Sunday, March 04, 2001

Military medics may train here


Air Force eyes trauma center

By Tim Bonfield
The Cincinnati Enquirer

        The Air Force is considering sending some of its surgeons, nurses and technicians to University Hospital in Cincinnati to get more experience handling trauma care.

        If approved, the new training program would be one of four nationwide in which military medical personnel work and learn at civilian hospitals, officials said Friday.

        Dr. Jay Johannigman, a trauma surgeon at University Hospital, also serves as a lieutenant colonel in the Air Force medical corps. He wrote the proposal.

TWO TYPES OF TRAINING
  The proposal calls for training two kinds of military medical teams:
  • Critical Care Air Transport Teams: These teams consist of a trauma doctor, a critical care nurse and a respiratory therapist who can be deployed within two hours to wherever the U.S. has military operations. The teams carry everything needed to support two intubated patients and another three patients who do not need airway support.
  • Mobile Field Surgical Teams: These teams include two types of surgeons, a trauma doctor, an anesthesiologist and a medical technician. Each carries a 75-pound pack of gear, enough to handle 10 to 20 field surgeries within 48 hours. These teams have been deployed to Haiti, Kosovo, South Africa and Oklahoma City in recent years.
        “The military medical corps is currently faced with a dilemma, namely how to meet the increasing demand to stay current in trauma and high-acuity medical skills in the face of a shrinking patient base,” he wrote in the proposal. “This is further complicated by an operational deployment schedule that has increased 10-fold over the past 10 years.”

        Training at a major trauma center such as University would allow the military personnel to further hone their skills on a large number of patients.

        Many of the program's details remain unclear — such as how many medical personnel may be trained, when and for how long — and no decisions have been made about the training center, said Amy Bomar, spokeswoman for University Hospital.

        But there have been several meetings and site visits by Air Force officials, she said. And the proposal has been presented to the state medical board.

        “The board felt that it was an interesting proposal,” said Tom Dilling, executive director of the Ohio State Medical Board.

        The program would need to clear a variety of regulatory hurdles, including sorting out medical licensing rules for Air Force doctors and nurses, who may be coming from other states to practice here. Ohio law allows for special licenses for medical students and visiting faculty.

        This proposal could work as a type of clinical fellowship for already practicing doctors and nurses, but more study is needed, Mr. Dilling said.

        The University of Cincinnati's trauma training program was the first of its kind in the United States, and it remains nationally known. The hospital is the only Level 1 Trauma Center in the Tristate, meaning it has high enough skills, equipment and facilities to handle almost any type of adult medical trauma in the region. Children's Hospital is its counterpart treating trauma in children.

        The training program would be near both Wright-Patterson Air Force Base, a major Air Force facility in Dayton, Ohio, and the Air National Guard unit based in Blue Ash.

        The use of civilian facilities for training reflects years of change in military medicine. In addition to the overall downsizing of the armed forces, the lack of battlefield patients is among the reasons the military has expanded its use of civilian hospitals for peacetime health care.

        UC's training program would join three similar efforts nationwide: a trauma training center in Houston that opened in 1998, an emergency medicine program slated to open in July in Baltimore and a proposed training program in St. Louis.



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