and can be reconstituted in the field.”