Rouse Awards: Charlie Toff’s evaluation of military patient care in Afghanistan

Charlie Toff (Upper Sixth) earned the Rouse Award for his exploration into pre-hospital patient care during the Afghanistan conflict.

With ambitions of becoming a military doctor, Charlie was eager to research a topic in the field in which he hopes to have a career.

As such, he decided to evaluate which changes to patient care had been the most instrumental in improving survival rates for injured services personnel in Afghanistan between 2001 and 2014, when the International Security Assistance Force ceased combat operations.

Charlie said: “Afghanistan is obviously very topical, but it’s also interesting from a medical perspective. In military medicine, you have some of the most recent advances and also because the conflict there was a bit different and more insurgent-based, so the military had to adapt quite quickly.”

Much of Charlie’s research came from reviewing journals of both military and civilian medicine, especially in relation to air medical evacuations and specific treatments for those injured.

He also spoke to several doctors at Addenbrooke’s Hospital who had come from a services background. “They were really helpful and gave me a lot of extra context,” he said.

Afghanistan is obviously very topical, but it’s also interesting from a medical perspective. In military medicine, you have some of the most recent advances.

Charlie Toff

Charlie found that even simple treatments such as the reintroduction of the use of tourniquets had made a big difference in helping stricken soldiers, but he felt there was a combination of factors in their increased survival rate.

He said: “The speed of air medical evacuations had a big role and the advanced resources that had been put in place had the effect of bringing the hospital closer to the patient and the site of injury.

“There’s also the pace at which the community of military medics adapted to the situation, It’s a very small community so once lessons are learned, they disseminate very quickly. Although unproven, I think this was probably key.”

Charlie added that the project had strengthened his resolve in terms of becoming a military medic.

He said: “Now I’ve had a brief glimpse into it, it looks very exciting and interesting. It was great to discover some basic principles of trauma care and I learned a lot from it.”

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