Col Ian Greaves was educated at the Manchester Grammar School and graduated from the University of Birmingham Medical School in 1986, training initially in general medicine. He joined the British Army in 1999 as a consultant in Emergency Medicine. He is a fellow of the Royal Colleges of Emergency Medicine, Physicians (London) and Surgeons of Edinburgh. Between 2008 and 2014 he was Defence Consultant Advisor in Emergency Medicine and clinical lead for Pre-hospital Care for the three Armed Services. He deployed to both Iraq and Afghanistan. Col Greaves was Honorary Surgeon to HM Queen Elizabeth II from 2011 to 2014 and was made Officer of the Order of St John in 2005. He is a fellow of the Royal Society of Arts and of the Royal Geographical Society and was made an honorary fellow of the Ambulance Services Institute in 2014 for services to pre-hospital medicine. Col Greaves holds a personal chair at the University of Teesside. He currently serves as Chief Medical Officer of the Order of St John and of St John Ambulance and as an examiner for the fellowships in Pre-hospital Emergency Medicine and Emergency Medicine and for postgraduate degrees in trauma at Queen Mary University of London. Col Greaves is the author or editor of textbooks on trauma, pre-hospital Care, major incident management and medical responses to terrorism and is editor of the journal Trauma. He is also a member of the Northern Region NHS Clinical Senate and has been actively involved in NHS clinical service provision reviews.

"This is a unique and important contribution for any provider, traumatologist or not, with an interest in the evolution of military healthcare during the recent Middle East wars. As two Surgeon Generals serving during these years note, the1990s saw enormous erosion in military medicine with degraded clinical capability. This work describes the efforts made to realize improvement in treatment, which has ultimately provided international rewards after the military experience in Iraq and Afghanistan. We now see the benefits originating with this military experience in civilian practice." David J. Dries, MD (University of Minnesota Medical School)

• Preface Role of honour Disclaimer Introduction Contributors Military abbreviations Medical abbreviations A note on operation names Echelons and levels of clinical care Acknowledgements Colour plate acknowledgements 1. A brief history of Operations Telic and Herrick 2. Organisation of the medical services in Iraq and Afghanistan 3. Pre-hospital emergency care 4. Emergency medicine and resuscitation 5. Anaesthesia and pain management 6. Intensive care medicine 7. Strategic medical evacuation – The critical care air support team 8. Torso trauma 9. Limb trauma 10. Ballistic weaponry, blast and personal protective equipment development 11. Head and neck 12. Internal medicine and communicable disease including diet and lifestyle 13. Imaging 14. Transfusion medicine 15. Mental health 16. Primary care 17. Defence rehabilitation 18. Paediatrics 19. Trauma governance: Scoring and data analysis 20. Ethics, legal and humanitarian issues 21. Deployed experience at sea 22. Education, training and human factors 23. Developments in equipment and therapeutics 24. The research dimension Appendix A: Forces deployed on Operation Telic Appendix B: Forces deployed on Operation Herrick Appendix C: Medical units deployed on Operations Telic and Herrick Appendix D: Publications by author Appendix E: Publications by subject Appendix F: Extracts from the key findings of the CQC Report Defence Medical Services: A Review of Compliance with the Essential Standards of Quality and Safety Appendix G: Summary of the report Treating Injury and Illness arising on Military Operations National Audit Office 2010 Appendix H: Campaigns in Iraq and Afghanistan Index

Col Ian Greaves was educated at the Manchester Grammar School and graduated from the University of Birmingham Medical School in 1986, training initially in general medicine. He joined the British Army in 1999 as a consultant in Emergency Medicine. He is a fellow of the Royal Colleges of Emergency Medicine, Physicians (London) and Surgeons of Edinburgh. Between 2008 and 2014 he was Defence Consultant Advisor in Emergency Medicine and clinical lead for Pre-hospital Care for the three Armed Services. He deployed to both Iraq and Afghanistan. Col Greaves was Honorary Surgeon to HM Queen Elizabeth II from 2011 to 2014 and was made Officer of the Order of St John in 2005. He is a fellow of the Royal Society of Arts and of the Royal Geographical Society and was made an honorary fellow of the Ambulance Services Institute in 2014 for services to pre-hospital medicine. Col Greaves holds a personal chair at the University of Teesside. He currently serves as Chief Medical Officer of the Order of St John and of St John Ambulance and as an examiner for the fellowships in Pre-hospital Emergency Medicine and Emergency Medicine and for postgraduate degrees in trauma at Queen Mary University of London. Col Greaves is the author or editor of textbooks on trauma, pre-hospital Care, major incident management and medical responses to terrorism and is editor of the journal Trauma. He is also a member of the Northern Region NHS Clinical Senate and has been actively involved in NHS clinical service provision reviews.

