PVC Goes on Patrol in Iraq and Afghanistan

Combat infantry setting out on a three-day patrol in Iraq or Afghanistan carry a load exceeding 60 pounds—and the medic carries over 20 pounds more. That extra load includes only the basics: bandages, pills, antibiotics, and a lot IV pouches and intravenous tubing made of PVC. Saline solution administered intravenously is critical in treating traumatic brain injuries and wounds involving great loss of blood.There’s one medic per platoon of about 50 infantry, explained Col. Geoffrey Ling, MD, PhD, who served in Iraq and Afghanistan and is now on the faculty of the Uniformed Services University of the Health Sciences in Bethesda, MD. Medics receive 36 weeks of training. Also, one infantry soldier in ten is trained as a Combat Lifesaver, and that soldier carries some IV supplies as well. Combat Lifesavers receive two weeks of specialized training, particularly in opening airways and starting IVs—two simple lifesaving procedures, Ling said. In addition, all soldiers receive one week of basic first aid to help one another, and every soldier has a tourniquet that can be applied with one hand.

This “medic and buddy” level is the first echelon of care, Ling explained, and developments at this level of trauma care have made a huge difference in saving lives that, in previous U.S. wars, would have been lost. Ling said that, thanks to improved training and equipment, the number of battlefield deaths from life-threatening injuries has gone from one in four in previous wars to one in 10 in Iraq and Afghanistan.

Once the medic has stabilized the wounded soldier, he is taken to the next echelon of care, a battalion aid station not far away. These have a limited supply of blood, stored in the familiar PVC pouches. Far greater blood supplies are available at the next level of care, the combat support hospital, where surgeries are carried out, Ling said.

PVC has long been recognized as the material of choice for these and other medical supplies, such as oxygen tents and catheters, which are also used extensively in civilian hospitals and trauma centers. According to Illinois-based Baxter Health Care, which provides blood bags and IV supplies to the U.S. government, PVC is one of the only materials to meet its basic performance criteria for transparency, impermeability, sterilizability, flexibility, and strength. Vinyl medical products are tough enough to be air-dropped into battlefields for use by troops on the move.

In addition, flexible PVC tubing is kink-resistant. Alternative materials often kink when bent to angles of 90 degrees or more. This can cut off the flow of blood or vital fluids to a patient if left undetected for any length of time. Also, PVC tubing resists “necking down,” that is, constricting when pulled. Alternative materials can constrict when inadvertently stretched, thus changing the diameter of the inner tubing and affecting the fluid delivery rate.

PVC meets safety as well as performance standards. Baxter has declared that the safety of its PVC medical products “has been confirmed by more than 40 years of use, with 5 to 7 billion patient days of acute exposure and 1 to 2 billion patient days of chronic exposure without any indication of adverse effects.”

Photo Courtesy of the U.S. Defense Department: U.S. Air Force medics attend wounded soldier in Iraq.