Warning: Army to "pay" for cold injuries

#1
bbc news

It has been reported by the BBC that the MOD may have to fork out compensation for Commonwealth soldiers who have suffered from NFCI.

The Army apparently didn't take into account that African and Afro-Caribbeans are at greater risk, probably because at the time they didn't realise it.

Stating sub-standard equipment, and a lack of knowledge on the part of trainers regarding the fact of the increased risk. But how do you separate the true people at risk and those who are just 'monging' it because it's cold and wet?

Now, I've looked after soldiers with all types of climatic injuries, and the main contributing factor in many of the cases is the soldier themselves not following the rules. In fact, one such Commonwealth soldier reported to me with Non-Freezing Cold Injury in 30 plus degree heat! The cause? He was wearing his winter issue gortex lined boots! :roll:

I know there will be genuine claims for compensation which will be deserved, but how many will try to 'milk' the system to try and get a meal ticket?

This, I'm sure, will demonstrate the need for good, accurate record keeping on the part of all medics, nurses and doctors, including an accurate account of the type of clothing that is being worn - and whether it is actually issue kit from the military or not.

I'd be interested to hear anyone else's take on this issue.
 
#2
It wasn't all commonwealth soldiers who were effected. According to the report it was "many" so probably a disproportionate amount bearing in mind the ercentage of them in the Army, but not all.

It's probably a difficult thing to judge whilst out on EX, I imagine the small minority of soldiers who will always find an excuse to mong it willbe all over this.
 
#4
Hmmmmmm

I am reminded of Ex Med Man 7 in 1991, where I stood next to the CO and told him I felt it had become a survival exercise instead of a tactical exercise.

Nonetheless we stayed out another 2 days whilst 10% of the BG were casevacced to Crowfoot with NFCI before we came in.

I believe that may have been the last MM7 exercise ever run.
 
#5
One of the problems associated with this sort of issue in the past would have been the lack of a consolidated record of injuries and the causes within the AMS.

As an example in 1998/99 I was pursuing the issue of of ballistic eye protection to all AFV crewmen because of the perceived possibility of eye injury from debris thrown up in battle or even just simply on the roads etc. One of my biggest hurdles in putting up a justification was that AMS were unable to provide me with a list of eye injuries and the associated causes either for operation, exercise or training because such a record was not held centrally.

Has that changed? Is there now a centrally maintained database of injuries and their causes?
 
#6
RogerOut! said:
One of the problems associated with this sort of issue in the past would have been the lack of a consolidated record of injuries and the causes within the AMS.

As an example in 1998/99 I was pursuing the issue of of ballistic eye protection to all AFV crewmen because of the perceived possibility of eye injury from debris thrown up in battle or even just simply on the roads etc. One of my biggest hurdles in putting up a justification was that AMS were unable to provide me with a list of eye injuries and the associated causes either for operation, exercise or training because such a record was not held centrally.

Has that changed? Is there now a centrally maintained database of injuries and their causes?
They used to keep a coding system called J97, which has now become obsolete due to DMICP coding. However, the problem was and is that it is quite subjective depending on the medic, nurse or doctors take. For example: does an eye injury sustained on a military exercise get put down under 'eye injury' which can cover a multitude of conditions including infection, or as an 'injury due to military training'.

You can put both down, but because they are 2 seperate codes, they may not get linked together as an 'eye injury due to military training' when an audit is done.

With climatic injuries it is easier because the Institute of Naval Medicine has developed paperwork which must be completed and returned to them. Further information on climatic injuries and the reporting forms are found in JSP 539.
 
#7
The_Seagull said:
It wasn't all commonwealth soldiers who were effected. According to the report it was "many" so probably a disproportionate amount bearing in mind the ercentage of them in the Army, but not all.

It's probably a difficult thing to judge whilst out on EX, I imagine the small minority of soldiers who will always find an excuse to mong it willbe all over this.
Agreed, but the bbc news report seems to concentrate mostly on them.
 
#8
The AMS can only treat the condition when it is brought to their notice. It is the immediate commanders who should be making foot inspection a normal part of their routine.
There is nothing worse when you're cold, wet and miserable than having to take your boots and socks off but that is exactly the time you should be doing it so that you can dry your feet, give them a massage, check for any signs of problem then put on dry socks from your kit. This should not be left to the individual but enforced as a routine by commanders. Foot inspection used to be a no-brainer, it was carried out routinely. Perhaps it's time we went back to some of the older ways and stop relying on the assumed intelligence/motivation of the soldier.
 
#9
It would be useful to see the incidence of climate-related foot injuries, from a similar group of soldiers, in hot climatic conditions.
 
