Trauma doctors gather to hone skills

Published March 31, 2008
By Staff Sgt. Mareshah Haynes
332nd Air Expeditionary Wing Public Affairs

BALAD AIR BASE, Iraq -- Editor's note: The identity of the Iraqi physician quoted in this article has not been released for security purposes.

Approximately 20 deployed military doctors, U.S. civilian doctors and Iraqi doctors gathered at the Air Force Theater Hospital here March 24-25 to share information about operations at their respective hospital facilities and discuss and how they could work to be more interoperable.

The Joint Theater Trauma System conference addressed how medical staff members could improve the delivery of care, and ultimately continue to decrease morbidity and mortality in Iraq among servicemembers and civilians, said Lt. Col. (Dr.) George Costanzo, Joint Theater Trauma System Surgeon, deployed from Moody Air Force Base, Ga. The doctor, who is currently based out of Baghdad, served as the AFTH commander in 2006 during a previous deployment.

The conference was the first sponsored by the JTTS in theater.

The U.S. military in collaboration with civilian medical experts, implemented the trauma system in 2004 for wartime operations. The trauma system is similar to those already established in civilian hospitals, and helps ensure wounded servicemembers have the optimal chance for survival and functional recovery following battlefield injuries.

One of the major differences between the care in theater versus what's done in the civilian sector is that patients aren't moved to different facilities for different levels of care as much in the U.S. as they are in Iraq.

A civilian physician, Dr. Peggy Knudson, a trauma surgeon from the University of California in San Francisco and San Francisco General Hospital, lent a civilian perspective to the conference.

"This is a very different type of system that we're not used to. We have been trying to understand each part of that movement, including the flight and the complications and challenges the people who fly these severely injured patients face," Doctor Knudson said.

In the military, patients are transported to military treatment facilities based upon the level of care the facility can provide. Many patients, servicemembers, and U.S. and Iraqi civilians are transported to the AFTH from austere locations for severe injuries.

Some of the issues discussed during the conference were resources, adherence to clinical practice guidelines, and intra-theater and inter-theater medical evacuation.

"This conference helps all the combat hospitals, be they Army, Navy or Air Force all begin to think alike and do things similarly," said Col. (Dr.) Jay Johannigman, 332nd Expeditionary Medical Operations Squadron trauma czar, the head trauma surgeon responsible for the care of all the patients in the intensive care unit and ward.
"That helps us improve and speed the care and access to the patient" said Doctor Johannigman who is deployed from Blue Ash Air National Guard Station, Ohio.

During the course of two days, the physicians from the around the theater and the United States, who often communicate by means of e-mail and telephone were finally able to put faces to names.

"Having this face-to-face encounter makes it a lot easier to communicate with each other and share experiences," said Navy Cmdr. (Dr.) Greg Jones, a surgeon deployed to Camp Taqqadum, located approximately 46 miles west of Baghdad. "I think that is the best thing."

Surgeons at smaller medical facilities, like Camp Taqqadum, who treat patients before they reach the Air Force Theater Hospital, had the opportunity to see what happens to patients once they reach the next echelon of care.

"Seeing how things work here helps us understand what we should do for our patients [before leaving a level two facility] and what is being done for them here," Doctor Jones said.

A handful of doctors stayed at the AFTH two additional days to makes rounds with the physicians deployed here and scrub in on surgeries.

The conference also gave U.S. military doctors and Iraqi doctors the chance to collaborate on the care of Iraqi patients.

Personnel at the AFTH treat Iraqis, civilians and servicemembers. For this reason, it was imperative to have Iraqi surgeons attend the conference so everyone in the treatment process can know how his or her colleagues operate.

"We never really met before, but we shared the same patients," said one Iraqi doctor. "We don't have a neurosurgeon, we don't have a cardiothoracic surgeon, we don't have a vascular surgeon and it's quite common to get patients with injuries in the head or in the chest and in the limbs. So we have a lot of patients referred to [this hospital] and returned to us post operatively.

"We only would see what the doctors [here] would write [about the patients' conditions], so we were very excited to meet them and see how they're doing things. Now we know what is more suitable for them because they're going to take the patient after us. It's better for us to know what to do to in order to give a better chance for the patient to get a better prognosis," he said.

Though many of the doctors traveled long distances to attend the conference, the attending Iraqi doctors, may have risked the most to be at the event.

"I'm an Iraqi, I'm a doctor, so I'm a target [for terrorists], this is the truth" the Iraqi doctor said. "If I'm not a doctor, who is going to treat my brother, who is going to treat my child when he gets sick? I have to do it. Why do [people] serve in the military? Because you think it's worth it because you're doing something for the good of yourself, your people and your society, we think we are doing the same."