US Army medics prepare for war with China

HONOLULU—Military casualty care in the Iraq and Afghanistan wars aimed to fly wounded troops to a hospital within “the golden hour.” But such quick medevacs are unrealistic in the vast Pacific.
“You can’t fly anywhere in an hour, and you may or may not have air dominance,” in a potential war with China, Maj. Gen. Darrin Cox, commander of the U.S. Army’s 18th Medical Command, said in an interview at the Land Forces Pacific conference here.
To prepare for that possibility, the Army has added a few days to the combat medic training course, is doing more realistic rehearsals with partner nations to build relationships, is building joint theater distribution centers to bring equipment west of the International Date Line, and is developing distributed command-and-control nodes in the region.
The additional training will enable medics to do a blood transfusion on the ground, extending the time that patients can survive without hospitalization, said Sgt. Maj. Jennifer Francis, the command’s senior enlisted advisor.
Cox said the war in Ukraine shows what the future battlefield may look like.
“Europe is not the Indo-Pacific, but we’ve certainly seen it in the Ukraine conflict, where casualties take hours to be evacuated. And that requires a rethinking in how we do things,” he said. “As an example, tourniquets. In Iraq and Afghanistan, you put a tourniquet on, and you didn’t worry about it, because it was going to get to [a hospital with advanced capabilities] in plenty of time, and then doctors would be taking the tourniquet off. That’s not what’s occurring in Ukraine right now.”
The availability of blood for transfusions is also a major concern, Cox said, as well as other logistical hurdles. But he said he’s hopeful.
“I actually hope that we’re able to assure and deter—assure our allies and deter our adversaries—so that we never have a conflict. But if we do, then I hope to hell that we’re ready. And I think we will be.”