Approaches to nutritional support for battle casualties and trauma: current military practice and lessons learned from the civilian sector.

In conflict, military medicine differs greatly from its civilian counterpart. Treatment strategies are designed to manage a potentially large number of severely wounded and function in an often hostile and poorly equipped environment. The most severely injured are stabilized and prepared for transport away from the war zone to a larger, better-equipped facility. At present no formal military policy exists concerning nutrition support. Traditionally, it has not been employed until the wounded arrived at a major medical center. Factors including the limited capacity to transport formula, lack of sophistication of battle zone facilities, and the rapid movement of wounded have been major drawbacks to providing early nutrition. The care of the urban trauma patient is relevant for the battle wounded of the military. There is ample evidence in the literature to support the use of nutrition support soon after injury. This article briefly describes the limitations of the military medical system in reference to nutrition support and the role of nutrition support for the civilian trauma patient. The lessons learned from the civilian experience may help formulate a nutrition strategy for the battle wounded that may become included into the standardized care policy.