Autopsies of War Dead Reveal Ways to Save Others

By Denise Grady, The New York Times. Posted May 26, 2009.

From the New York Times:

The medical examiners have scanned about 3,000 corpses, more than any other institution in the world, creating a minutely detailed and permanent three-dimensional record of combat injuries. Although the scans are sometimes called “virtual autopsies,” they do not replace old-fashioned autopsies. Rather, they add information and can help guide autopsies and speed them by showing pathologists where to look for bullets or shrapnel, and by revealing fractures and tissue damage so clearly that the need for lengthy dissection is sometimes eliminated. The examiners try to remove as many metal fragments as possible, because the pieces can yield information about enemy weapons.

One discovery led to an important change in the medical gear used to stabilize injured troops on the battlefield.

Col. Howard T. Harcke, a 71-year-old Marine Corps radiologist who delayed retirement to read CT scans at Dover, noticed something peculiar in late 2005. The emergency treatment for a collapsed lung involves inserting a needle and tube into the chest cavity to relieve pressure and allow the lung to reinflate. But in one case, Colonel Harcke could see from a scan that the tube was too short to reach the chest cavity. Then he saw another case, and another, and half a dozen more.

In an interview, Colonel Harcke said it was impossible to tell whether anyone had died because the tubes were too short; all had other severe injuries. But a collapsed lung can be life-threatening, so proper treatment is essential.

Colonel Harcke pulled 100 scans from the archives and used them to calculate the average thickness of the chest wall in American troops; he found that the standard tubing, five centimeters long, was too short for 50 percent of the troops. If the tubing was lengthened to eight centimeters, it would be long enough for 99 percent.

“Soldiers are bigger and stronger now,” Colonel Harcke said.

The findings were presented to the Army Surgeon General, who in August 2006 ordered that the kits given to combat medics be changed to include only the longer tubing.

“I was thrilled,” Colonel Harcke said.

The medical examiners also discovered that troops were dying from wounds to the upper body that could have been prevented by body armor that covered more of the torso and shoulders. The information, which became public in 2006, led the military to scramble to ship more armor plates to Iraq.

Read the full article here.

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