man-made catastrophe such as an heinous terrorist act that could range anywhere from a mass casualty with chem-bio, be it small pox, be it chemical gasses, be it tactical nuclear effect, to a pandemic. avian influenza. how prepared will we be? let's get back to that marine or sailor that's blown up? in previous conflicts from the time you were grievously injured to the time you were eventually immediate vaked back to the states to a tertiary care facility such as a tertiary care medical facility such as walter re d or bethesda or san diego or brooke army in texas or a va medical center, that time of injury to time of immediate vak was 45 to 60 days. ladies and gentlemen, today if you are a warrior and you are blown up or griefously injured, on average from the time you are grievously injured to the time you arrive in my icu in bethesda is 3 days. that capability is provided to us by on screen care with unparalleled first responder action that can save the live, tourniquet therapy, clotting agents, understanding, robust immediatevac capibility, and then a continuing continuum to germany and back to