Monday, April 7, 2008

Surgeon Generals Speak at Conference

Vice Admiral Adam M. Robinson Jr, MC, U.S. Navy Surgeon General & Chief, Bureau of Medicine and Surgery, said “the Navy not only deals with the consequences of war and the wounded, but the Navy also helps family members acting as caregivers with emotional issues. Taking care of the wounded warrior and the family at the same time has never been done before. The Surgeon General made these remarks at the 6th Annual Battlefield Healthcare Conference held at Georgetown University on April 1-2, 2008.

According to the Vice Admiral, when wounded warriors enter the Navy medical system, they are assigned a team that may have physicians, nurses, case managers, social workers, therapists, chaplains, and others to help.

The Navy not only has to sustain the care for the wounded, but also care for soldiers that will have debilitating chronic illnesses in their lifetime. Many of the injured soldiers will be in the military health system for the next 40 to 50 years. That is why it is so important for the Navy to provide patient and family centered care and to partner with the VA.

Today, mental health professionals need to deal with many problems with military personnel that may be common, potentially disabling, and possibly preventable. Some of the problems that they see have to do with drug and alcohol abuse, depression leading to suicides, and abuse to family members in the home.

Many developments have helped combat casualty care. For example, resuscitative teams have been able to stop and stabilize injuries before the wounded go to the hospital. Great success occurs because the right medical teams are at the front lines and able to provide the correct care en route to the hospital. Some of the advances in military medicine have resulted in vacuum-assisted wound closure devices, advanced clotting sponges, advanced prosthetics, and advances in imaging that provide information on both hard and soft tissue and provide limited radiation exposure.

There are new ways to handle blast injuries that result in brain swelling. Today, the surgeons are able to remove large brain plates, do 3-D imaging and obtain a description of what has been lost. This enables the surgeons to do complex planning for the next step that involves implanting a prosthesis that fits precisely in the skull. After the healing process, reconstruction of the brain is then performed.

Lt. General James G. Roudebush, MC, Surgeon General of the Air Force, also addressing the attendees at the Battlefield Healthcare Conference, is proud that the Air Force’s air evacuation and en route care provides critical care at the right place and at the right time by getting the wounded rapidly to their first damage control surgery. Although getting the wounded to the right medical facility quickly is critical, the Air Force Medical Service not only takes care of the patient’s medical needs, but at the same time is able to make the patient comfortable while in flight.

As the Air Force Surgeon General explained, the wounded are stabilized and transported to Landstuhl Regional Medical Center in Germany, to Andrews Air Force Base, or to wherever necessary for treatment usually within 36 hours. Transporting the wounded is helped by using TRAC2ES, a system put in place to monitor and track patients leaving theater via Air Force aero medical evacuation.

According to General Roudebush, the Air Force currently has new techniques and devices available to better care for wounds, control infection, and to help control pain. Medical personnel are now better able to monitor the wounded during flights using devices that are lightweight, small, mobile, and rugged.

In addition, CT scanners and handheld blood analyzers have helped enormously in getting the wounded to the operating room with the right information at the right time. This is particularly important in trauma injury cases because the vast majority of trauma patients require multiple procedures done by a team of surgeons in the operating room. This means that all of the surgeons on the team must have immediate data to proceed.

For more information on the Battlefield Conference and on future meetings, go to