Wound Registry

from ScienceBlogA new registry being established is helping track casualty information from Iraq and Afghanistan to give senior leaders the concrete information they need as they make decisions about everything from what protective gear troops will use to how to better deliver combat casualty care. The Joint Theater Trauma Registry is ensuring that decision makers have more than anecdotal evidence to guide their decisions that directly affect troops on the ground, explained retired Army Col. L. Harrison Hassell, director of the registry system.

The registry captures details about wounds received and the medical care provided from combat support hospitals, aboard ships and aircraft and throughout the course of their treatment, as well as the results.

This shows medical care providers what treatments were most effective as they apply those lessons learned to other patients with similar wounds, Hassell explained. "A lot of the focus is on life-saving measures at the point of injury," he said. Medical care providers call this the most important stage of the patient's treatment and ultimate recovery.

The data collected in the registry demonstrates the effectiveness of new medical devices and techniques, such as one-armed tourniquets, Hassell said. "You really want to know are you having an impact with a new device you have developed? Is it saving lives?" he said.

The registry also helps medical instructors better tailor their training for the theater, he said.

But the data has longer-term implications as well, Hassell said, helping planners look to the future as they conceive the next-generation combat support hospital and better methods of evacuating patients from the battlefield.

In addition to improving the quality of trauma care, the registry is providing concrete data about a full range of issues of interest to military leaders and decision makers, such as the effectiveness of the new Kevlar helmet and the impact of roadside bombs on the force.

"This is data that affects people fighting right now," Hassell said. "It's helping answer the question, 'What should we do to protect them, and if they are injured, to save them?'"

The Army's Soldier Support Center in Natick, Mass., is studying the data as it strives to improve body armor systems and the Defense Advanced Research Projects Agency is evaluating the amputation data as it works on futuristic limb regeneration concepts.

Monthly reports that summarize the data collected so far have whet the military's collective appetite for more information. "It's like a feeding frenzy," Hassell said. "They all want more."

But providing more information and speeding up its delivery aren't as simple as it might seem. It's a slow, labor-intensive process that involves sorting through files of hand-written notes from weary battlefield healthcare providers, extracting the critical details, translating them into medical codes and entering them into the database.

"It's painfully slow," Hassell acknowledged, emphasizing that until all the data is collected and up-do-date, it offers only a partial view of the big picture.

But in the meantime, the database is providing combat trauma care information never before available, and certainly not while the war was still under way. In the past, medical data from the theater was never collected, and inpatient records were retired to the National Personnel Records Center in St. Louis as soon as each patient left the hospital.

Hassell said the emerging registry is already beginning to pay off in terms of supporting medical improvements, logistics and operational planning, force modeling, casualty forecasting, training and research and development.

"It's helping ensure that when decision makers or policymakers go forward, they're making decisions based on the best data available," he said.