"This is a unique and important contribution for any provider, traumatologist or not, with an interest in the evolution of military healthcare during the recent Middle East wars. As two Surgeon Generals serving during these years note, the1990s saw enormous erosion in military medicine with degraded clinical capability. This work describes the efforts made to realize improvement in treatment, which has ultimately provided international rewards after the military experience in Iraq and Afghanistan. We now see the benefits originating with this military experience in civilian practice." David J. Dries, MD (University of Minnesota Medical School)

• Preface Role of honour Disclaimer Introduction Contributors Military abbreviations Medical abbreviations A note on operation names Echelons and levels of clinical care Acknowledgements Colour plate acknowledgements 1. A brief history of Operations Telic and Herrick 2. Organisation of the medical services in Iraq and Afghanistan 3. Pre-hospital emergency care 4. Emergency medicine and resuscitation 5. Anaesthesia and pain management 6. Intensive care medicine 7. Strategic medical evacuation – The critical care air support team 8. Torso trauma 9. Limb trauma 10. Ballistic weaponry, blast and personal protective equipment development 11. Head and neck 12. Internal medicine and communicable disease including diet and lifestyle 13. Imaging 14. Transfusion medicine 15. Mental health 16. Primary care 17. Defence rehabilitation 18. Paediatrics 19. Trauma governance: Scoring and data analysis 20. Ethics, legal and humanitarian issues 21. Deployed experience at sea 22. Education, training and human factors 23. Developments in equipment and therapeutics 24. The research dimension Appendix A: Forces deployed on Operation Telic Appendix B: Forces deployed on Operation Herrick Appendix C: Medical units deployed on Operations Telic and Herrick Appendix D: Publications by author Appendix E: Publications by subject Appendix F: Extracts from the key findings of the CQC Report Defence Medical Services: A Review of Compliance with the Essential Standards of Quality and Safety Appendix G: Summary of the report Treating Injury and Illness arising on Military Operations National Audit Office 2010 Appendix H: Campaigns in Iraq and Afghanistan Index

Col Ian Greaves was educated at the Manchester Grammar School and graduated from the University of Birmingham Medical School in 1986, training initially in general medicine. He joined the British Army in 1999 as a consultant in Emergency Medicine. He is a fellow of the Royal Colleges of Emergency Medicine, Physicians (London) and Surgeons of Edinburgh. Between 2008 and 2014 he was Defence Consultant Advisor in Emergency Medicine and clinical lead for Pre-hospital Care for the three Armed Services. He deployed to both Iraq and Afghanistan. Col Greaves was Honorary Surgeon to HM Queen Elizabeth II from 2011 to 2014 and was made Officer of the Order of St John in 2005. He is a fellow of the Royal Society of Arts and of the Royal Geographical Society and was made an honorary fellow of the Ambulance Services Institute in 2014 for services to pre-hospital medicine. Col Greaves holds a personal chair at the University of Teesside. He currently serves as Chief Medical Officer of the Order of St John and of St John Ambulance and as an examiner for the fellowships in Pre-hospital Emergency Medicine and Emergency Medicine and for postgraduate degrees in trauma at Queen Mary University of London. Col Greaves is the author or editor of textbooks on trauma, pre-hospital Care, major incident management and medical responses to terrorism and is editor of the journal Trauma. He is also a member of the Northern Region NHS Clinical Senate and has been actively involved in NHS clinical service provision reviews.

"This is a unique and important contribution for any provider, traumatologist or not, with an interest in the evolution of military healthcare during the recent Middle East wars. As two Surgeon Generals serving during these years note, the1990s saw enormous erosion in military medicine with degraded clinical capability. This work describes the efforts made to realize improvement in treatment, which has ultimately provided international rewards after the military experience in Iraq and Afghanistan. We now see the benefits originating with this military experience in civilian practice." David J. Dries, MD (University of Minnesota Medical School)

• Preface Role of honour Disclaimer Introduction Contributors Military abbreviations Medical abbreviations A note on operation names Echelons and levels of clinical care Acknowledgements Colour plate acknowledgements 1. A brief history of Operations Telic and Herrick 2. Organisation of the medical services in Iraq and Afghanistan 3. Pre-hospital emergency care 4. Emergency medicine and resuscitation 5. Anaesthesia and pain management 6. Intensive care medicine 7. Strategic medical evacuation – The critical care air support team 8. Torso trauma 9. Limb trauma 10. Ballistic weaponry, blast and personal protective equipment development 11. Head and neck 12. Internal medicine and communicable disease including diet and lifestyle 13. Imaging 14. Transfusion medicine 15. Mental health 16. Primary care 17. Defence rehabilitation 18. Paediatrics 19. Trauma governance: Scoring and data analysis 20. Ethics, legal and humanitarian issues 21. Deployed experience at sea 22. Education, training and human factors 23. Developments in equipment and therapeutics 24. The research dimension Appendix A: Forces deployed on Operation Telic Appendix B: Forces deployed on Operation Herrick Appendix C: Medical units deployed on Operations Telic and Herrick Appendix D: Publications by author Appendix E: Publications by subject Appendix F: Extracts from the key findings of the CQC Report Defence Medical Services: A Review of Compliance with the Essential Standards of Quality and Safety Appendix G: Summary of the report Treating Injury and Illness arising on Military Operations National Audit Office 2010 Appendix H: Campaigns in Iraq and Afghanistan Index