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KSDK - A local doctor who served in Iraq returned with a mission: to use what he learned overseas to save more lives right here at home.

"Doesn't she look like Sarah Silverman?" jokes Dr. Phil Spinella to a nurse in the pediatric intensive care unit. "Can you get her on TV too? Do you have a good joke to tell?"

It's often the lighter moments that get you through the day, when you're caring for the smallest trauma patients.

Finding ways to cope is something Dr. Spinella, who is a pediatric critical care specialist, learned during the year he spent in Iraq working in a combat army surgical hospital.

It was 2004. He was an army pediatric specialist working in a combat army surgical hospital.

"Very often in our 20 bed ICU, we'd have the bomb maker we're taking care of, the enemy combatant, next to a solider that got blown up, and then next to a child," Dr. Spinella said.

Children who were caught in the crossfire. Hundreds of them.

"It brings tears to your eyes," said Newschannel Five's Kay Quinn.

"Yeah," Dr. Spinella said. "It might happen a lot. It was tough."

The pediatric intensive care unit here at St. Louis Children's Hospital is thousands of miles away from that military surgical unit where Dr. Spinella saved so many soldier's lives. It was an experience so profound that it continues to play out in his life here every day.

"I do often also say that it's my therapy, for my PTSD," Dr. Spinella said, "for what I went through."

Dr. Spinella's therapy is slowly changing the way blood transfusions are done.

In Iraq, he found that giving oxygen-rich whole blood to soldiers with traumatic injury increased their chances of survival.

But that practice in not the standard of care here in the U.S.

And he says that's not the only problem.

"The blood bank will give them the oldest in inventory," said Dr. Spinella of his patients here. "It's just like the supermarket. The oldest milk is up front."

But according to Dr. Spinella, trauma patients need the freshest blood.

"And we are sacrificing quality for inventory management," Dr. Spinella said.

He pushed hard for this change in protocol in war-time medicine.

Now, he's spent the past eight years putting together an eight million dollar clinical trial to prove it works.

Over the next five years, all critical care patients at Children's hospital and at participating medical centers across the country, will be put into two groups: one group gets the freshest red cells, and the other gets standard care.

Dr. Spinella is not just out to prove a point.

He's also paying back a debt. One he feels he owes to all of the soldiers he left his heart with in that military army surgical hospital in Iraq.

"There's a lot of guilt when you leave the army and when I left in 2007 it was a tough decision. You kind of feel like you're leaving soldiers behind. So in my mind, continuing the research would help improve their outcomes too," Dr. Spinella said.

The changes Dr. Spinella is proposing would require a complete overhaul of the blood banking system and agreement from the blood transfusion community.

But he says he won't stop until he sees patients get what he believes works best.

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