Now and then: combat casualty care policies for Operation Iraqi Freedom and Operation Enduring Freedom compared with those of Vietnam.

Between December 2004 and June 2007, 13 key Operation Iraqi Freedom/Operation Enduring Freedom combat casualty care policies were published to inform medical practice in the combat theater of operations. Published policies were authored by the 44th Medical Command (1), the Office of The Army Surgeon General (11), and the Office of the Assistant Secretary of Defense (Health Affairs) (1). These policies, published as an All Army Action message (and/or in memorandum format signed by The Army Surgeon General), were compared with published medical newsletters and medical bulletins issued during the Vietnam War era, beginning in 1966. Common to both wartime eras was the recognition that the presence of a medical research team in theater was a critical element to ensure accurate data capture for subsequent analysis, to document lessons learned, and to study the impact of new wounding mechanisms, whether it be the Pungi sticks and mines of Vietnam or the types of explosions specific to Operation Iraqi Freedom/Operation Enduring Freedom. It is important to recognize that both then and now, medical practice has been a reflection of the current state of medical practice, and that in both conflicts military medical personnel have been equally devoted to saving lives of combat casualties.