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Medical innovators of the battlefield

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In his first deployment to Iraq in 2005, Air Force Col. Todd Rasmussen saw firsthand why innovation was needed to change combat casualty care. An outdated system of evacuating wounded service members from the battlefield no longer worked with the high number of casualties.

 “We were evacuating and caring for injured patients based on an old system, in which the unit’s doctor or surgical team were the ones responsible for that unit’s injured,” Rasmussen said. The joint force in Iraq and Afghanistan and the nature of combat had changed. “As the volume of casualties increased, it was important for us to shift our thinking to allow, for example, an injured Marine to be evacuated by an Army medevac helicopter to an Air Force theater hospital.”

 As a result of his experiences, Rasmussen and others developed what would become the Joint Trauma System, a system built around coordination among the services. Now, a wounded service member soldier is transported within the “Golden Hour” – the first hour after injury – to the surgical facility with the right capabilities regardless of which service owns the facility or staffs the transfer. This changed the course of combat casualty care. It also helped sustain what Rasmussen considers one of the most important aspects of the U.S. military – the all-volunteer force.

“Every combatant commander I’d see said the reason our guys and gals fight is because they know – if they’re injured – they’ll be taken care of by the best, most enabled trauma care system in the world,” said Rasmussen. “What the Military Health System did in combat casualty care to increase the survival rate to greater than 98 percent and to coordinate care afterward – including getting injured service personnel back to Germany and the states quickly – has a direct link to a talented young person’s will to enlist and to take the fight to the enemy.” 

Since then, Rasmussen has seen and been a part of many changes in DoD trauma care. As deputy commander of the Army’s Institute of Surgical Research in San Antonio from 2010 to 2013 and now director of the DoD Combat Casualty Care Research Program (CCCRP) at Fort Detrick, Maryland, Rasmussen has helped develop solutions that improve combat trauma care and, in many cases, trauma care in civilian settings. 

One CCCRP project now being investigated by the Food and Drug Administration is a device to stop bleeding and keep a person’s blood pressure from dropping after significant blood loss. The balloon-like device is inserted inside the aorta and inflated above the level of bleeding in order to slow or stop the bleeding. The innovation came from a military patent now shared with the University of Michigan. It could work in both military and civilian settings. 

Other devices and techniques developed or improved on the battlefield have already saved civilian lives. Tourniquets that are used to stop the flow of blood from extremity injuries were revisited and revamped by the Military Health System to be more durable. The new tourniquets are credited with saving between 1,500 and 2,000 military personnel during the Iraq and Afghanistan wars. The same tourniquets were used to save limbs and lives in the aftermath of the Boston Marathon bombings in 2013. 

“This translation of military lessons into best practices in the civilian sector is important,” said Rasmussen, “especially during any interwar period when it’s easy for interest to wane. But, sustained commitment to the military’s requirements-driven trauma research program and ongoing collaborations with the civilian community are essential.” 

Rasmussen and the staff at CCCRP are already looking to the future, toward military operations that will present new challenges. During the most recent wars, U.S. troops had the ability to fly fleets of helicopters, relatively unimpeded, to most conflict areas. The next operation may have injured troops in remote locations with no nearby surgical facilities. Rasmussen said CCCRP’s mission is to answer the question: How do you treat a service member who is severely injured and can’t be evacuated for 40 hours? 

In May, Rasmussen was awarded the 2015 Air Force Hero of Military Medicine Award by the Henry M. Jackson Foundation, a moment he ranks as one of the most meaningful of his career. That statement carries extra weight from someone who has deployed six times during a 21-year career as a vascular surgeon. He performed more than 1,000 operations in Iraq and Afghanistan alone.

Rasmussen said the award was recognition of work performed by thousands of men and women to improve the military’s response to trauma. For him the evening was matched in importance by one other accomplishment in his career.

“The other truly rewarding moments came during early deployments, when I was able to put my surgical training to use as part of a remarkable team caring for the most important patients I’ll ever treat: the young men and women of our volunteer force.”


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On The Blood Grid: Sailors And Marines Donate At Camp Pendleton

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The summer months are in full-swing and many Armed Services Blood Program regular blood donors are on vacation with families thus making blood collection difficult.  However, the Sailors and Marines from the 3rd Battalion, 5th Marine Regiments at Camp Pendleton, California, volunteered to jack into the Blood Grid and infuse life for patients in need.    

This blood drive was particularly special because of the unit’s nine-month deployment rotation which means there was a high probability of donor deferrals due to travel restrictions and vaccinations. However, the efforts of Navy Petty Officer 3rd Class Christopher Courtney, a first time ASBP donor and the unit’s blood drive coordinator, provided ample donors.    

“The biggest challenge was determining which individuals recently came back from deployment and those who recently received smallpox vaccination,” Courtney said.  “I was afraid the turn out would be low because of these challenges but the word got out that there was a blood drive and the support started pouring in from different units in the area.  I was determined to make it a successful blood drive in support of our guys deployed forward and [for] patients at the hospital.” 

