Operating room surgeons David Callaway, M.D. (left) and Michael Clemens, M.D. (right) pose for a photo in one of the trauma bays in the emergency department at Atrium Health’s main campus on Oct. 1 in Charlotte, North Carolina. ). It is now part of a civilian-military partnership that combines medical care in the emergency department. Logan Cyrus/NPR Hide Caption
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As the ambulances began arriving and news trickled in that multiple police officers had been shot, Kathy Bernard braced herself for one of the worst days of her 26 years on the job. But one thing gave her confidence.
“I hope we never go through something like this again, but we had military doctors on duty. We had military nurses on duty,” said Bernard, a nurse manager at Atrium Health in Charlotte, North Carolina. Ta.
The day was April 29, when four police officers were killed and four others were injured while trying to execute an arrest warrant. The hospital’s experienced civilian staff was supplemented by active-duty Army doctors and nurses from nearby Fort Liberty.
“We had the right team here to execute on the amazing care we gave to everyone who came through our doors that day,” Bernard said.
Operating room surgeon Dr. David Carraway wears a commemorative bracelet every day while performing his duties within the emergency department. Logan Cyrus/NPR Hide Caption
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Techniques learned in war
The partnership, funded by the Mission Zero Act passed by Congress in 2019, created dozens of civil-military public health partnerships across the country, making them ideal for working together in a crisis just like this. .
“Eight victims were injured by high-caliber rifle gunfire, and this is what we train for. We train for multiple patients. We train for these high-velocity wounds. ,” said Dr. Michael Clemens, an Army special operations combat surgeon on duty at Atrium Health in Charlotte.
This partnership provides more than just additional staff and expertise for high-casualty events. This could solve the twins’ health crisis. Private hospitals are suffering from staffing shortages across the country, exacerbated by coronavirus burnout. At the same time, the Pentagon acknowledged that its efforts to outsource health care to the private sector have gone too far, denying its own health care workers valuable experience. And this cooperation allows the hard-won medical gains of two decades of war to be preserved and put into practice in peacetime, hence the name Mission Zero.
The facade of the FH Sammy Ross Jr. Trauma Center is seen at the Main Atrium Health Campus in Charlotte, North Carolina Logan Silas/For NPR Hide Caption
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“The idea behind this was how can we get to zero preventable deaths from trauma,” said David Carraway, director of emergency response at Atrium Health.
Callaway himself is a veteran. He became a military doctor in time for 9/11. He witnessed a steep learning curve for the U.S. military in Iraq, where medical advances such as whole blood and the use of tourniquets cut combat deaths by nearly half. Callaway was stunned to learn that some of these life-saving technologies are not new. They were only discovered in previous wars and forgotten. This phenomenon is known as the “Walker dip,” and is used to describe how important medical advances dating back more than a century are repeatedly forgotten during periods of peace.
“We have invested trillions of dollars and thousands of lives. We need to learn from this and help members of American communities and even help the men and women who serve overseas. ,” Caraway said.
His hope is that these Mission Zero collaborations will keep that knowledge current in a continuous cycle between military and civilian providers.
Dr. Clemens works in a dark place. He shared his special forces training with civilians to find all the medical equipment while blindfolded. Those skills came in handy this year for a team sent to help with North Carolina’s hurricane response. Dr. Michael Clemens Hide Caption
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Dr. Michael Clemens said it worked. He graduated from medical school as the wars in Iraq and Afghanistan ended. He worried that his job treating soldiers and their families at a military hospital wasn’t enough to keep his skills sharp between special operations assignments.
“It was such a contrast. I’m looking at appendicitis, I’m looking at hernia repair, I’m treating those day-to-day processes. … All of a sudden, I’m thrown into a combat zone, where my patients Most of them come in groups, and they come in with explosive trauma from IEDs. They come in with rifle wounds and large-caliber wounds,” Clemens said.
Working shifts in Charlotte gives Clemens the opportunity to perform more complex surgeries, keep his technology up to date, and often sees how civilian medicine and battlefield technology build on each other. He said it can be done. One example is a balloon used to block off the aorta.
“This is something we use to reduce bleeding during trauma. This is a skill that has evolved and has been commonly used on the battlefield, so we recommend that you use it before using it in more austere environments. You can experience the device firsthand,” Clemens said.
In the United States, the same device is currently used to stop bleeding in high-risk pregnancies, which also occurs during deployment. In conflict zones like Syria, American doctors often treat civilians as well as war wounds. Clemens said he and his colleagues routinely perform emergency C-sections.
Knowledge flows both ways. Experienced civilian surgeons have a lot to teach new military personnel, and it’s also a good way to learn about civilian hospital culture in preparation for the day they transition from active duty to non-military work. Military medical staff are trained to work in low-light or zero-light and other disaster situations, which they can share with their civilian colleagues. This feature came in handy last month when an Atrium Health team traveled to assist in parts of North Carolina that were hit hard by Hurricane Helen.
Dr. David Carraway poses for a portrait in one of the trauma bays in the emergency department at Atrium Health’s main campus in Charlotte, North Carolina.Logan Silas/For NPR Hide caption
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Dr. Carraway was at the scene of the April 29 shooting, but returned to the hospital to treat patients. He said there is another thing this exchange and mentorship can offer.
“The other thing is being able to put your hand on someone’s shoulder afterward and say, ‘There was nothing else I could have done.’ And have them trust you. It’s, ‘Hey, great job.’ This is not a common word. “It is a deep and solemn realization that there was nothing else that could have been done,” he said.
