Joint physician training improves readiness

FORT CARSON, Colo. — Army Maj. Michal Sobieszczyk demonstrates how to perform a cricothyrotomy Jan. 14 for doctors with 4th Infantry Division and the U.S. Air Force Academy at Evans Army Community Hospital’s new medical simulation lab. Sobieszczyk is a pulmonary/critical care doctor who provided joint education with his critical-care mobile training team assigned to Brooke Army Medical Center at Joint Base San Antonio. (Photo by Jeanine Mezei)

By Jeanine Mezei, Medical Department Activity-Fort Carson Public Affairs Office

FORT CARSON, Colo. —Whether the military’s mission takes doctors to the battlefield or stateside to care for troops and their Families, military physicians are versatile.

Maintaining and exceeding proficiency in critical skills is an important priority for the medical team, which is why Evans Army Community Hospital (EACH) recently hosted a critical-care mobile training team at Fort Carson.

A team of four pulmonary/critical care physicians from Brooke Army Medical Center (BAMC) at Joint Base San Antonio, provided a two-day training event Jan. 14-15 focused on skills within individual critical tasks lists (ICTL) necessary to care for wounded service members while deployed overseas.

Known as the Army ICTL Education and Validation Course, the instruction is geared toward training subspecialty doctors in critical lifesaving tasks they normally don’t practice day-to-day. This is the first time the BAMC team has taken the training on the road to reach more medical providers.

“The biggest challenge the military has right now, is the internal medicine subspecialty group, your GI (gastro­intestinal) doctors, your allergy immunologists, that don’t do these war-time critical procedures,” said Army Maj. Tyson Sjulin, pulmonary/critical care doctor, BAMC. “We are focusing on procedures to save the warfighter from point of injury until we can provide medical evacuation.”

With 18 students from Peterson Air Force Base, the U.S. Air Force Academy, 4th Infantry Division and EACH, the BAMC team was able to provide hands-on training for 12 of 20 individual critical tasks aimed at field and brigade surgeons. These tasks included central venous catheters, mechanical ventilation, paracentesis, thoracentesis, intubation, chest tube placement, massive transfusion and ultrasound.

“The full trauma scenarios in which we combined all procedural and ventilator management skills were the highlight of the training,” said Army Capt. David Sorenson, battalion surgeon, 704th Brigade Support Battalion, 2nd Infantry Brigade Combat Team, 4th Inf. Div. “It gave me confidence that I could manage a critical patient downrange, if need be.”

While many of the physicians who attended the training specialized in family medicine or internal medicine, they were eager to take advantage of joint training with some of BAMC’s most knowledgeable specialty physicians.

“We are privileged to have this training at Fort Carson by leaders in military critical care medicine,” said Sorenson. “Not only that, but also to have the simulation center that can support this training benefits our physicians immensely.”

EACH recently invested in an on-site simulation lab for medical personnel to locally train to help the team stay current on their individual critical tasks. The BAMC team was able to use the newly-available technology during their training.

“I think it’s extremely important we focus on the education component and not just the validation component — you have to feel comfortable doing this procedure to save a life,” said Sjulin. “You can watch a YouTube video or read a book, but if you need hands-on experience, the best way to do that is with experts in the field that can teach you.”

At some medical treatment facilities, physicians may not have the quantity and or acuity of patients they will encounter downrange.

“These skills can perish,” said Sjulin. “It’s our job every year to come in and get these skills back up. That way, if we have to go to war tomorrow, they are ready to go downrange to take care of the most critically ill warfighter we have and save the individual’s life.”

Small nuances in technique are also important to performing critical tasks when it comes to stabilizing and treating the wounded. Sjulin and his team were open to sharing the micro skills of the procedures.

“You can read the book and the 15 steps to accomplish it, but we can give you three-four micro skills that will increase your success rate,” said Sjulin.

Whether it was learning how to perform a bedside ultrasound or practicing intubation, the Soldiers and Airmen walked away with more comfort when it comes to providing critical care and gathering data within seconds to save a life.

“The training was extremely valuable, particularly as a refresher for skills that will be required of us in a deployed environment,” said Sorenson.

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