Trauma systems on the battlefield

Battlefield trauma care has been documented since the beginning of warfare. In the United States, an organized plan to provide expeditious care to the wounded on the battlefield was first emphasized and demonstrated by the “Father of Modern Battlefield Medicine,” Jonathan Letterman. Further advances in care and the implementation of a system for the battlefield occurred in the 20th century through the two World Wars and in the United States during Korea and Vietnam. It wasn’t until the 21st century, in the post–September 11th era, that lessons in civilian trauma system development in the last part of the prior century were translated for the battlefields of Iraq and Afghanistan. The Joint Theater Trauma System was developed in the first decade of the century and this structure was formalized in doctrine as the Department of Defense Joint Trauma System in 2011. There have been many advances in battlefield trauma care since 2001, but arguably, the creation of the Joint Trauma System is the greatest achievement and will have the most enduring impact. Lessons in trauma system development have been carried to other areas of the world as a result of Department of Defense efforts in global health engagement as well. Finally, lessons in battlefield trauma care and recent events such as the pandemic have only highlighted the need in the United States for a national trauma care system in order to be best prepared for national health security threats and for the next military conflict.