First-time Armed Services Blood Program donor and unit coordinator, Navy Petty Officer 3rd Class Christopher Courtney, donates blood during a recent summer blood drive.First-time Armed Services Blood Program donor and unit coordinator, Navy Petty Officer 3rd Class Christopher Courtney, donates blood during a recent summer blood drive.

Courtney also coordinated the unit’s first ASBP blood drive. It was his desire to help with the mission of the blood program of saving lives and to make sure blood is available this summer.   

“It’s very important to support our own,” Courtney said. “There should be no reason for the blood program to buy blood when we can support them.  That’s exactly my purpose of having a blood drive.  We should be supporting each other especially when patients rely on our own blood to live.”   

Along with Courtney, Navy Petty Officer 1st Class Kevin Boggs assisted in recruiting for blood donors. Boggs, an advocate of giving blood to the ASBP, persuasively recruited donors to roll up their sleeves and donate for ill or injured service members, veterans and their families worldwide.    

“It’s important for the military as a whole to donate blood because we are the one that benefits from all of this.  The blood that we give is the same blood that our patients will receive,” Boggs said. “We have to be self-sufficient and supply our own blood or else we end up getting them from civilian organization.”   

When asked to share some words of encouragement to fellow service members, Boggs said: “When people go down range and sustain injuries, it’s important for our military to be taken care of instantly.  There is always a need for blood and we have to be prepared to have them available anytime.  So I highly encourage everyone to give blood.”   

About the Armed Services Blood Program 

Since 1962, the Armed Services Blood Program has served as the sole provider of blood for the United States military. As a tri-service organization, the ASBP collects, processes, stores and distributes blood and blood products to Soldiers, Sailors, Airmen, Marines and their families worldwide. As one of four national blood collection organizations trusted to ensure the nation has a safe, potent blood supply, the ASBP works closely with our civilian counterparts by sharing donors on military installations where there are no military blood collection centers and by sharing blood products in times of need to maximize availability of this national treasure. To find out more about the ASBP or to schedule an appointment to donate, please visit www.militaryblood.dod.mil. To interact directly with ASBP staff members, see more photos or to get the latest news, follow @militaryblood on Facebook, Twitter, Flickr, Pinterest and YouTube. Find the drop. Donate. 

Disclaimer: Re-published content may have been edited for length and clarity. Original post




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Exercise tests, demonstrates new DOD capabilities

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As a C-17 Globemaster III flown by the Air National Guard slowly made its way down the Offutt Air Force Base, Nebraska, flightline, ambulances from the Omaha Fire and Rescue Department along with other local emergency response vehicles waited just outside an aircraft parking ramp.

This was all part of exercise Patriot 15, an interagency field training exercise used to practice domestic operations within the United States. 

The annual exercise included aeromedical evacuation of patients with highly infectious illnesses from Volk Field, Wisconsin, to Offutt AFB; however, this was not the first time a scenario like this has occurred. 

Last September, Dr. Rick Sacra, a patient infected with the Ebola virus, was flown to Offutt AFB by commercial air, where he was transferred by ambulance to the University of Nebraska Medical Center's Biocontainment Unit for treatment. 

As part of this year's exercise, three simulated patients with varying degrees of highly infectious illnesses were flown in and transferred into ambulances waiting on the ramp. Offutt's role in the exercise was to coordinate the reception of the aircraft and to provide a safe and secure airfield for the transfer of the patients. 

"Overall, we think the exercise went very well," said Lt. Col. Chris Luther, the 55th Wing Crisis Action Team director, who oversaw the exercise and led the first Ebola patient reception in 2014. "It was a collaborate effort with local emergency response agencies that reinforced our preparedness for such an event."

Omaha Fire and Rescue Department personnel in personal protective equipment transfer a simulated patient with a highly contagious disease to an ambulance on Offutt Air Force Base, Nebraska, as part of exercise Patriot 15. Omaha Fire and Rescue Department personnel in personal protective equipment transfer a simulated patient with a highly contagious disease to an ambulance on Offutt Air Force Base, Nebraska, as part of exercise Patriot 15. Three patients with simulated illnesses were airlifted from Volk Field, Wisconsin, to Offutt AFB for transfer to the University of Nebraska Medical Center’s Biocontainment Unit. The annual exercise, sponsored by the National Guard Bureau, is used to practice domestic operations within the U.S. (U.S. Air Force photo/Delanie Stafford)

In addition to training, the exercise was also used to demonstrate the Transport Isolation Unit, which is a newly developed piece of equipment that became operational earlier this year. 

According to sources, each module of the Transport Isolation Unit can be configured to carry up to four patients at a time, depending on the degree of their illness. Three modules make up one unit. The unit provides an enclosed negative pressure environment intended to prevent the spread of biological contaminates through the air or by contact. 

