Front Line Surgery: Mastering Military Trauma Care

Blast Injury and New Injury Patterns from Drone Warfare

In this episode of Frontline Surgery: Mastering Military Trauma Care, Drs. Joshua Dilday and Jeff Conner are joined by COL (ret) John Holcomb, MD to examine how modern drone warfare is reshaping battlefield injury patterns and the challenges facing deployed trauma teams. Drawing on recent experience working alongside Ukrainian clinicians and multinational partners, Dr. Holcomb discusses the evolving mechanisms of injury associated with drone-delivered explosives and the operational realities of providing care in contested environments. The conversation explores how fragment injuries from aerial munitions are producing different anatomic injury patterns compared with previous conflicts, including increased head, neck, and upper extremity trauma. Dr. Holcomb highlights the importance of understanding mechanisms of injury, recognizing blast-related complications such as tympanic membrane rupture and traumatic brain injury, and managing patients with extensive fragment wounds. The episode also addresses the operational constraints affecting casualty evacuation and resuscitation timelines in drone-dominated battlefields. With evacuation delays ranging from hours to significantly longer, frontline teams must adapt their approach to hemorrhage control, resuscitation, and resource management. Dr. Holcomb emphasizes that preparation for these environments requires both clinical readiness and system-level training, noting that high-volume trauma experience and strong team coordination remain essential for military medical teams preparing for deployment. Keywords: Blast Injury, Drone Warfare, Military Trauma Care, Fragment Injuries, Combat Casualty Care, Damage Control Resuscitation, Battlefield Evacuation, Trauma Systems, Military Surgery, Austere Trauma Care

Pediatric Surgery

In this episode of Front Line Surgery: Mastering Military Trauma Care, hosts Drs. Jeff Conner and Jay Yelon are joined by Drs. Matt Martin and Luke Neff to discuss the critical aspects of pediatric trauma care in a deployed military setting. They emphasize the importance of preparation, improvisation, and understanding the unique challenges faced when treating children in trauma situations. Key topics include initial assessment, resuscitation techniques, vascular access, damage control resuscitation, hypothermia management, and surgical approaches to hemorrhage control. The conversation also highlights the need for military surgeons to be equipped with pediatric supplies and knowledge to effectively care for injured children in combat zones.  Keywords: pediatric trauma, military surgery, resuscitation, vascular access, damage control, hypothermia management, surgical techniques, deployment preparation Literature: ACS M Curriculum: Pediatric Surgery Module [https://apps.facs.org/militaryclinicalreadinesscurriculum/#/lessons/vnlIJEgKcV1Sf_f9pwxAjpJjdif5pUXd]

Military Communication and Lingo

In this episode of Front Line Surgery: Mastering Military Trauma Care, hosts Drs. Joshua Dilday and Matt Eckert engage with COL Jennifer Gurney, MD, to explore the critical role of military communication and lingo in trauma care. The conversation dives into the operational challenges surgeons face when translating medical realities into terms commanders can act upon. COL Gurney shares insights from her multiple deployments on learning to “speak two languages”—medical and operational—and how credibility, clarity, and humility are vital for bridging the gap between surgical expertise and command decision-making.  Keywords: Military communication, operational lingo, trauma surgery leadership, combat casualty care, bridging medical and operational language, credibility in military medicine, risk communication, surgeon preparation, military command relationships, surgical mentorship Literature: Front Line Surgery: A Practical Approach [https://www.amazon.com/Front-Line-Surgery-Practical-Approach/dp/3319567799]

Mass Casualty Management

In this episode of Frontline Surgery: Mastering Military Trauma Care, Col (ret) Jeremy Cannon, MD joins hosts Drs. Joshua Dilday and Rachel Russo to break down the realities of managing a mass casualty (MASCAL) event. The discussion focuses on battlefield triage systems, including the 10-second triage tool, priority categorization (P1, P2, P3, expectant), and rapid decision-making under extreme resource constraints, limited blood supply, and uncertain evacuation timelines.  Key topics include damage control surgery, hemorrhage control, tourniquet application, TCCC principles, walking blood bank activation, junctional and torso trauma prioritization, resuscitative thoracotomy decision thresholds, prolonged field care considerations, and blood product logistics. Dr. Cannon emphasizes the importance of a designated triage officer, patient accountability systems (PAD tracking), communication roles, and maintaining situational awareness during combat casualty surges.  The episode also explores military–civilian trauma system integration, disaster preparedness exercises, leadership under pressure, expectant category decision-making, and the emotional and ethical challenges of battlefield surgery. Preparation, rehearsal, shared mental models, and disciplined surgical leadership are highlighted as essential to optimizing survival in high-acuity combat trauma and mass casualty scenarios Keywords: mass casualty, trauma surgery, military medicine, triage, leadership, combat casualty care, surgical skills, resource management Literature Mentioned: Front Line Surgery: A Practical Approach [https://www.amazon.com/Front-Line-Surgery-Practical-Approach/dp/3319567799]Ten Second Triage Tool [https://fphc.rcsed.ac.uk/the-faculty/about-us/news/2023/april/ten-second-triage-tool-tst]Disaster Management and Emergency Preparedness Course [https://www.facs.org/quality-programs/trauma/education/disaster-management-and-emergency-preparedness/]STOP THE BLEED Program [https://www.stopthebleed.org/]

Deployed Burn Management

In this episode of Frontline Surgery: Mastering Military Trauma Care, hosts Drs. Rachel Russo and Jay Yelon discuss the critical aspects of military burn care with Colonel (ret.) Lee Cancio, MD, a leading expert in the field. The conversation covers essential topics such as the preparation for managing burns in deployed settings, the principles of burn resuscitation, the importance of situational awareness, and the necessity of effective wound care. Dr. Cancio emphasizes the challenges faced by surgeons in resource-limited environments and the need for teamwork in providing optimal care. The discussion also touches on the potential for increased burn injuries in future conflicts and the importance of triage in managing casualties effectively. Keywords: military trauma care, burn care, battlefield injuries, resuscitation, wound management, surgical training, emergency care, military medicine, trauma surgery, surgery Literature Mentioned: ACS M Curriculum - Burn Module [https://apps.facs.org/militaryclinicalreadinesscurriculum/#/lessons/DWrFBSIfQ3z2huWjUD-WGeTfLCMlc3gm]ABLS:  https://www.ameriburn.org/burn-care-team/education/advance-career/abls [https://www.ameriburn.org/burn-care-team/education/advance-career/abls]ABLS NOW:  https://www.pathlms.com/american-burn-association [https://www.pathlms.com/american-burn-association]