Wartime medical innovations slash Israel’s troop mortality rate

Custom-designed helmets that stave off major brain injuries. Mobile blood banks and preliminary surgery on the battlefield. Dog tags that broadcast medical data. Evacuation by helicopter to hospitals, measured in minutes. Fentanyl lollipops to ease the pain.

As Israel plows into the second year of open-ended war on several fronts, its military doctors have been innovating trauma care on the fly and grimly boast a record survival rate. That, in turn, may help shore up public support in Israel for a conflict that has inflicted the country’s worst losses in decades.

“We accrue battlefield knowledge and apply it and improve on it even as the fighting continues,” said Lt.-Col. Ofer Almog, head of technological development for the Israel Defense Forces Medical Corps.

Of Israeli soldiers who sustain wounds in the Gaza Strip or southern Lebanon that require urgent treatment, 6.9 percent die, the corps says — a case fatality rate, or CFR, less than half that of Israel’s last major war, in 2006. It also compares favorably to the CFRs that U.S. forces suffered from similar kinds of attacks in Iraq and Afghanistan — 10 percent and 8.6 percent, according to a 2019 study published by the U.S. military’s Joint Trauma System.

An inherent advantage the Israelis have is in the proximity of hospitals. The average time it takes to evacuate a Gaza casualty to a trauma center is 66 minutes, the corps says. The record was 17 minutes.

But intervention begins beforehand, sometimes within seconds of the injury, administered by doctors, paramedics or medics deployed with every IDF combat company. Not far behind is an armored ambulance equipped with a specially cooled blood-bank, for type-O transfusions in large quantities.

“Our staff in the field are even equipped to do intraosseous infusions — directly into the bone marrow — when a soldier’s veins aren’t accessible,” Almog said.

Kyle Remick, a retired U.S. Army colonel and now trauma chief at Meritus Medical Center in Hagerstown, Maryland, described such “scoop and run” evacuations and rapid hemorrhage control as critical factors in saving lives.

He called a CFR of 6.9 percent unprecedented, and noted that Israel has long been known as a leader in such battlefield care.