Last fall, Marion General Hospital and local emergency and law enforcement agencies hosted a disaster drill to demonstrate preparedness for a mass casualty incident, such as a bus crash, tornado, or shooting incident.
Prior to that, Dr. Ronald Luethje attended a conference in Las Vegas dedicated to trauma and acute care during such an event. Luethje spoke about the training and the necessity for it recently and shared his thoughts on a variety of relevant topics.
“Recent domestic and international events have raised the level of narrative regarding the management of trauma, especially mass casualty incidents,” he said. “Discussion is ongoing regarding bolstering a systematic plan to operate effectively in a tactical environment, evaluate and optimize use of regional infrastructure and ultimately minimize the pain, suffering and mortality of victims of trauma. These issues were elevated to a new level of scrutiny in the aftermath of the unprecedented carnage in Las Vegas, Nev.”
Luethje said from the perspective of trauma management, those have been the ongoing efforts of collaboration between the American College of Surgeons, U.S. Military, Department of Homeland Security, federal law enforcement, and numerous representatives of emergency medical services, fire officials and multiple agencies.
“The objective is to create and sustain a system that functions seamlessly when confronted with mass casualties, tactical threats, overwhelming of regional capacities and numerous accessory factors that contributed to victim morbidity and mortality,” he said. “The consensus of this endeavor is entitled the Hartford Consensus IV. Congruent with this strategic direction, there exists a highly-respected clinical course: Trauma, Critical Care & Acute Care Surgery 2017 and its timely second component: Medical Disaster Response – 2017.”
Luethje attended the courses and hopes they can translate into helping patients in Marion County if the disciplines are needed,
“The faculty is represented by world-renowned luminaries in each discipline,” he said. “An annual event, 2017 was notably the 50th consecutive year the course was offered. As would be expected, the curriculum content has undergone continual updating. The course material contains highly-practical information derived from real world, ‘been-there, done-that,’ experiences. It allowed direct communication with the trauma surgeons who treated the victims of the Pulse Nightclub shooting, the attack on Dallas law enforcement officers, the Baltimore civil disturbances and Kandahar province engagements, among others. The curriculum emphasized planning, evaluation of existing infrastructure, preparation, logistics, technique and effective communication.”
The course content parallels the current philosophy of creating a seamless system form the point of injury to the place of definitive care, according to Luethje.
“The military experience in Iraq and Afghanistan has unequivocally shown that survivability from penetrating wounds in greatly enhanced if appropriate first responder level care ins rendered within 10 minutes of the injury,” he said. “Thus, what used to be considered the ‘Golden Hour’ of trauma has been modified to reflect the ‘Platinum 10 Minutes’ of trauma. Many of the data obtained from battlefield injuries in the Middle East can be applied to domestic trauma due to physical similarities. This was evident in Lass Vegas, Orlando, Boston, Newtown, Aurora, Sutherland Springs and multiple other locations where penetrating trauma predominated.”
Luethje said that using information derived from the Middle East experience, as well as upgraded civilian strategies, it was concluded that many of the fatal injuries would have had a much higher potential for survival if rapid first-responder care had been available.
“Of course, this would require proximity, training, capability and tactical feasibility,” he said. “This represents the current trauma model: train those who would be closest to the victims to act so that an injured person’s chances of making it to the hospital and surviving would be increased.”
The outreach component of the program is called the “Stop the Bleed” program, according to Luethje, and he along with others, hopes to implement it in Marion County.
“As progress continues, however, the outcome for victims of trauma is expected to improve accordingly,” he said. “Also, it should be noted that not all major trauma involves criminal attacks. Let’s consider Marion County; agricultural equipment, logging activities, industrial jobs, livestock and precarious roads. Any one of those examples, even under reasonable conditions, can potentially result in immediately life-threatening injury.”
Marion County possesses an experienced group of professionals, which translates into high quality emergency care, according to Luethje.
“As plans move forward to provide assets to immediate responders, the margin of care should also improve,” he said. “I am fortunate enough to have attended and completed the Trauma, Critical Care & Acute Surgery-2017 and Medical Disaster Response – 2017 courses and the information and skills acquired are of immeasurable value. Additionally, having become a registered instructor for the ‘Stop the Bleed’ program brings a valuable opportunity to share a skill set and further the goal of keeping Marion Countains safe.”
Luethje said he hopes to help introduce instructional classes for area residents.
“We hope to offer this training here soon,” he said. “We’re looking forward to getting it formalized. It’s not just for law enforcement and firefighters; this is practical knowledge for anyone. You never know when you might be put in a situation where you could assist someone who has suffered a major trauma incident. The study of trauma and acute care is fascinating and rewarding. This is especially so when the results of the study translate into reduced pain, suffering and loss of life for the victims of trauma.”
Pictured Above: Dr. Ronald Luethje recently attended an acute care and trauma seminar. | File Photo
