Lt. Gen. Eric B. Schoomaker, Army surgeon general and commander of the 50,000-member Army Medical Command, told reporters during a media roundtable at the Pentagon that issues stemming from such combat conditions are a “great concern” to soldiers, their families and the American public.

“We know the importance of prevention of these injuries and illnesses; we know the importance of timely diagnosis and treatment of both concussive and post-traumatic stress symptoms,” Schoomaker said.

Adding, “And we are aggressively executing programs that are designed to educate, to prevent, to screen and to provide the appropriate care in a timely fashion for all of these deployment-related stresses and injuries.”

Concussive injuries and their psychological responses are “not new concepts to us,” Schoomaker said.

He noted that concussions occur domestically – on America’s highways and sports fields – as often as they do in combat, and that referring to them as the war’s “signature injury” is a mischaracterization.

Schoomaker said he doesn’t believe the war on terror has produced any one signature injury. But he believes there is a signature weapon used by insurgents: a blast.

“It’s being used very effectively in combat,” he said.

He added, “It blinds our soldiers in some cases if they’re unprotected. It deafens them. If it defeats our protective equipment, it may cause a mild concussive injury all the way to a very severe penetrating head injury.”

He said military health care professionals must identify and treat blast-related injuries as soon as possible after the event.

“Doing an effective screening as close as possible to the actual event and then making a decision whether that soldier should take a knee and step out of the battle so that they can recover … is our most important goal,” he said.

Schoomaker said the Army created initiatives to increase the rapidity and efficiency of treatment, including arming medics to allow them to more safely treat wounded troops in combat zones, providing service members with improved first aid kits, and training troops in medical techniques.

He told the Military Health System conference attendees in late January that there were parallels between warfighting and medical care in the need for rapid fielding of the best technology and the development of doctrine to treat casualties and illnesses in combat zones.

Schoomaker cited hypothermia kits, new helmets and protective plates as examples of working together with developers that have increased survivability of wounded soldiers.

He said the survival rates are at 90 percent for wounded service members in Afghanistan and Iraq versus the historic 75 percent standard of the Vietnam War. “We need to synchronize all aspects of health care and leverage electronic records and lessons learned.”

He added, “We are returning to duty 77 percent” of those service members injured in combat, and “90 percent of those are E-4s to E-7s. These are not easy soldiers to recruit, train, and retain.

“We consider this to be, as our motto in Army medicine, conserve the fighting strength, still one of the most important ambitions of our whole comprehensive care plan.”

In addition, in 2007 the Army instituted an 800,000-strong chain-teaching initiative – from the most seasoned commander down to the most junior soldiers – on concussive injuries and post-traumatic stress.

Army health officials are looking into the role context plays in a concussive injury and its aftermath, Schoomaker said, which may be a more significant factor than originally thought.

To illustrate the importance of context, the general made an analogy to a quarterback who is hit hard in the course of a football game. Regaining consciousness while surrounded by thousands of sympathetic fans is a vastly different context from awakening in a combat zone, surrounded by the wounded bodies of your battle buddies, he said.

At the medical conference, he showed a helmet with sensors to monitor concussive force. “This is not a medical device. … It is a monitoring system” that sometime in the future may allow researchers “to map the battlefield of all the threats the combatant faces.”

Adding, “We are more interested in hitting the right target of care, not just sending widgets of care down range.”