During its post-9/11 counterinsurgency operations in Iraq and Afghanistan, the US military achieved its lowest case fatality rate in history. An unprecedented number of casualties received life-saving treatment, and an extraordinary number of service members survived wounds that would have been fatal in any previous conflict. This was largely because of the care they received—beginning with tactical combat casualty care on the battlefield and continuing through evacuation to medical facilities in theater and transport to military hospitals at Landstuhl, Germany and in the United States.

Collectively, this is known as prolonged casualty care. And in Iraq and Afghanistan, the process was enabled by a set of conditions—overwhelming military superiority and air supremacy, for instance—that will not be present in the case of a major war. In such a conflict, characterized by large-scale combat operations, the way treatment is delivered to US casualties must be very different. To explore why—and what will be required to meet the challenges—John Amble is joined on this episode of the MWI Podcast by two guests. Colonel Jennifer Gurney is an experienced trauma surgeon, a veteran of multiple combat deployments, and the chief of the DoD Joint Trauma System. And Lieutenant Colonel Max Ferguson is the commander of 2nd Battalion, 14th Infantry Regiment, whose recent deployment experience offers insights on how this crucial issue affects tactical-level maneuver units.

The MWI Podcast is produced through an endowment generously funded by the West Point Class of 1974. You can listen to this episode of the podcast below, and if you aren’t already subscribed, be sure to find it on Apple PodcastsStitcher, or your favorite podcast app so you don’t miss an episode. While you’re there, please take just a moment to leave the podcast a rating or give it a review!

Image credit: Spc. Seth Cohen, US Army National Guard