Nearly 1.9 million U.S. troops have been deployed to Afghanistan and Iraq since October 2001. Many service members and veterans face serious challenges in readjusting to normal life after returning home. This initial book presents findings on the most critical challenges, and lays out the blueprint for the second phase of the study to determine how best to meet the needs of returning troops and their families.

Out of the Crucible: How the U.S. Military Transformed Combat Casualty Care in Iraq and Afghanistan edited by Arthur L. Kellermann, MD and MPH, and Eric Elster, MD is now available by the US Army, Borden Institute. This comprehensive resource, part of the renowned Textbooks of Military Medicine series, documents one of the most extraordinary achievements in the history of American medicine - the dramatic advances in combat casualty care developed during Operations Enduring Freedom and Operation Iraqi Freedom. Each chapter is written by one or more military health professionals who played an important role in bringing the advancement to America's military health system. Written in plain English and amply illustrated with informative figures and photographs, Out of the Crucible engages and informs the American public and policy makers about how America's military health system, devised, tested and widely adopted numerous inventions, innovations, technologies that collectively produced the highest survival rate from battlefield trauma in the history of warfare.

Specialty Volume of Textbooks of Military Medicine. TMM. Edited by Shawn Christian Nessen, Dave Edmond Lounsbury, and Stephen P. Hetz. Foreword by Bob Woodruff. Prepared especially for medical personnel. Provides the fundamental principles and priorities critical in managing the trauma of modern warfare. Contains concise supplemental material for military surgeons deploying or preparing to deploy to a combat theater.

Over the last five centuries, the development of modern weapons and warfare has created an entirely new set of challenges for practitioners in the field of military medicine. Between Flesh and Steel traces the historical development of military medicine from the Middle Ages to modern times. Military historian Richard A. Gabriel focuses on three key elements: the modifications in warfare and weapons whose increased killing power radically changed the medical challenges that battle surgeons faced in dealing with casualties, advancements in medical techniques that increased the effectiveness of military medical care, and changes that finally brought about the establishment of military medical care system in modern times. Others topics include the rise of the military surgeon, the invention of anesthesia, and the emergence of such critical disciplines as military psychiatry and bacteriology. The approach is chronological--century by century and war by war, including Iraq and Afghanistan--and cross-cultural in that it examines developments in all of the major armies of the West: British, French, Russian, German, and American. Between Flesh and Steel is the most comprehensive book on the market about the evolution of modern military medicine.

Many veterans returning from the conflicts in Iraq and Afghanistan have health problems they believe are related to their exposure to the smoke from the burning of waste in open-air "burn pits" on military bases. Particular controversy surrounds the burn pit used to dispose of solid waste at Joint Base Balad in Iraq, which burned up to 200 tons of waste per day in 2007. The Department of Veterans Affairs asked the IOM to form a committee to determine the long-term health effects from exposure to these burn pits. Insufficient evidence prevented the IOM committee from developing firm conclusions. This report, therefore, recommends that, along with more efficient data-gathering methods, a study be conducted that would evaluate the health status of service members from their time of deployment over many years to determine their incidence of chronic diseases.

Provides a detailed look at how war affects human life and health far beyond the battlefield Since 2010, a team of activists, social scientists, and physicians have monitored the lives lost as a result of the US wars in Iraq, Afghanistan, and Pakistan through an initiative called the Costs of War Project. Unlike most studies of war casualties, this research looks beyond lives lost in violence to consider those who have died as a result of illness, injuries, and malnutrition that would not have occurred had the war not taken place. Incredibly, the Cost of War Project has found that, of the more than 1,000,000 lives lost in the recent US wars, a minimum of 800,000 died not from violence, but from indirect causes. War and Health offers a critical examination of these indirect casualties, examining health outcomes on the battlefield and elsewhere—in hospitals, homes, and refugee camps—both during combat and in the years following, as communities struggle to live normal lives despite decimated social services, lack of access to medical care, ongoing illness and disability, malnutrition, loss of infrastructure, and increased substance abuse. The volume considers the effect of the war on both civilians and on US service members, in war zones—where healthcare systems have been destroyed by long-term conflict—and in the United States, where healthcare is highly developed. Ultimately, it draws much-needed attention to the far-reaching health consequences of the recent US wars, and argues that we cannot go to war—and remain at war—without understanding the catastrophic effect war has on the entire ecosystem of human health.