#10
Markintime said:
The AMS can only treat the condition when it is brought to their notice. It is the immediate commanders who should be making foot inspection a normal part of their routine.
There is nothing worse when you're cold, wet and miserable than having to take your boots and socks off but that is exactly the time you should be doing it so that you can dry your feet, give them a massage, check for any signs of problem then put on dry socks from your kit. This should not be left to the individual but enforced as a routine by commanders. Foot inspection used to be a no-brainer, it was carried out routinely. Perhaps it's time we went back to some of the older ways and stop relying on the assumed intelligence/motivation of the soldier.
You are entirely correct. Foot inspections, however, should take place in all environments, together with kit, sleeping bags, cleanliness inspections and more. Personally, I rigorously enforced such checks during Op GRANBY in order to minimise the incidence of ineffective headcount. This level of management and supervision seems to have fallen by the wayside in recent years - I stand ready to be corrected however.
 
#11
We looked at this a couple of years ago. I would need to look for the reference, but there is US research suggesting that the reasons for greater susceptibility of Afro-Caribbean recruits for non-freezing cold injury are not genetic, but is down to the climate in which the individual was brought up. White recruits from (say) Florida were more susceptible than white recruits from Northern States.
 
#12
pombsen-armchair-warrior said:
Markintime said:
The AMS can only treat the condition when it is brought to their notice. It is the immediate commanders who should be making foot inspection a normal part of their routine.
There is nothing worse when you're cold, wet and miserable than having to take your boots and socks off but that is exactly the time you should be doing it so that you can dry your feet, give them a massage, check for any signs of problem then put on dry socks from your kit. This should not be left to the individual but enforced as a routine by commanders. Foot inspection used to be a no-brainer, it was carried out routinely. Perhaps it's time we went back to some of the older ways and stop relying on the assumed intelligence/motivation of the soldier.
You are entirely correct. Foot inspections, however, should take place in all environments, together with kit, sleeping bags, cleanliness inspections and more. Personally, I rigorously enforced such checks during Op GRANBY in order to minimise the incidence of ineffective headcount. This level of management and supervision seems to have fallen by the wayside in recent years - I stand ready to be corrected however.
I think part of the problem is that the Army gives its soldiers a degree of autonomy they didn't have before. They are expected to be intelligent and well-motivated enough to do things of their own volition. The Army forgets that there are a million reasons for putting off your own foot inspection then fatigue or operational necessity takes over and your window of opportunity has gone for another period of time.
I've seen good men binned out of Arctic Warfare because of cold injury caused by just a small breakdown in self-discipline in an otherwise well disciplined and organised soldier. Making the men have foot inspection also meant that I had to have it too and kept my drills in order.
 
#13
hackle said:
We looked at this a couple of years ago. I would need to look for the reference, but there is US research suggesting that the reasons for greater susceptibility of Afro-Caribbean recruits for non-freezing cold injury are not genetic, but is down to the climate in which the individual was brought up. White recruits from (say) Florida were more susceptible than white recruits from Northern States.
It is totally logical that those in a hot climate where it is desirable to lose body heat will be badly adapted to colder climates. After all the Army acclimatises for Kenya why not the reverse? I suppose it is easy to forget in Catterick that not everyone lives in our British climate.
When rugby league was played in the winter there was a similar problem with Aussie players over here. It took them a long time to acclimatise to the cold, damp conditions and their performance was adversely affected because of that.
 
#14
Lesleycape said:
bbc news

It has been reported by the BBC that the MOD may have to fork out compensation for Commonwealth soldiers who have suffered from NFCI.

The Army apparently didn't take into account that African and Afro-Caribbeans are at greater risk, probably because at the time they didn't realise it.

Stating sub-standard equipment, and a lack of knowledge on the part of trainers regarding the fact of the increased risk. But how do you separate the true people at risk and those who are just 'monging' it because it's cold and wet?

Now, I've looked after soldiers with all types of climatic injuries, and the main contributing factor in many of the cases is the soldier themselves not following the rules. In fact, one such Commonwealth soldier reported to me with Non-Freezing Cold Injury in 30 plus degree heat! The cause? He was wearing his winter issue gortex lined boots! :roll:

I know there will be genuine claims for compensation which will be deserved, but how many will try to 'milk' the system to try and get a meal ticket?

This, I'm sure, will demonstrate the need for good, accurate record keeping on the part of all medics, nurses and doctors, including an accurate account of the type of clothing that is being worn - and whether it is actually issue kit from the military or not.

I'd be interested to hear anyone else's take on this issue.
My bold if the correct forms are being filled out whenever an NFCI pt is seen then all the above information is required for completion. The forms are filled out in triplicate, one for your records, one to the centre for climatic injuries (or something like that) in Haslar and one for the single service medical stats. So yes accuate record keeping, but if by that you mean putting all that is required for the forms into the consult then you are just duplicating work, as the form should be filled out in every instance, once it is completed you put what you need to in the consult then scan and attach the form to the consult. No point reinventing the wheel, there are proceedures already in place for dealing with these injuries.
 
#15
D0lly86 said:
My bold if the correct forms are being filled out whenever an NFCI pt is seen then all the above information is required for completion. The forms are filled out in triplicate, one for your records, one to the centre for climatic injuries (or something like that) in Haslar and one for the single service medical stats. So yes accuate record keeping, but if by that you mean putting all that is required for the forms into the consult then you are just duplicating work, as the form should be filled out in every instance, once it is completed you put what you need to in the consult then scan and attach the form to the consult. No point reinventing the wheel, there are proceedures already in place for dealing with these injuries.
Surely an ounce of prevention?
 
