Treating Military Injuries Among Veterans and Active-Duty Service Members

Veterans who have experienced severe wounds are more likely to have difficulty readjusting to civilian life, develop mental health issues, and have poorer overall health. To help your organization better serve Veterans and active-duty military members who sustained injuries while serving, let’s review the most common injuries your organization will treat as well as the basics of treatment.

Common types of military injuries

Many active-duty military members and Veterans come home with injuries sustained in the line of duty. Studies have found that 10% of veterans were injured while in the military, and 75% of these injured Veterans were wounded in combat.

According to research published with the National Center for Biotechnology Information, the most common combat injuries that Veterans return home with are:

• Open wounds
• Traumatic brain injuries (Type 1 and Type 2)
• Leg injuries
• Burns
• Chest and/or abdominal injuries

These injuries can all have major impacts on an individual’s holistic health. Building your organization’s ability to properly assess and treat these common military injuries is essential to providing quality care.

The building blocks of a wound care program

Initiating the wound care process for military injuries requires a systematic approach. First, your medical team must conduct a comprehensive assessment of the patient’s condition. This entails gathering, organizing, and documenting all pertinent health data while also scrutinizing skin integrity and tissue composition to ascertain the precise nature of the injury.

After the assessment, it is imperative to meticulously analyze the data you’ve gathered to identify any existing or potential complications. This analysis forms the foundation for formulating diagnoses and devising a tailored care plan.

Next comes the planning phase, when the care team decides on both short- and long-term objectives to address any identified concerns. Engaging the patient in this process fosters continuity of care, enhances the likelihood of positive outcomes, and cultivates trust with their healthcare team, bolstering adherence to the care plan.

The third phase, implementation, involves translating the plan into action through the application of strategies for meeting the individual’s needs and desired outcomes.

Lastly, your team will need to go through the evaluation phase — a continual process to gauge the efficacy of the client’s care plan. In this phase, your team will gather data, compare it against treatment benchmarks, and look for any factors interfering with treatment. Based on this assessment, the care plan may continue as is, need modification, or come to an end.

Basic strategies for treating common military injuries

Now that we understand what an effective wound care program looks like, let’s cover the basics of treating the common military injuries discussed above. As this is a basic overview, we’ll group these injuries into three main categories: wounds, burns, and TBIs.

Wound care for Veterans and military personnel

In this section, we’ll cover three important techniques to promote the healing of wounds: debridement, compression, and negative-pressure wound therapy.

First, your staff should be familiar with debridement. This is a technique that removes dead tissue in and around the wound to promote the growth of healthy tissue and faster healing. This is important as wounds with dead tissue can remain in the inflammatory phase and have an increased risk of bacterial infection. Several different types of debridement have been shown to be effective in the wound care process.

Another important technique in wound care is compression. Proper utilization of compression can aid in reducing edema (an abnormal accumulation of fluid between the skin and muscle layers that is both palpable and visible), which facilitates healing for surgical and traumatic wounds. This is a critical step in treating military injuries, as edema can impede wound healing by diminishing the available oxygen because it increases the distance of the capillaries from the wound bed.

For facilities with the ability to house more advanced technology, negative-pressure wound therapy (NPWT) can prove highly beneficial. This wound therapy uses suction pumps, tubing, and dressing to remove exudate that causes inflammation. Originally, NPWT was intended for use in open wounds, but it has proven effective in treating flaps and grafts as well as managing postoperative incision lines to prevent infection and other complications.

Burn assessment and treatment

Research has shown that burns account for 5-20% of combat injuries among U.S. military members. While burn injuries occurring in the line of duty are treated by clinicians as close to the incident as possible, these types of military injuries and their effects can persist beyond the initial treatment. To that end, your staff need to have the knowledge to assess burns and provide ongoing treatment to the Veterans you serve.

There are four distinct types of burns, each categorized by how the burn occurred:

• Extreme temperature (thermal)
• Chemical
• Electrical
• Radiation

Adding to that, 82% of these burns were the result of blast injuries. But no matter the burn type or how it occurred, there are steps your staff needs to know to properly treat these military injuries.

First, gauge the severity of the burn. The following criteria will inform your analysis:

• Patient’s age
• Total body surface area (TBSA) that the burn covers
• The type of burn (covered above)
• How deep the burn extends into the tissue

After assessing the burn injury’s severity, your staff will need to provide any necessary pain relief and clean and dress the burn. This process typically involves cleaning the area with mild soap and water and recovering the burn with clean, non-adherent dressing. Depending on the type of burn, different techniques may be needed.

For information on how to assess the severity of a burn and properly dress this type of injury, see our partner site, Wound Care Education Institute (wcei.net).

Treating traumatic brain injuries

Traumatic brain injuries (TBI) make up a significant number of reported military injuries. From 2001-2016, 244,217 TBI cases were reported by the Defense Medical Surveillance System. Among these cases, 75% were categorized as mild (i.e., concussions).

Even for mild TBIs, however, the brain can develop symptoms that are severe and potentially life-threatening. If your client has experienced any type of bump or blow to the head, you should consider the following symptoms as red flags of potentially serious injury:

• Pupils that appear to be different sizes or react differently to light
• Severe drowsiness
• Worsening headache
• Slurred speech
• Difficulty with balance or muscle coordination
• Weakness or numbness
• Repeated vomiting
• Seizures
• Unusual changes in behavior, such as agitation or confusion
• Loss of consciousness

These symptoms can lead to comorbidities if left untreated and have deleterious effects on an individual’s physical and behavioral health. It’s important to begin TBI treatment as soon as possible, as research has shown that the complications of TBIs can impact the effectiveness of treatment.

Depending on the severity of the injury, a variety of medical interventions may be required. It is crucial to approach treatment comprehensively to address all symptoms. For example, interventions like vestibular rehabilitation or pain management (both pharmacological and non-pharmacological) may be beneficial for managing TBI-related symptoms. Severe TBI cases, however, may require invasive neurosurgical intervention and long-term monitoring.