The Afghan Theater: A Review of Military Medical Doctrine From 2008 to 2014

Abstract

This article forms part of a series that will explore the effect that Role 2 (R2) medical treatment facilities (MTFs) had on casualty care during the military campaign in Afghanistan and how we should interpret this to inform the capabilities in, and training for future R2 MTFs. Key aspects of doctrine which influence the effectiveness of R2 MTFs include timelines to care, patient movement capabilities, and MTF capabilities. The focus of this analysis was to review allied doctrine from the United States, United Kingdom, and the North Atlantic Treaty Organization to identify similarities and differences regarding employment of R2 related medical assets in the Afghan Theater, specifically for trauma care. Several discrepancies in medical doctrine persist among allied forces. Timelines to definitive care vary among nations. Allied nations should have clear taxonomy that clearly defines MTF capabilities within the combat casualty care system. The R2 surgical capability discrepancy between United States and North Atlantic Treaty Organization doctrine should be reconciled. Medical evacuation capabilities on the battlefield would be improved with a taxonomy that reflected the level of capability. Such changes may improve interoperability in a dynamic military landscape.

Extending existing recommended military casualty evacuation timelines will likely increase morbidity and mortality: a UK consensus statement

“…Casualty evacuation timelines for UK service personnel who are injured or suffer from acute medical conditions are broadly based on descriptions within a NATO document termed Allied Joint Publication (AJP) 4-10. 1 The first version (edition A) was published in 2006 and formally introduced increasingly accepted concepts such as damage control surgery (DCS). 2 It stated that battlefield advanced trauma (BATLS) and battlefield advanced resuscitation techniques should occur within 1 hour of wounding.…”