AAST Senior Visiting Surgeon Program
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1 AAST Senior Visiting Surgeon Program Landstuhl Medical Center Mary C. McCarthy, MD Professor of Surgery Wright State University School of Medicine 2007 McCarthy
2 Objectives After participating in this activity, the participant should be able to: 1. Describe current military medical care and the flow of patients through that system; 2. Prepare for roles in the optimal care of wounded warriors; and, 3. Develop knowledge about typical wartime injuries in Iraq and Afghanistan.
3 U.S. Troop Deaths in Iraq USA Today
4 Wounded Warriors
5 Goals as Visiting Professor Familiarize myself with the military medical system in order to better prepare our residents and Air Force Attendings for their involvement Experience as a trauma surgeon in the care of the wounded in wartime Implement the changes adopted from the military experience at MVH
6 Landstuhl Service Area
7 Landstuhl Regional Medical Center
8 Ramstein Inn
9 ICU Call Room
10 Vascular Surgeons
11 Facilities for Visitors
12 Workout Facilities
13 Workout Facilities
14 Intensive Care
15 Goals as Visiting Professor Familiarize myself with the military medical system in order to better prepare our residents and Air Force Attendings for their involvement Experience as a trauma surgeon in the care of the wounded in wartime Implement the changes adopted from the military experience at MVH
16 Geography
17 Geography
18 Transport Forward Surgical Hospital (FSH) Baghdad BaladBalad Ramstein Air Base Landstuhl Medical Center CCATT CCATT Transport Walter Walter Reed, Bethesda, San Diego, other bases
19 C-117 Transport Plane
20 Open Humerus Forearm Fasciotomies 11/9 Balad
21 Evac-istan
22 Interior of C-117C
23 ICU Team: Resuscitation and Stabilization
24 Operating Room
25 GSW to the Abdomen
26 Ambulance
27 Ambulance
28 Outcomes 0.38% 0.38% Mortality Highest Highest ratio of injuries to deaths of any war 16:1 Transport systems raise new issues in care of the injured Pneumothorax Prolonged intubation Transfusion thresholds
29 Goals as Visiting Professor Familiarize myself with the military medical system in order to better prepare our residents and Air Force Attendings for their involvement Experience as a trauma surgeon in the care of the wounded in wartime Implement the changes adopted from the military experience at MVH
30 Open Abdomen and Leg Amputation
31 IED Improvised Explosive Device Components salvaged from munitions, electronics, mobile phones, garage door openers Charge-Detonator Detonator-Initiation-Armor penetration system Antipersonnel: Shrapnel (Shipyard confetti) Responsible for 63% of Coalition deaths in Iraq (Washington Post) Explosive Ordnance Disposal personnel
32 IED discovered in Bagdhad by Iraqi police Department of Defense 2005
33 Injuries due to Improvised Explosive Devices (IED) Right Leg Left Leg
34 Injuries due to Improvised Explosive Devices (IED) Right arm Left hand
35 Pneumonia and Mediastinal Abscess=Tetraplegia
36 Traumatic Asphyxia
37 Traumatic Asphyxia
38 Burns
39 Morning Changeover
40 Open Fracture, Penetrating Neck and Abdominal Injuries
41 Trauma Conference
42 Goals as Visiting Professor Familiarize myself with the military medical system in order to better prepare our residents and Air Force Attendings for their involvement Experience as a trauma surgeon in the care of the wounded in wartime Implement the changes adopted from the military experience at MVH
43 Novalung
44 Trauma Care Protocols Factor Factor VII in the treatment of Coagulopathy Massive Massive Transfusion Protocol: Ratio of RBC:Plasma:Platelets Damage Control Abdomen Vascular Research Collaboration
45 TBI Traumatic Brain Injury is the signature injury of the Iraq war 22% 22% of the patients passing through Landstuhl have injuries to the head, face or neck 56% 56% of Walter Reed patients exposed to a blast have a TBI; 59% severe All patients are now screened for TBI
46 Traumatic Brain Injury Grant Department of Defense TBI/PTSD Research Program Funding Funding Opportunity Number: W81XWH CC-CSSCSS Components 1: Traumatic Brain Injury Acute Acute Head Injury Studies: Trauma Service 2: Post-traumatic traumatic Stress Disorder Psychiatry: Dr. Douglas Lehrer
47 Nanstein: : Knights of Sickingen Castle at Landstuhl/Palatinate
48 World War II Cemetery
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