By Thomas E. Bowen

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Forward Resuscitative Surgical System (FRSS). ♦ Embedded organically as part of the TO&E of the surgical company, if employed reduces the capability of its parent surgical company. 5 Emergency War Surgery ♦ Rapid assembly, highly mobile. ♦ Resuscitative surgery for 18 patients within 48 hours without resupply. ♦ 1 OR, 2 surgeons. ♦ No holding capability. ♦ No intrinsic evacuation capability. ♦ Chem/bio protected. ♦ Stand alone capable. Level III Represents the highest level of medical care available within the combat zone with the bulk of inpatient beds.

The shorter this time interval, expect the complexity of triage decisions to increase, especially sorting the worst emergent patients from the expectant. Longer intervals will result in the opposite, with “autotriage” of the sicker patients from the emergent to the expectant/dead on the battlefield category. ♦ Time spent with the individual casualty. In a mass casualty situation, time itself is a resource that must be carefully triaged/husbanded. All patients receive an evaluation, but only some receive operative intervention.

Fragments of depleted uranium should be treated during initial wound surgery as any retained metal foreign body should. There is a hypothetical risk, over years, that casualties with retained depleted uranium fragments may develop heavy metal poisoning. This concern by itself does not justify extensive operations to remove such fragments during initial wound surgery. 10 Weapons Effects and Parachute Injuries ♦ Injuries to those inside a vehicle are due to the direct effects of the penetrator or from fragments knocked off the inside face of the armored plate.

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