This is a facinating article about how researchers enter the battlezones, to study wounds and injuries and make recommendations for preventing such injuries.

Suggesting that troops use effective safety measures while burning trash is just one example of contributions researchers have made while in the Iraqi theater of operations.

“With a war ongoing, we need to be able to provide fast feedback for troops in the field as well as to people making decisions about research priorities,” said Col. Lee Cancio, a trauma surgeon with the U.S. Army Institute of Surgical Research who deployed to the 86th Combat Support Hospital in Baghdad in April 2005.

Researchers at the ISR, which also runs the Army Burn Center at Brooke Army Medical Center, were able to provide quick, relevant advice to the field because of the types of burns they were seeing with their patients.

For instance, many Marine patients at the burn center had both hand and face burns. Hand injuries, Cancio said, have a long-term effect because they can hinder the person from being able to return to duty. Based on those findings, Army researchers were able to tell the Marines Corps that any Marine who might encounter an improvised explosive device should wear fire-proof hand protection, like Nomex flight gloves. Researchers were also able to tell the field that many of the burn injuries occurred when servicemembers were burning human waste or trash.

I know several doctors who specialize in this type of work. They are amazing. It seems they can tell almost exactly how a certain wound or injury occured, just by looking at it. Many injuries occur during non-battlefield time.

Studies that take place while a conflict is ongoing also tell researchers what their priorities should be, Cancio said. Take tourniquets, for example. During the Vietnam War researchers found that the number-one cause of preventable battlefield death was hemorrhagic shock. Based on that information, they recommended that today’s warfighters receive improved tourniquets.

“Now we’re still seeing patients who are dying of hemorrhagic shock from penetrating torso injuries that would not respond to a tourniquet, so that’s an example of where our research priorities should be. They should be oriented toward those particular types of injuries and treating shock from those injuries because we don’t have a good product for that,” Cancio said. “That’s the sort of important information that we need to get out of this type of analysis.”

And when the doctors are right there, they can relay these facts back to those who make decisions about body armor and the like. The military has reasons for doing things the way they do.

Researchers see a real need for gathering data in theater vice waiting for the information to migrate into databases in the States.

“There are a number of data sources that would have been irretrievably lost unless there were investigators who were actually deployed, looking out for preserving the data for later review,” Cancio said.

Doing research in a combat theater isn’t a novel idea; in fact, it’s been done since World War I, the colonel said. What has changed since those research studies were conducted, however, is the regulatory environment overseeing research. Before any research study can start, its plan, called a protocol, has to be reviewed at various levels to make sure the plan is a good one. In the States, the final okay comes from a body called an institutional review board.

“As you might imagine, the institutional review board is a fairly sophisticated committee with experienced research and regulatory people who meet on a regular basis,” Cancio said. “We, of course, did not intend to deploy any such committee to Iraq.”

Lt. Col. Jennifer Thompson of the Walter Reed Army Institute of Research’s institutional review board did deploy to Iraq, namely to the 44th Medical Command, from June to October 2005 to set up a process for researchers to have their protocols reviewed. Cancio, as well as a few other researchers at the 86th Combat Support Hospital, had their draft research protocols ready for her when she landed.

Her arrival was a welcome one because researchers were warned not to begin any studies without first getting all the same approvals they’d need in the States.

For the most part, the types of studies researchers were hoping to undertake were retrospective studies, meaning researchers would look at data gathered from patient medical records or other clinical data that’s available in a medical treatment facility to identify injury trends and outcomes.

A little red tape if you ask me, but it wouldn’t be the MILITARY without some of that. It’s alot like forensic science, this work. There is more to this article and I recommend folks read it…there is a lot more to body armor than just testing the suits and plates. Looking at actual data and actual wounds help form professional recommendations.