Photo By Petty Officer 1st Class Trey Hutcheson | A Special Operations Forces Arctic Medic (SOFAM) performs a blood transfusion on a...... read more read more
In a virtual alumni event held June 3, the Ted Stevens Center for Arctic Security Studies convened a timely discussion on the future of cold-weather casualty care, spotlighting the operational and medical challenges of delivering life-saving care in the world’s harshest environments.
The event, “Advancements in Sub-Zero Medicine,” brought together military medical leaders and austere medicine experts to share practical innovations and expose gaps in readiness that could jeopardize Arctic operations if left unaddressed. The session featured Dr. Emily Johnston, founder of Cascadia Mountain Institute and a global leader in extreme cold medicine, and Alaska Army National Guard Maj. Titus Rund, a flight surgeon assigned to the 207th Aviation Troop Command.
The dialogue emphasized the growing need to prepare U.S. and allied forces to operate in austere Arctic conditions. Johnston and Rund shared lessons learned from field experience, research, and military training—reinforcing the Department of Defense’s priorities to restore the warrior ethos, rebuild military capability, and reestablish deterrence through integrated Arctic preparedness.
Johnston, an emergency medicine physician who has worked across all seven continents, outlined significant limitations in the current combat medicine playbook when applied to extreme cold. She explained that equipment, techniques, and medications optimized for desert or temperate environments routinely fail in Arctic conditions, where freezing temperatures degrade materials and threaten casualty survivability.
“We can’t rely on the systems and tactics that worked in the desert to function in minus 30 degrees,” Johnston said. “Batteries fail. Medications freeze. Blood tubing cracks. Every link in the chain of care must be reengineered for extreme cold.”
Johnston introduced a low-tech but field-proven base layer transport—dubbed the “BLT”—used by medics to keep critical medications and blood warm through body heat. The system, sewn into a standard merino wool base layer, allows providers to maintain temperature control during cold-weather missions without reliance on battery-powered devices.
“It’s not flashy tech,” Johnston said. “But it works. It protects the mission—and more importantly, it protects lives.”
Rund, a military physician specializing in cold weather and austere medicine, expanded on the importance of rethinking traditional casualty evacuation timelines and doctrine. Drawing from his own operational and research experience, he emphasized that the “golden hour” for trauma response is often unattainable in the Arctic. Instead, combat medics must be trained and equipped to manage “golden days” of prolonged field care in remote, contested environments.
“We need to accept that medical evacuation may be delayed or denied altogether in a high-end Arctic fight,” Rund said. “Momentum wins wars—and casualties stop momentum. If we can’t stabilize and protect our injured in the cold, we lose more than lives. We lose initiative.”
Rund presented several innovations designed to address critical operational gaps, including a cold weather casualty collection point shelter and a transportable warming system capable of preserving blood and temperature-sensitive supplies. He also described how his team converted an Alaska Railroad train into a mobile hospital and successfully tested an augmented reality surgical guidance system during a live simulation. The prototype enabled medics to perform complex procedures while receiving real-time instruction from trauma surgeons located thousands of miles away.
Both presenters emphasized that knowledge-sharing across military, civilian, and international domains is essential to improving outcomes in Arctic operations. For alumni of the TSC—many of whom serve in joint or multinational commands—the discussion reinforced the importance of integrating operational medicine into broader deterrence strategies. Participants joined from across the United States and Canada, contributing to an open dialogue that addressed National Guard training requirements, innovative field solutions, and the logistics of storing and transporting blood and pharmaceuticals in freezing conditions.
“Sharing these lessons with our alumni community is vital,” said Matthew Hickey, Associate Director for Strategic Engagement at the TSC. “They are on the front lines of building partnerships, shaping doctrine, and preparing our force for what comes next.”
Johnston closed by emphasizing that cold-weather capability is not only a logistical concern—it is a matter of warfighter survival and strategic credibility.
“The cold isn’t the enemy,” she said. “It’s an environment. The more we respect it, the better we’ll perform in it. That’s what saves lives—and that’s what strengthens deterrence.”
| Date Taken: | 06.27.2025 |
| Date Posted: | 06.27.2025 18:43 |
| Story ID: | 501780 |
| Location: | JOINT BASE ELMENDORF-RICHARDSON, ALASKA, US |
| Web Views: | 31 |
| Downloads: | 0 |
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