ABCDE


HEALTH&SCIENCE Thewell-armedmedic


tuesday, november 2, 2010 LIFESKILLS


Locked and overloaded Multi-task much? You need the right heuristics. AnyBODY, E3


Make your Medicare choices


Consumer Reports Insights: Do’s and don’ts for boomers approaching 65. E3 Insuring Your Health: 2011 will bring new options for Part D. E6


K How the military is reducing fatalities among the wounded BY DAVID BROWN AT BAGRAM AIR BASE, AFGHANISTAN B


leeding to death has always been the chief hazard of war wounds—and the control of bleeding the first task of the combat surgeon. Ambroise Pare knewthat 460 years ago. ¶ A French physician who treated some of the first combat wounds caused by firearms, Pare observed in 1550 that when amputating a limb there was less bleeding if blood vessels were tied


off with silk thread rather than cauterized with a hot iron. For that and other gentler practices he became known as the “father of surgery.” ¶ Pare’s professional descendants are still obsessed with bleeding. ¶ The improvements in the care of casualties that have come out of the Iraq and Afghanistan wars almost all involve hemorrhage, the medical term for bleeding. They include better ways to stop it, keep it from restarting, and reverse it by restoring blood to the circulation (an option not available to Pare). They are the main reason survival of battlefield casualties is so much greater now than in the past. ¶ Data presented at a conference in August revealed that 8.8 percent of theU.S. combat casualties in Iraq and Afghanistan died, either on the battlefield or later of wounds. That compares with 16.5 percent of the VietnamWar’s casualties and 22.8 percent ofWorldWar II’s.


casualties continued on E4 A heavy burden


Combat medics’ kits have room for only key lifesaving components, yet the gear still weighs about 60 pounds. Army Sgt. Robin Veazey in Afghanistan displayed the tools of her trade:


Backpack contents


1. Foil blanket. 2. Combat Gauze, a bandage that makes blood clot quickly (2a and 2b are other types of gauze). 3. Abdominal bandage, which can hold organs in place. 4. Emergency trauma bandage, which stops bleeding from wounds not severe enough to require a tourniquet. 5. Elastic bandage wraps. 6. Stethoscope. 7. Drugs to relieve pain and one that reverses the action of morphine in case of overdose (from leg pack). 8. Tourniquet that can be tightened and locked with one hand. 9. Seal for sucking chest wounds. 10. Pulse oximeter, put on finger to measure oxygen content of blood. 11. Nasopharyngeal tubes, which hold the upper airway open. 12. Hextend, an intravenous fluid that helps counter shock, or dangerously low blood pressure. 13. IV tubing. 14. Splint kit. 15. Needle disposal container. 16. Needles to relieve a tension pneumothorax, a dangerous compression of the lung that can occur aſter a chest wound. 17. Another device that holds the airway open. 18. Intraosseous device, which delivers fluid and drugs to the circulation via the bone marrow when a vein can’t be found.


7 9 8 14 11 6 3 2a 10 2b 1 5 2 17 4


LINDA DAVIDSON, BONNIE BERKOWITZ AND ALBERTO CUADRA /THE WASHINGTON POST


18 12 13 8


Main medical kit (Contents below.)


Weapon


M-4 assault rifle with ammunition.


Personal first aid kit Every soldier carries two tourniquets, gauze and tape.


16 17 11 15


Leg pack Contains pain medications and a drug that reverses the effects of morphine in case of overdose or dangerous side effects (see No. 7 at leſt), plus some extra gauze and wrap. A medic may carry only this into rough terrain where the backpack would be too heavy and unwieldy.


Veazey also carries a few items that aren’t visible: gloves, adhesive bandages and heavy-duty scissors called trauma shears.


E EZ


URBANJUNGLE


Leaves of 5, let it thrive Virginia creeper turns red, bright and blue. E6


Stellar science fiction that shouldn’t be eclipsed


From “TheWar of theWorlds” to “1984,” some science fiction goes down in history. What about the brilliant books that got away?NewScientist magazine asked scientists and writers to nominate lost sci-fi classics.


‘FLOATINGWORLDS’ (BY CECELIA HOLLAND)


Nominated by Kim Stanley Robinson, science-fiction writer: “ ‘FloatingWorlds’ was published to acclaim in 1976, but has not been remembered as much as it should be. But


Holland’s immense power as a novelist, and her new take on old science fiction themes, turn everything to gold.”


WES BEDROSIAN FOR THE WASHINGTON POST


Outline: A story about Earth and other colonies in the solar system, some hundreds of years from now, when humans have begun to evolve into separate species and Earth is a mess. “FloatingWorlds” is the only science- fiction book by historical novelist Cecelia Holland.


‘THE CYBERIAD’ (BY STANISLAWLEM)


Nominated by Sean Carroll, cosmologist: “ ‘The Cyberiad’ is actually very appreciated among experts, but not well known in the wider world. It’s a wide-ranging exploration of robotics,


technology, computation and social structures. Very mind-expanding, with a fantastic sense of humor.”


Outline: Trurl and Klapaucius are constructor robots who try to out-invent each other. They travel to the far corners of the cosmos to take on freelance problem-solving jobs, with dire consequences for their employers. “The Cyberiad,” published in 1967, is by Polish writer Stanislaw Lem, best known for his novel “Solaris.”


‘RANDOMACTS OF SENSELESS VIOLENCE’ (BY JACKWOMACK)


Nominated byWilliam Gibson, cyberpunk sci- fi novelist: “It’s a book you really have to read to see why.”


Outline: Set in a near- future New York, this dark book describes a


disintegrating society where the air is toxic, gangs roam the streets and tuberculosis is rampant. In vivid language worthy of “A Clockwork Orange,” the story is told through the diary of 12-year-old Lola, who descends from a life of privilege and private schooling into a deadly gangster underworld as her family struggles to survive.


books continued on E6


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34  |  Page 35  |  Page 36  |  Page 37  |  Page 38  |  Page 39  |  Page 40  |  Page 41  |  Page 42  |  Page 43  |  Page 44  |  Page 45  |  Page 46  |  Page 47  |  Page 48  |  Page 49  |  Page 50  |  Page 51  |  Page 52  |  Page 53  |  Page 54  |  Page 55  |  Page 56