This unique volume presents the experience of 37 U.S. military nurses sent to the Iraq and Afghanistan theaters of war to care for the injured and dying. The personal and professional challenges they faced, the difficulties they endured, the dangers they overcame, and the consequences they grappled with are vividly described from deployment to discharge. In mobile surgical field hospitals and fast-forward teams, detainee care centers, base and city hospitals, medevac aircraft, and aeromedical staging units, these nurses cared for their patients with compassion, acumen, and inventiveness. And when they returned home, they dealt with their experience as they could. The text is divided into thematic chapters on essential issues: how the nurses separated from their families and the uncertainties they faced in doing so; their response to horrific injuries that combatants, civilians and children suffered; working and living in Iraq and Afghanistan for extended periods; personal health issues; and what it meant to care for enemy insurgents and detainees. Also discussed is how the experience enhanced their clinical skills, why their adjustment to civilian life was so difficult, and how the war changed them as nurses, citizens, and people. Key Features: Describes verbatim the experiences of 37 nurses in two brutal, chaotic theaters of war Offers poignant encounters with patients Includes advice, clarity, and lessons learned about nursing in war Offers a women's health perspective on working and living in a war zone Demonstrates the dedication, expertise, and spirit of military nurses

This book focuses on an organization, the U.S. Army Nurse Corps, which the author has been privileged to be affiliated with – in one way or another – for the greatest part of her adult life. As an active duty officer, the author had first-hand knowledge about the Army Nurse Corps inner workings and spent the last years of her Army career (from 1992) researching and writing the Corps history. One of her goals in researching and writing this history was to intrigue and provide a sense of gratification for the reader. After the conclusion of the Vietnam War, several wide-ranging and significant changes exerted myriad effects on the Army Nurse Corps. The most influential of these phenomena included the dismantling of the Selective Service System, the reorganization of the Army, the launch of the Health Services Command (HSC), the opening of the Academy of Health Sciences, the transformation of the Office of the Army Surgeon General, the inauguration of improvements in the Army Reserve and National Guard, and the evolution in the roles and status of women.

Problems stemming from the misuse and abuse of alcohol and other drugs are by no means a new phenomenon, although the face of the issues has changed in recent years. National trends indicate substantial increases in the abuse of prescription medications. These increases are particularly prominent within the military, a population that also continues to experience long-standing issues with alcohol abuse. The problem of substance abuse within the military has come under new scrutiny in the context of the two concurrent wars in which the United States has been engaged during the past decade-in Afghanistan (Operation Enduring Freedom) and Iraq (Operation Iraqi Freedom and Operation New Dawn). Increasing rates of alcohol and other drug misuse adversely affect military readiness, family readiness, and safety, thereby posing a significant public health problem for the Department of Defense (DoD). To better understand this problem, DoD requested that the Institute of Medicine (IOM) assess the adequacy of current protocols in place across DoD and the different branches of the military pertaining to the prevention, screening, diagnosis, and treatment of substance use disorders (SUDs). Substance Use Disorders in the U.S. Armed Forces reviews the IOM's task of assessing access to SUD care for service members, members of the National Guard and Reserves, and military dependents, as well as the education and credentialing of SUD care providers, and offers specific recommendations to DoD on where and how improvements in these areas could be made.

Advances in trauma care have accelerated over the past decade, spurred by the significant burden of injury from the wars in Afghanistan and Iraq. Between 2005 and 2013, the case fatality rate for United States service members injured in Afghanistan decreased by nearly 50 percent, despite an increase in the severity of injury among U.S. troops during the same period of time. But as the war in Afghanistan ends, knowledge and advances in trauma care developed by the Department of Defense (DoD) over the past decade from experiences in Afghanistan and Iraq may be lost. This would have implications for the quality of trauma care both within the DoD and in the civilian setting, where adoption of military advances in trauma care has become increasingly common and necessary to improve the response to multiple civilian casualty events. Intentional steps to codify and harvest the lessons learned within the military's trauma system are needed to ensure a ready military medical force for future combat and to prevent death from survivable injuries in both military and civilian systems. This will require partnership across military and civilian sectors and a sustained commitment from trauma system leaders at all levels to assure that the necessary knowledge and tools are not lost. A National Trauma Care System defines the components of a learning health system necessary to enable continued improvement in trauma care in both the civilian and the military sectors. This report provides recommendations to ensure that lessons learned over the past decade from the military's experiences in Afghanistan and Iraq are sustained and built upon for future combat operations and translated into the U.S. civilian system.