DoD News, Defense Media Activity
WASHINGTON, Aug. 13, 2015 – “In your operations … in sea-, air- and land-unique environments, unfriendly as they may be … understand that we’re there with you or ahead of you.”
That’s military medicine’s pledge to operating service members, as articulated by Navy Rear Adm. Bruce Doll. The admiral is dual-hatted as director of the Research, Development and Acquisition Directorate, one of six directorates at the Defense Health Agency, and as the deputy commander of the U.S. Army Medical Research and Material Command.
Speaking to DoD News about an upcoming symposium focused on military medical research across the joint force, Doll listed five key concepts that drive the Defense Department’s medical research and acquisition: Discover, deliver and develop for force protection and readiness.
That commitment to soldiers, sailors, airmen and Marines, he said, means service members know they have “the absolute best, research-based efforts behind them, responsive to [them.]”
Troops also, if injured, have the best rehabilitative resources to assure they are restored and returned to duty, he added.
Doll said his directorate matches its priorities to operational requirements. “In terms of our discovery, we partner with whoever has the credible capabilities to move forward together,” he added.
Development of new products involves engagement with entities such as the Food and Drug Administration, he said, and in “the actual delivery of the product ... it’s very important that we see a relevance to our operational commitments.”
Meeting Operational Requirements
Air Force Col. Todd E. Rasmussen directs the U.S. Combat Casualty Care Research Program for the U.S. Army Medical Research and Materiel Command at Fort Detrick, Maryland. He noted that unlike many of the other important aspects of military medical research, from human performance to infectious disease prevention and treatment, “there are no other federal agencies [besides DoD] providing research funding for trauma care.”
That means the department holds the only “safety net” for improving trauma care, he said.
DoD’s “stalwart partners” at the National Institutes of Health run proven and effective research programs, Rasmussen said, to counter cancer, infectious disease, neurologic disease and stroke, and heart, lung and blood disorders.
But, he added, “The federal research landscape in this country is set up such that’s there’s not any amount of that equity applied to trauma.”
Combat casualty –- or trauma – care thus becomes the department’s “clarion research mission,” he said.
Successes: Tourniquets, Preserved Blood Products
Rasmussen offered two examples that demonstrate why today’s service members can expect to survive combat injuries their fellow troops in past wars didn’t: tourniquet advances and use of blood products.
Knowledge and materiel solutions combine in advancing trauma care, he explained: so while, for example, current tourniquets are much more effective because of their construction, questions remain about “when you can apply the tourniquet, how long can you leave the tourniquet on, how tight can you tighten” it. “Those aren’t a materiel solution, that’s the knowledge,” Rasmussen noted.
Applying research and development to drive innovation across the spectrum of trauma care is the goal, he explained: at point of injury, in transfer between care facilities, and at care facilities.
Advanced blood products now in the pipeline promise new capabilities at all three points of care, likely in two to four years, Rasmussen said: dried or preserved plasma, fibrinogen and possibly red blood cells will offer shelf-stable alternatives to fresh blood in treatment conditions.
That is an example of the “tremendous, step-change” progress military research has enabled in resuscitation, he said.
Before the Afghanistan and Iraq wars, he said, except in cases of surgery or massive hemorrhage, blood loss was replaced with solutions such as saline or Ringer’s Lactate.
The work done in blood replacement during the wars is a “shining example” of research success, he added, “because it brings together epidemiologic study … innovation in knowledge [of blood products] … [and] materiel solutions.”
Gaps in trauma care, identified by service and other senior leaders, drive specific efforts, Rasmussen explained: then-Defense Secretary Bob Gates in 2008, for example, called for work on controlling blood hemorrhages resulting from injuries to the arms, hands, legs and feet.
“There’s a myriad of user communities that define the gaps,” he said. Rasmussen’s staff guides the research efforts into “different portfolios” that exist within the military and also academia, industry and the public health community, he said.
Symposium Gathers, Recognizes Research Experts
Doll said the Military Health System Research Symposium, set for Aug. 17 to 20 in Fort Lauderdale, Florida, is the annual event designed to bring together the research community’s far-flung members, American and international, who work on ships, in planes and on the ground, in labs and treatment facilities.
With limited but generous funding, looking across the services to find synergy across research efforts is part of managing the scale of the enterprise, he noted: the symposium deliberately seeks Army, Air Force and Navy participation.
The event recognizes and publicizes research results, the admiral said, allowing attendees to share “current, cutting-edge efforts.”