Training For Trauma
October 30, 2007
I remember well the training I went through to become a Paramedic. After 3 months of classroom work, we spent 3 months in our clinicals, working in various areas of hospitals, such as the Emergency Room, Surgery, Obstetrics, a Burn Unit, Neonatal ICU and Cardiac Care. For my Emergency Department rotation, I was fortunate to do my 2 weeks of ER clinicals in one of the busiest Level 1 Trauma Centers in the state of Kansas, where the most severely injured patients from all over the state were sent. The time we spent in the Emergency Department prepared us for what we would face, as we went into jobs working as Paramedics on various ambulance services. It was time well spent. Without that type of training, we’d have had no clue what we would be facing out in the field. The training allowed us to have hands on experience with actual patients and allowed us to practice and hone our skills that we’d been learning in the classroom.
AP Photo by Wilfredo Lee
The Army is seeing the value in this type of hands on training as well. For 2 weeks, Army medics, nurses, doctors and nurse anesthetists have been experiencing hands on trauma medicine and teamwork under pressure at the Ryder Trauma Center at Miami’s Jackson Memorial Hospital. It’s a place that sees so many traumatic injuries, that many times, it resembles a war zone. Ryder is one of the busiest trauma centers in the United States. They see an average of 11 trauma patients per day. About equal to the amount seen in the biggest military hospital in Iraq.
Jackson Memorial Hospital lies in Miami’s most crime ridden sections. Patients who arrive there have often been stabbed, injured in horrific automobile accidents, wounded in gang shootouts with high-powered assault weapons or injured in falls and fights. Many of the injuries they see every day, resemble those seen on the battlefield.
The Army send 10 forward surgical teams through Ryder’s ER every year. It was selected 6 years ago, because of the levels of trauma that they see. It is the only trauma training center that the Army uses. The Air Force sends their teams through similar programs at St. Louis University, as well as in Baltimore and Cincinnati; the Navy’s trauma personnel train in Los Angeles.
In this rotation, the medical professionals being trained are all Ohio reservists, part of the Army’s 848th Forward Surgical Team. In their civilian lives, some raise their families, others tend bar, attend college or work for the Post Office. Their team leader, Col. Michael Oddi is a thoracic surgeon in Akron, Ohio.
?My practice consists of a lot of surgery, but we don’t do a lot of trauma surgery. So a program like this, to prepare us for acute, multiple casualties, really helped us on our last deployment and it will help us again,” Oddi said. “It is extremely busy here.”
On this particular day, the trauma center’s radio crackled to life. A 34 year old woman who was injured in an automobile accident was being flown in by helicopter. A portion of her scalp was torn back exposing her skull. She had various broken bones, some which were sticking out of the skin on her left leg, according to the report they were given. Oddi and two medics, a nurse and a nurse anesthetist from his team don green long sleeved hospital gowns and blue gloves as they make their way onto the roof to await the arrival of the helicopter.
When the helicopter arrives, they ease her onto a gurney. Her head and neck are immobilized in a cervical collar. Her arms is bandaged, but the report about the let appears to okay, the radio report was inaccurate. They wheel their patient into the elevator and make their way into the trauma room, once they arrive back at the ER. They assess the patient, paying particular attention to her head injuries and assessing whether she has suffered any sort of brain injury. After about an hour, she is wheeled away for X-Rays and scans.
The team then prepares for the next patient that will come through the doors. The team members say that their time training at Jackson Memorial Hospital prepared them well, to care for wounded Soldiers and Iraqi civilians that they encountered on their last tour in Iraq in 2004. In Miami on that trip, they saw similar injuries - head trauma, multiple gunshot wounds. They learned to work at the frenzied pace that was required for the environment. In Miami, they even sometimes had to deal with language barriers, just as they encountered in Iraq. One of the team members, Sgt. Robert Bartl, also came through Ryder Trauma Center in 2004.
“Coming down here before we got deployed and getting hands-on with real patients, doing IV’s again with actual people instead of rubber plastic arms, it did wonders for my confidence,” Bartl said.
This type of training, actual hands on experience, is invaluable. Not only will the medical teams be more prepared for what they may encounter. They also have the opportunity to refresh their skills and learn to work together as a team. In places such as Ryder Trauma Center, everyone is part of the team… even those who are there to learn. Everyone is expected to pull their share of the load. Many times, with multiple casualties coming in at the same time, there is no choice, except to roll up their sleeves and get busy saving lives. When they arrive in Iraq, they’ll be glad that they did.