While the media focus on "smart bombs" and remote-controlled drones, the ravages of war are still a harrowing reality for U.S. Army soldiers. In Afghanistan, Iraq and other global hot spots, frontline soldiers face life-threatening injuries. But until the turn of the century, soldiers were barely equipped to deal with their wounds.
"While we have made tremendous advances in modern medicine, we have not figured out how to keep people from being killed in combat," wrote retired Lt. Col. Donald Parsons in a 2004 issue of Infantry magazine.
Roughly 90 percent of soldiers killed in ground combat die before reaching medical facilities. Parsons, who served 30 years as an Army Special Forces medic and physician's assistant, and now works in the Army's Department of Combat Medic Training, says many deaths can be prevented through improved training and first aid gear.
The three leading causes of preventable battlefield death are blood loss from extremity wounds, collapsed lungs and obstructed airways. The Army's Improved First Aid Kit, or IFAK, is designed to address those immediate needs.
Developed since the Sept. 11, 2001, terrorist attacks, IFAKs are issued to every combat soldier. More streamlined than a full Army medic kit, the individual IFAK is a lightweight collection of supplies designed to limit many combat injuries that can often be applied by the injured solider.
"What soldiers used to carry was just a pressure dressing," said Major Kenneth Koyle, deputy chief of the Army Medical Department's Center of History and Heritage at Fort Sam Houston, Texas. "So if you got shot, you had one course of action, and that was to tie a bandage around it. That was the case up until shortly after 9/11. Then the IFAK came out. The kits have definitely evolved."
Today's Army IFAK weighs less than a pound (0.45 kilogram) and features a one-handed tourniquet (enabling self-application), a nasopharyngeal airway tube, elastic emergency trauma bandages (or "Israeli pressure dressing"), hemostatic combat gauze, adhesive tape and surgical gloves. All items are contained in a compact, folding kit that slides into a water-repellent pouch.
The Army IFAK shouldn't be confused with similarly named first aid kits from other branches of the armed services. The Marine IFAK is much more comprehensive, with a larger array of adhesive and compression bandages, burn dressing, iodine solution, antibiotic ointment, water-purification tablets and "quikclot" packets.
There's also the Army's Combat Lifesaver Aid Bag. What's in it? Keep reading.
What's a Combat Lifesaver?
On the battlefield, the faster a wound can be treated, the better chance of recovery. According to retired Lt. Col. Donald Parsons, improved training coupled with superior medical supplies can reduce the number of battlefield deaths by as much as 15 to 20 percent.
"The days of not providing self-aid and lying there and yelling 'Medic' are over," wrote Parsons in 2004. "We must have the ability to assess our own wounds, provide self- or buddy aid if needed, and continue the mission if able."
Since medics aren't always available -- and self-aid isn't always possible -- the Army instituted the "combat lifesaver" program. With medical training somewhere between basic and combat medic, these nonmedical soldiers' second mission (after combat) is to offer lifesaving aid.
That soldier is equipped with a Combat Lifesaver Bag, which is more extensive than the IFAK each soldier carries. In addition to the IFAK basics, the constantly evolving Combat Lifesaver Bag (also known as a Medical Equipment Set) includes an expanded array of:
- Bandages, dressings and adhesive tape
- Clotting agents, diazepam injection syringe
- Abdominal wound trauma kit and chest wound dressing
- Atropine injection syringe, intravenous equipment
- Water repellent heating blanket or survival blanket
- Shears, scissors and splints
- Eye shield
- Nasal trumpet
- Alcohol pads
Further, every soldier has received detailed training in how to use the lifesaving gear contained in the Combat Lifesaver Bag.
"The Army policy used to be one combat lifesaver per squad of soldiers," said Maj. Kenneth Koyle. "They have determined -- in the past couple of years -- that that training is so beneficial that every soldier now gets combat lifesaver training as part of basic training … Every soldier is now a combat lifesaver."
The 40-hour training course is extensive. It covers care under fire, tactical care, controlling bleeding with and without a tourniquet, opening and managing the airway, treating an open chest wound and possible collapsed lung, treating torso trauma and tactical movement of an injured soldier.
Finally, the full Army combat medic's kit is even more wide-ranging, and includes a stethoscope, suction kits with catheter, surgical sponges, traction tools, a pulse oximeter to measure oxygen saturation, hand-operated resuscitator, sodium chloride injections, an airway toolkit and surgical drainage tubes.
Want to know more about Army first aid? Visit the links and resources on the next page.
Preventive medicine in the U.S. Army is similar to civilian medicine. Test your knowledge with the preventive medicine in the U.S. Army quiz.
- Evenhouse, Matt. "The 'IFAK' Explained." Medical Security International. (April 7, 2011)http://www.medsecintl.com/pages.php?pageid=53
- Koyle, Kenneth. Maj. Deputy Chief of the Army Medical Department's Center of History and Heritage. Personal Interview. April 6, 2011.
- Maxwell, Sarah. "Army Fields New Equipment to Stop Bleeding." Mercury. December 2008 (April 6, 2011)http://www.armymedicine.army.mil/news/mercury/08-12/stopbleeding.cfm
- Parsons, Donald. Retired Lt. Col. "Battlefield Medicine: A New Perspective." Infantry Magazine. March-April 2004. (April 7, 2011).
- Parsons, Donald. Retired Lt. Col. E-mail correspondence, April 6-8, 2011.
- U.S. Army. "Marker Battle Reference Combat Medic." Excel document. April 2009. (April 7, 2011)
- U.S. Army Institute for Professional Development. "Combat Lifesaver Course." (April 7, 2011)http://www.armyrotc.mtu.edu/Materials/ISO871_Student_Self_Study.pdf
- U.S. Army, Medical Simulation Training Center. "Courses Offered at the Ft. Lewis MSTC." May 13, 2009. (April 7, 2011)http://www.mamc.amedd.army.mil/mstc/mstc-home.htm
- World News. "IFAK US Army Issue." Video. (April 8, 2011)http://wn.com/IFAK_US_ARMY_ISSUE