War at Sea: Burn Care Challenges-Past, Present and Future

Area of Science:

• Naval Medicine
• Military Health
• Burn Injury Management

Background:

• Seafarers face thermal injury risks in naval warfare, but improved prevention has reduced burn incidence.
• This reduction has led to a clinical skills gap, particularly concerning severe burn injuries.
• Ships with limited medical capabilities (Role 1) show worse outcomes than those with surgical support (Role 2).

Purpose of the Study:

• To highlight the need for Military Medicine to prepare for future burn care challenges in naval warfare.
• To emphasize the importance of historical lessons from World War I and World War II.
• To advocate for essential resources and training for managing burn casualties.

Main Methods:

• Reviewing historical approaches to burn and trauma care in naval settings.
• Analyzing the impact of medical capabilities (Role 1 vs. Role 2) on burn injury outcomes.
• Identifying critical needs for resuscitation fluids and formal training.

Main Results:

• Burn injuries in warfare are often associated with other traumatic injuries.
• Access to whole blood and dried plasma is vital for resuscitation in burn and hemorrhagic shock.
• Formal burn care training and skills sustainment are necessary for medical personnel.

Conclusions:

• Military Medicine must prepare for complex burn and trauma scenarios at sea by recalling historical best practices.
• Increased availability of whole blood and dried plasma is urgently needed.
• Enhanced burn care education, training, and skills sustainment are imperative, alongside investments in prevention and countermeasures for modern warfare threats.