#16
Markintime said:
D0lly86 said:
My bold if the correct forms are being filled out whenever an NFCI pt is seen then all the above information is required for completion. The forms are filled out in triplicate, one for your records, one to the centre for climatic injuries (or something like that) in Haslar and one for the single service medical stats. So yes accuate record keeping, but if by that you mean putting all that is required for the forms into the consult then you are just duplicating work, as the form should be filled out in every instance, once it is completed you put what you need to in the consult then scan and attach the form to the consult. No point reinventing the wheel, there are proceedures already in place for dealing with these injuries.
Surely an ounce of prevention?
From what I have seen the prevention is there also. Before I did Arctic Warfare in Norway I had 3 days of briefings, included in this was a step by step instruction on how to get dressed for cold weather, signs and symptoms of cold injury etc etc everyone on that exercise was as clued up as they could have been, all the kitting was checked and double checked, as the Medic and AELO for the exercise I was given another full days training on cold injuries in a one to one lesson from my SMO. We only had one cold injury on that exercise and that was the patients fault.
 
#17
D0lly86 said:
Markintime said:
D0lly86 said:
My bold if the correct forms are being filled out whenever an NFCI pt is seen then all the above information is required for completion. The forms are filled out in triplicate, one for your records, one to the centre for climatic injuries (or something like that) in Haslar and one for the single service medical stats. So yes accuate record keeping, but if by that you mean putting all that is required for the forms into the consult then you are just duplicating work, as the form should be filled out in every instance, once it is completed you put what you need to in the consult then scan and attach the form to the consult. No point reinventing the wheel, there are proceedures already in place for dealing with these injuries.
Surely an ounce of prevention?
From what I have seen the prevention is there also. Before I did Arctic Warfare in Norway I had 3 days of briefings, included in this was a step by step instruction on how to get dressed for cold weather, signs and symptoms of cold injury etc etc everyone on that exercise was as clued up as they could have been, all the kitting was checked and double checked, as the Medic and AELO for the exercise I was given another full days training on cold injuries in a one to one lesson from my SMO. We only had one cold injury on that exercise and that was the patients fault.
Because the focus was on cold and so it was a real consideration. NFCI occur in the UK as well and so attention may not be focused on the not so obvious. You would think our knowledge and experience with heat would prevent all heat injuries, yet we continue to see them in the UK
 
#18
pombsen-armchair-warrior said:
Markintime said:
The AMS can only treat the condition when it is brought to their notice. It is the immediate commanders who should be making foot inspection a normal part of their routine.
There is nothing worse when you're cold, wet and miserable than having to take your boots and socks off but that is exactly the time you should be doing it so that you can dry your feet, give them a massage, check for any signs of problem then put on dry socks from your kit. This should not be left to the individual but enforced as a routine by commanders. Foot inspection used to be a no-brainer, it was carried out routinely. Perhaps it's time we went back to some of the older ways and stop relying on the assumed intelligence/motivation of the soldier.
You are entirely correct. Foot inspections, however, should take place in all environments, together with kit, sleeping bags, cleanliness inspections and more. Personally, I rigorously enforced such checks during Op GRANBY in order to minimise the incidence of ineffective headcount. This level of management and supervision seems to have fallen by the wayside in recent years - I stand ready to be corrected however.
Anybody seen the film My Boy Jack where Rudyard Kipling's son is commissioned into the Irish Guards and is seen doing foot inspections in the trenches?
 
#19
These reported injuries arent happening in Arctic Warfare training though, they are happening in infantry training in the United Kingdom.
 
#20
D0lly86 said:
From what I have seen the prevention is there also. Before I did Arctic Warfare in Norway I had 3 days of briefings, included in this was a step by step instruction on how to get dressed for cold weather, signs and symptoms of cold injury etc etc everyone on that exercise was as clued up as they could have been, all the kitting was checked and double checked, as the Medic and AELO for the exercise I was given another full days training on cold injuries in a one to one lesson from my SMO. We only had one cold injury on that exercise and that was the patients fault.
You were well briefed Dolly and so was I when I was out there (as a medic) but it isd the local commanders who should be checking their men regularly and ensuring that the correct drills are adhered to. You don't even have to make it an inspection, just gather everyone round and tell them to do their own foot admin there and then.
As Sniffer says there are injuries occurring in our (to us) more temperate climes. Exercising in Brecon was always accompanied by that pernicious drizzle that seemed to eat into your very soul it made you miserable and disinclined to take warm boots and socks off at exactly the time you should be doing so!
Particularly for Commonwealth soldiers who are used to much hotter climes with different customs they need educating and guiding and that is the unit commander's responsibility. They shouldn't ever get as far as you other than to blag foot creams and powder or feast upon your pink frillies and webbing.
 

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