# Golden hour, challenges, changes



## Devildoc (Oct 8, 2018)

Good article about the "Golden Hour" and challenges with near-peer adversaries, and changes we need to make.

How Long Can the U.S. Military’s Golden Hour Last?


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## CQB (Oct 9, 2018)

Interesting, the article implies the next fracas will be set piece battles.


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## Cookie_ (Oct 9, 2018)

Really great article.  It's sobering to realize that in a conflict like the one's suggested, triage might have to flip around and essentially accept that the most gravely injured in a MASCAL event are going to have to be put off for last.



CQB said:


> Interesting, the article implies the next fracas will be set piece battles.



It's probably best to plan for that scenario.  I mean, what's the last full blown war that has occurred between countries on the USA+allies/Russia/China level of capabilities?


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## Devildoc (Oct 9, 2018)

Cookie_101st said:


> Really great article.  It's sobering to realize that in a conflict like the one's suggested, triage might have to flip around and essentially accept that the most gravely injured in a MASCAL event are going to have to be put off for last.
> 
> It's probably best to plan for that scenario.  I mean, what's the last full blown war that has occurred between countries on the USA+allies/Russia/China level of capabilities?



We've been "lucky" with the types of conflicts we have been in with regards to numbers of casualties and how we treat and transport.  I am afraid if we battle peer/near-peer competitors we would see numbers reach horrific levels; not percentage of platoons, but whole companies.  

The last time we saw that type of conflict was WWII, though one could easily argue, Korea.

Not for nothing...a good friend of my wife and I is a retired O-5, retired mid-80s after 25 years in the sea-going Navy (destroyers).  He told me over bourbon one night in San Diego that his entire career was being told to expect 75-100% casualties in a sea war against the Soviet Union.


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## CQB (Oct 10, 2018)

I'd go with China on the sea war. To reply to @Cookie_101st, I get it, plan for the biggie, but most (not all) conflict currently is below the threshold of out and out declaration.


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## Cookie_ (Oct 10, 2018)

Devildoc said:


> We've been "lucky" with the types of conflicts we have been in with regards to numbers of casualties and how we treat and transport.  I am afraid if we battle peer/near-peer competitors we would see numbers reach horrific levels; not percentage of platoons, but whole companies.
> 
> The last time we saw that type of conflict was WWII, though one could easily argue, Korea.
> 
> Not for nothing...a good friend of my wife and I is a retired O-5, retired mid-80s after 25 years in the sea-going Navy (destroyers).  He told me over bourbon one night in San Diego that his entire career was being told to expect 75-100% casualties in a sea war against the Soviet Union.



Even without utilizing chemicals, nukes, or thermobaric weaponry, the devastation possible in an out-and-out fight would likely dwarf anything we've seen before.  Our ability to prevent or stave off death has progressed leaps and bounds since our last major war, but I think our abilities to kill each other have far outpaced that.


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## policemedic (Oct 10, 2018)

If people knew that Cowley scribbled the golden hour on a cocktail napkin after pulling the number out of a pint glass they’d look at the term differently.


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## Devildoc (Oct 10, 2018)

policemedic said:


> If people knew that Cowley scribbled the golden hour on a cocktail napkin after pulling the number out of a pint glass they’d look at the term differently.



One of my favorite docs worked with him/under him at Shock Trauma.  Oh, the stories he'd tell.  Why 60 minutes/"Golden Hour"?  Because it had a nice ring, and coincided with the thought the sooner you get to the hospital, the better the outcome.  Arbitrary number.


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## policemedic (Oct 10, 2018)

Devildoc said:


> One of my favorite docs worked with him/under him at Shock Trauma.  Oh, the stories he'd tell.  Why 60 minutes/"Golden Hour"?  Because it had a nice ring, and coincided with the thought the sooner you get to the hospital, the better the outcome.  Arbitrary number.



Exactly.  And yet, it's become the word of God as handed down to Cowley.


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## FisherAD1 (Dec 2, 2018)

We've been working hard on several fronts to develop capabilities for the POI and Role 1. We just had the Prolonged Field Care Damage Control Resuscitation CPG published. CoTCCC is also working on some things.


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## policemedic (Dec 2, 2018)

That’s quality work.


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