Echelon I interventions and triage are effective and concordant with echelon II care in combat operations

We describe identified injuries, effectiveness of treatment, and triage categories for combat casualties at echelon 1 from April 1 to June 30, 2005 from western Iraq. A total of 133 casualties were evaluated including 12 who were killed in action and 7 who died of wounds. A medic or corpsman treated 75% of the remaining patients, 9% were treated by bystanders, 2% were seen by a physician or physician assistant, and 15% administered self-aid. Most injuries (84%) were blast related. Commonly wounded regions were the head (47%), lower extremities (40%), upper extremities (22%), and back (11%). Common interventions included dressings (37%), splints (8%), and intramuscular morphine (8%). Field triage categories at echelon I and casualty evacuation categories at echelon II were congruent. No significant injuries were missed and there were no detrimental interventions. In conclusion, combat casualties were assessed, treated, and evacuated appropriately by echelon I providers during this time frame.