HFES BULLETIN • AUGUST 2006 1 supplies include a new first-aid kit containing a wrap-style ban- dage and clamp to apply compression to a wound, an improved tourniquet that can be applied with one hand if necessary, and the chitosan hemostatic dressing, made from a shrimp-cell extract, which immediately stops bleeding by bonding to blood cells to form a clot (Cox, 2005; Fleming-Michael, 2005). All basic recruits now receive first-aid training that focuses on using the new medical supplies to control bleeding and to assist with other medical problems (Wood, 2005). Receiving realistic training prior to deployment also eases the effects of battle stress (Funk, 2005). Although all soldiers receive first-aid training and many have earned a Combat Lifesaver designation, it is the combat medic who possesses the necessary skills to assess, stabilize, and provide emergency medical treatment for those with life-threatening trau- ma. Combat medics receive realistic training in which they expe- rience the entire process from precombat checks to after-action reviews so they can learn from their mistakes without risking lives (“Golden Medic Exercise,” 2005). The advanced training program for these trauma specialists is one of many demanding specialty training programs in the mili- tary. A major challenge for these courses is high failure rates. A landmark HF/E study (Rice et al., 2006a, 2006b) is under way to develop a tool to provide individualized strategies for academic success at the beginning of the course. In a series of studies, focus groups were conducted with the combat medics’ instructors and leaders, revealing both “internal” (e.g., motivation, stress, life skills, cognitive ability, and behavioral symptoms similar to those associ- ated with attention deficit and hyperactivity disorder) and “exter- nal” issues (e.g., selection and training of instructors, the length of the training day and program, and the difficulty level of the training material) that were believed to influence attrition. An interview study investigated why soldiers believe they failed or did well in their advanced individual training program. A prediction study was conducted to determine which cogni- tive and personal risk factors influence academic performance, to develop a prediction model to forecast student performance, to create a valid survey instrument to identify those at risk for aca- demic difficulty, and to design a software program to administer the survey and provide feedback to soldiers and their academic advisers. The HBO documentary film “ER Baghdad” provides a rare glimpse of daily activities in a combat support hospital as medical personnel treat burns, fractures, penetrating wounds, massive tis- sue damage, respiratory problems, and head injuries inflicted by the single most common cause of traumatic injury in Iraq – impro- vised explosive devises (IEDs). Medical personnel in these hospitals are saving U.S. soldiers’ lives at unprecedented rates. Much of their success is attributed to recent advances in medical technolo- gy, innovative care, and enhanced training. This article highlights some of the challenges confronted by combat casualties and those providing treatment, as well as human factors/ergonomics (HF/E) efforts to overcome these challenges. Combat Challenges Advancements in protective equipment are an important con- tribution. To protect soldiers from IEDs, the U.S. Army has im- proved armor for vehicles and upgraded personal equipment such as body armor, ballistic helmets, and combat goggles. The fit and wear of the new equipment is vastly preferred by soldiers and was evaluated with the assistance of HF/E researchers. (Go to http:// peosoldier.army.mil/multimedia.asp to listen to soldier testimonials.) For example, the “interceptor body armor” has ergonomically designed front and back plates that facilitate ease of movement and webbed attachment loops so soldiers can tailor their loads to mission requirements. In addition, body armor now includes addi- tional protection for the shoulder and upper-arm areas. Another example is the advanced combat helmet, which is lighter and more comfortable for extended periods than previous helmets. A third example speaks to the importance of appearance: Soldiers were not wearing their combat goggles because they thought the goggles were ugly. Since they were replaced with “cooler-looking” goggles, soldiers wear them more readily, and there has been a significant decrease in eye injuries (Gawande, 2004). Advances in Medical Technology Advances in medical technology, coupled with solid training that imparts the knowledge to effectively use the technology, is critical to providing patient care in austere field environments. Uncontrolled bleeding from injury is one of the major causes of death in combat. To restrict blood flow, recently fielded medical Volume 49 Number 8 August 2006 Human Factors and Ergonomics Society CONTENTS B ANNUAL MEETING ........................................3 ELECTIONS .................................................6 STANDARDS ...............................................6 STUDENT VIEWS ..........................................6 CALLS FOR PAPERS ......................................7 ulletin Saving Soldiers: Combat Challenges in Iraq Spur Medical Innovations By Pam Savage-Knepshield, Valerie Rice, Jenny Butler, & Carita DeVilbiss