WASHINGTON, DC — Of all of the injuries servicemembers suffer on the battlefield, among the most feared, psychologically as well as physically, are genitourinary. In fact, a recent report offered anecdotal information that some servicemembers have “do not resuscitate” pacts with their fellow warriors in case of this type of injury, as well as other devastating wounds.

Brig. Gen. Joseph Caravalho, who led for the Dismounted Complex Blast Injury Task Force, released the task force's report. -DoD Photo by Paul Prince

That information was included in a new military report that said the “increased rate of double and triple amputees, coupled with pelvic and genital injuries represented a new level of injury to overcome.”

While the report cited no specific instances of DNR requests, the anecdotes are plausible, said Army Brig. Gen. Joseph Caravalho, chair of the Dismounted Complex Blast Injury Task Force, which put out the report.

Complex, multiple injuries on the battlefield are increasing, particularly injuries to the arms, legs and genitalia, the report noted.  

"I don’t want anybody to ever say this is a desperate situation and not worth living,” Caravalho said.       

“These are life-defining injuries for these warriors and for their families, but it is not desperate,” he added. “All of us in uniform understand it is not just about saving lives; it is about doing everything military medicine can do to help them lead full and productive lives.”

Caravalho and his team said that, in 2009, there were 86 servicemembers who had amputations and 23 of those had multiple limb loss. In 2010, there were 187 servicemembers who suffered a major limb amputation, and of those 72 had multiple limb loss. As of September of this year there have been 147 servicemembers who had a limb amputation. Of these, 77 servicemebers have had two or three limbs lost.

The largest number of troops who sustained a limb loss or a devastating lower extremity injury were “dismounted,” rather than in a vehicle, Caravalho said.

Caravalho defined “dismounted complex blast injuries” as explosion-induced battle injuries sustained by a servicemember on foot patrol that involves traumatic amputation of one leg, at least a severe injury to the other leg and a possible pelvic, abdominal and/or genital or urinary injury.