Until recently, patients with illnesses such as the Ebola virus and severe acute respiratory syndrome could only be transported by a single-occupancy patient isolation unit that limited the type of care that could be given. 

"We can provide critical care in the air, inside the (Transport Isolation Unit), that other units really aren't capable of doing," said Brig. Gen. (Dr.) Kory Cornum, the Air Mobility Command surgeon. "So it gives us not only capability for more patients, but care during transport." 

The Defense Department is in the process of acquiring more of the units and hopes to have 25 available by the end of the year. Each unit can be loaded onto a C-17 or C-130 Hercules for the transfer of multiple critical-care patients anywhere in the world. 

"Last year we had several thousand people in Liberia potentially exposed to Ebola," Cornum said. "That's when we realized (the single-patient isolation unit) wasn't good enough." 

More than 50 people from University of Nebraska Medical Center, Offutt AFB, and local medical response agencies attended a demonstration inside the cargo area of a C-17 during a pause in the exercise. Doctors from the Critical Care Air Transport Team, assigned to the 59th Medical Wing at Joint Base San Antonio-Lackland, Texas, gave demonstrations on personal protective equipment and how their team will use the system to transport and treat the most critical patients. 

Staff from the biocontainment unit at the University of Nebraska Medical Center, which is the largest unit in the nation, were impressed by the demonstration and capabilities of the new unit. 

"This is exciting and an honor for UNMC to be here and to be involved on the receiving end," said Dr. Phillip Smith, the medical director of the biocontainment unit. "This is just a way to keep getting ready because you never know when you're going to get the call."

Disclaimer: Re-published content may have been edited for length and clarity. Original post



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Canada’s top military doc meets with MHS leaders

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MacKay also met with Air Force Lt. Gen. Douglas Robb, director, Defense Health Agency (DHA), in Falls Church, Virginia. The visit was to discuss how the two countries’ militaries can continue to leverage the assets and knowledge each brings for better health care for the troops and their families.MacKay also met with Air Force Lt. Gen. Douglas Robb, director, Defense Health Agency (DHA), in Falls Church, Virginia. The visit was to discuss how the two countries’ militaries can continue to leverage the assets and knowledge each brings for better health care for the troops and their families.

 

 

 


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MHS leaders honored by American Hospital Association

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Two Military Health System (MHS) leaders were recognized recently by the American Hospital Association for their outstanding service to the health care field. Retired Air Force Brig. Gen. Charles Potter and Army Col. James D. Carrell received the honors during the recent American Hospital Association’s (AHA) Leadership Summit in San Francisco. Potter was the first chairman of the MHS Medical Operations Group, while Carrell served as chief of the Reception Medical Clinic at Fort Jackson, South Carolina.

“General Potter and Colonel Carrell exemplify the commitment to serve our beneficiaries – from active duty military members to retirees to families,” said Assistant Secretary of Defense for Health Affairs Jonathan Woodson. “The AHA’s recognition highlights the work we do for our patients whether it’s on the battlefront or back home at their local clinic.”

Potter received the 2014 Federal Health Care Executive Award for Excellence. He was a major contributor to the MHS Governance structure. As the first-ever chairman of the DHA’s Medical Operations Group, he supported centralized, coordinated policy and guidance for delivering health services to all 9.5 million MHS beneficiaries.

As the director of Manpower, Personnel and Resources and chief of the Medical Service Corps, he advised the Air Force Surgeon General on all aspects of planning, programming, budgeting and execution for a program serving 2.6 million beneficiaries and 75 military treatment facilities worldwide. In addition, Potter managed personnel policy, force development and staffing requirements for 43,000 active-duty officer, enlisted and civilian personnel and was responsible for all Air Force medical education and training worldwide. He retired recently after 35 years of military service.

Carrell received the 2014 Federal Health Care Executive Special Achievement Award. In 2013, he recognized a significant problem: only 1 percent of soldiers who received their basic training at Fort Jackson arrived at their first duty station with their vision readiness, immunizations, medical warning tags and lab results documented in MEDPROS, the Army’s medical record system. By the time he and his clinic staff finished improving the process, 99 percent of soldiers from Fort Jackson arrived at their duty station with complete records.

“The honorees exemplify dedication to excellence and service to their country. On behalf of the American Hospital Association, I thank them for the work they do each day,” said Richard Umbdenstock, AHA president and CEO. “Our federal hospitals are priceless resources to our nation. The care provided is critical and the knowledge shared with other hospitals has added immeasurably to our capacity to treat complex conditions.”


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Did you know?

A veteran’s family must request a United States flag.

A flag is provided at no cost to drape the casket or accompany the urn of a deceased veteran. Generally, the flag is given to the next of kin. Only one flag may be provided per veteran. Upon the request of the family, an “Application for United States Flag for Burial Purposes” (VA Form 21-2008) must be submitted along with a copy of the veteran’s discharge papers. Flags may be obtained from VA regional offices and most U.S. Post Offices.