The Department of Defense Combat Trauma Surgical Committee held their annual meeting here and the future of military trauma medicine was high on the agenda.

The committee coordinates sustainable combat trauma surgery training programs and recommends tri-service policy changes to improve combat trauma outcomes.

The committee was formed as a direct result of several DOD and General Accounting Office reports on medical operations during the Persian Gulf War that questioned the military’s ability to meet its wartime medical mission -– particularly in providing trauma care.

In the past nine years, the committee has assessed policy, made recommendations and established trauma training standards and initiatives that have closed the trauma training gap.

“The tri-service membership of the committee has crossed service lines to improve casualty care,” said Lt. Col. (Dr.) Donald Jenkins, the chief of trauma at Wilford Hall Medical Center at Lackland Air Force Base, Texas.

“Every person in the room leaves their service pride objectives outside the door and we talk just about the wounded troop,” he said. “No one talks bad about each other. There are only honest recommendations. Everyone in the room is a high powered, high ranking, very senior member of this corporation of military healthcare and keeps the focus on the wounded troop. It is unparalleled.”

Army Col. (Dr.) David Burris said, “The CTSC has made significant strides partnering with civilian trauma training centers, whose caseloads match battlefield injuries.”

Dr. Burris is chairman of surgery at the Uniformed Services University of Health Science in Bethesda, Md.

“At first, the goal was to have a joint trauma training center,” Dr. Burris said. “Today, we have three trauma training centers, the Army Trauma Training Center in Miami, the Air Force Trauma Training Center in Baltimore and the Navy Trauma Training Center in Los Angeles.

“While there are specific training centers for the services, the curriculum is the same and the student seats are interchangeable,” he said.

Dr. Jenkins likes what the committee has done in laying the foundation for future military trauma medicine.

“Because of the work of CTSC members, the Emergency War Surgery Handbook was created,” he said. “This handbook was turned over to the next generation of trauma leaders, who used it as the foundation for the Emergency War Surgery Course.”

Formerly known as the Trauma Refresher Course for Surgeons, this three-day course, held at various locations, is a standardized training program that gives medical personnel exposure to critical life saving skills necessary to sustain the force that will fight and win the wars of today and the future.

Dr. Jenkins will be the next theater trauma director in Iraq. He will replace an Army surgeon for approximately six months starting in the spring of 2006. His duties will include serving as a consultant to maintain a theater-wide joint expeditionary trauma network to provide the optimal management of traumatically injured troops.

“Someone said that the system was broken at one time, but it’s fixed now,” Colonel Jenkins said. “We’re doing great stuff, and now we have the tools in place to fine tune it.”
He said improvements can still be made in the business processes between the services.

“A lot of good things are happening in the grassroots,” Dr. Jenkins said. “For example, the recommendation of putting an Air Force person in an Army system to direct trauma care in the theater is huge. While there is evidence of improvements across service lines, the system needs to be fine-tuned so processes will work on a continual basis and not be dependent on individuals.”