South Florida Hospital News
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June 2007 - Volume 3 - Issue 12

Army Surgical Teams Train for Iraq at Ryder Trauma Center

The Army has gone civilian in a South Florida hospital that is providing training for Army medical professionals and producing exemplary surgical teams to provide lifesaving care for injured soldiers in the chaotic battlefield of the Iraq War.

The meticulously-prepared forward surgical teams, consisting of Army Surgeons, Registered Nurses, Anesthetists and Surgical Technicians, are deployed overseas following their training at the Army Trauma Training Center (ATTC), located at Jackson Memorial Hospital (JMH). The ATTC unites the assets of the University of Miami School of Medicine and JMH with those of the Army Medical Department, creating a center that supports military medical capability by utilizing the existing resources and expertise of the Ryder Trauma Center at JMH.

Captain Blumberg, M.D., and Lt Frantz, CRNA, transfer an ER patient to the OR table

Ryder is one of the world’s leading trauma centers, caring for over 4,000 patients annually. With an urban location, Ryder treats numerous patients with penetrating injuries, often inflicted by guns and knives. As a result, its trauma teams have developed exceptional expertise in managing such injuries. These wounds are similar to those that are sustained by soldiers in Iraq, making Ryder an ideal setting to prepare Army and Reserve surgical teams for service there.

"Ryder is the perfect facility for us," says Donald Robinson, M.D., director of the ATTC program. "We want our teams to learn to treat penetrating injuries in real situations; many of them come from facilities where they have little exposure to them. Penetrating injuries from improvised explosive devices, or IEDs, are the ‘signature wound’ of this conflict, along with burns and inhalation injuries."

Dr. Robinson and Captain Randy Smith (back) in the OR

Army teams come to Ryder from all over the U.S. All are accomplished professionals with at least basic trauma experience, but varying levels of skill. Turning the trainees into competent, cohesive teams as they rotate through the14-day course is the goal, says Robinson. Following four days of didactic learning, they have eight days of intense training in the emergency rooms, operating rooms and ICU. Throughout the program, the emphasis is on efficiency and absolute focus on the patient.

The ATTC program, however, does more than enhance clinical experience.

"We teach them to function as a team," says Robinson. "They’ll be deployed together and their identity is as a team. We augment their clinical skills within the context of team building so that they function with maximum efficiency. On the battlefield, efficiency is everything. Time saves lives, and that’s the reason we’re there."

To achieve this level of efficiency and focus, the ATTC helps teams learn to anticipate each other’s moves and develop a common language. "The OR nurse can better anticipate what the surgeon’s going to do next, always staying one step ahead of him, when they use this language. Otherwise, he could be slowed down and that could cost a life."

The course places trainees in severely stressful circumstances, conditioning them somewhat to the stress they will face overseas. "In Iraq, you perform emergency procedures on critically wounded people while a mortar could be going off outside the tent," says Robinson. "You can’t think about yourself, your family or the danger. The training takes the chaos out of trauma; it has to become normal to you so that you don’t react to it; you stick to the basics and do the job, no matter what." To cope with stress, team members can talk to chaplains, but Robinson says that they learn to rely on internal resources. They are debriefed and given counseling when they return home.

Captain Randy Smith watches his team perform a teamwork drill

Army captain Randy Smith, R.N., a nurse on the peripheral vascular and liver transplant surgery teams at the University of Wisconsin-Madison Medical Center, is currently rotating through the ATTC program. "This is an overwhelmingly positive experience and the opportunity of a lifetime," he says. "I wish all Army medical personnel could have this training. Everyone in my unit already has top-notch skills, but the training prepares us for what we will see in combat."

According to Robinson, the forward surgical teams treat both soldiers and civilians.

"We treat everyone – soldiers, civilians, children and even insurgents. I cared for a severely injured Iraqi that we knew had set off an IED. After he recovered, he was sent to prison. One day, a guard called me to say thank you, because this man gave them the names of 15 insurgents and said he did it because of the care I gave him. We’ll never know how many soldiers may have been saved because of that."

Robinson says that the ATTC is developing the very best trauma forces that can be put on the battlefield to handle injuries. When an injured soldier receives advanced medical care and surgical intervention immediately, the chances of survival and recovery are far greater.

To learn more about the Army Team Training Center at Jackson Memorial Hospital’s Ryder Trauma Center, visit
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