Need some M*A*S*H with that surge? A recently uncovered Army report (not released to the media or public, of course) found that medical support services in Iraq are not what they should be. The report noted shortcomings in medical staff training, medevac facilities and a lack of lab personnel and facilities that means blood samples are shipped all the way to Germany for testing.

A shortage of lab and pharmacy technicians makes it difficult to conduct tests near the battlefields, according to briefing slides prepared by the Army Medical Department. When the Army can hire lab personnel, they frequently need additional training, according to the briefings. To complete lab tests, the Army must send patients’ samples to the Landstuhl Regional Army Medical Center in Germany, a process that can take two to three weeks to return results to medical facilities in Iraq.

Even when lab work can be done in Iraq, it is often conducted on an ad hoc basis. “Blood collection and apheresis [separation of blood components, such as platelets] are ‘Hey you’ tasks,” according to the briefings, which were conducted in February during a mid-year review for Maj. Gen. Ronald Silverman, commander of the Iraq-based Task Force Three Medical Command. The Army Medical Department Center and School conducted the review, which included representatives from major Army commands, divisions and brigade combat team surgeons.

The findings point out deficiencies in what is otherwise a vast improvement in battlefield medicine in the past 15 years. The advances, together with a system of medevac helicopters that can transport a wounded soldier from the battlefield to a field hospital in an hour or less, have boosted the survival rate of Iraq casualties to nearly 95 percent.

Still, the briefings portray a combat medicine operation struggling under inadequate and poor training. For example, the briefings describe combat medics who are poorly trained to perform emergency surgical airways when working in the field. Performing airway procedures is a key component of emergency medicine, which includes insuring that a patient can breathe and stopping a patient’s bleeding.

Government Executive, which broke the story, sent written questions to the Army regarding the specifics of the briefings. The Army’s response was a typical Catch-22:

Army headquarters did not respond by the time this article was posted. Cynthia Vaughn, head of public affairs at the Army Medical Department, declined to respond because she said the briefings were marked “For Official Use Only” and “are not intended for public release, and it would be inappropriate for us to respond to questions relating specifically to this document.”

So let’s be clear, since the materials were not intended for public release, the Army won’t comment on them, even though the materials now have been released, as of publication of this article. Sounds like a new version of “Don’t Ask, Don’t Tell” only it’s now “You Can Ask Till You’re Blue in the Face, but We Won’t Tell.”

Although the survival rate of casualties is about 95 percent, the kinds of wounds inflicted in Iraq are typically more serious than in previous conflicts. And as improvised explosive devices get ever more powerful, the wounds they cause require faster, better critical care. We have just finished what has been the bloodiest month of 2007, with 127 Americans and two Britons killed in May. The total of American casualties has now exceeded 25,000 since the war began.

And it looks like it will get worse before it gets better. Even George Bush has admitted that his so-called surge will likely produce more U.S. casualties.

“We’re going to expect heavy fighting in the weeks and months. We can expect more American and Iraqi casualties,” Bush said at a press briefing in the Rose Garden in late May. “It could be a bloody — it could be a very difficult August.”

And just when the troops will need it most, it appears that their medical support won’t be as good as it should be. Typical. Just like the administration sent them into Iraq without body armor or armored Humvees, so it now is surging them with insufficient medical supplies, personnel and facilities.

Heckuva job, Bushie!