The trauma system we operated with Mujahed Medical Center in Afghanistan was a good lesson in life support. Let us compare the outcome of the first period (year 1989) with the second period (1990 – 92).
In 1989 too many patients died, 26%. So, we did three major changes:
- Shorter response times: paramedic combat teams should get at the patients within 30 minutes after the injury.
- Early chest tubes: Paramedics placed chest tubes and gave IV ketamine pain-relief on site.
- Ban on tourniquets: External bleeding was controlled by sub-fascial packing and long compressive dressings.
Early forward life support reduced the trauma mortality rate at Jalalabad from 26% to 13%.
Significantly less patients with chest and severe limb injuries died with the new aggressive rescue system.
Good life support is early life support !