Registry Yields Life-saving Treatment Lessons

BAGRAM AIRFIELD, Afghanistan — A reg­istry estab­lished six years ago to track casu­al­ty infor­ma­tion from Iraq and Afghanistan is pro­vid­ing valu­able data that’s sav­ing wound­ed war­riors’ lives, the com­man­der of the the­ater hos­pi­tal here report­ed.
Air Force Lt. Col. (Dr.) Guiller­mo Tellez, com­man­der of the Staff Sgt. Heathe N. Craig Joint The­ater Hos­pi­tal at the largest aeromed­ical evac­u­a­tion point in Afghanistan, praised the lessons learned through the Joint The­ater Trau­ma Reg­istry.

Joint Theater Hospital at Bagram Airfield
Air Force Lt. Col. (Dr.) Guiller­mo Tellez, com­man­der of the Staff Sgt. Heathe N. Craig Joint The­ater Hos­pi­tal at Bagram Air­field, said lessons learned through the Joint The­ater Trau­ma Reg­istry are sav­ing lives of trau­ma patients arriv­ing reg­u­lar­ly at the hos­pi­tal, the largest aeromed­ical evac­u­a­tion point in Afghanistan.
DOD pho­to by Don­na Miles
Click to enlarge

The Defense Depart­ment launched what has grown to become the world’s largest data­base of com­bat injuries in 2005. It cap­tures details about wounds received, med­ical care pro­vid­ed at com­bat sup­port hos­pi­tals, aboard ships and air­craft and through­out a patient’s treat­ment, as well as the results.

Tellez called this knowl­edge base a huge advan­tage in help­ing med­ical care providers to iden­ti­fy treat­ments that proved most effec­tive in treat­ing patients with sim­i­lar wounds. “It is how we fol­low sta­tis­ti­cal­ly, over time, what made the dif­fer­ence,” he said.

The reg­istry, he said, pro­vides insight from how much flu­id to give patients to what types of blood prod­ucts to admin­is­ter to the best way to keep air­ways open, body tem­per­a­tures con­trolled or infec­tion rates down.

“It is mak­ing our course of care bet­ter and the man­age­ment of care bet­ter,” Tellez said. “It is a very dynam­ic, ongo­ing qual­i­ty assur­ance of care.” He cit­ed exam­ples of the lessons that are improv­ing the care wound­ed war­riors receive and pro­mot­ing the heal­ing process. Tourni­quets, for exam­ple, once dis­cour­aged for fear they could cause limb loss, now are embraced as a valu­able life-sav­ing tool. “We have learned that if you stop the bleed­ing, stop the hem­or­rhag­ing, you have a good chance of liv­ing,” Tellez said.

Stom­ach wounds heal faster and are less prone to infec­tion if left open, the reg­istry revealed. For patients suf­fer­ing head trau­ma, doc­tors have learned the ben­e­fit of remov­ing the skull cap until brain swelling goes down. When the skull cap was replaced too quick­ly, patients tend­ed not to do so well, Tellez said.

“So, many times, that skull cap is now removed and lat­er recon­struct­ed. The brain is less swollen and less trau­ma­tized,” he said. After recon­struc­tion and recov­ery, Tellez said, it’s near­ly impos­si­ble to detect that the patient ever had a large skull defect. “That is because we have learned how to bet­ter man­age these types of wounds,” he said.

The staff at the hos­pi­tal applies these lessons dai­ly in treat­ing wound­ed war­riors. Dur­ing the first three months of 2011, they treat­ed more than 2,300 trau­ma patients, with about 800 of them suf­fer­ing the most severe “Lev­el 1” injuries, Tellez said. “It is a very dynam­ic trau­ma cen­ter,” he said. “We are busy.”

Despite the sever­i­ty of injuries treat­ed here, sta­tis­tics show that the exper­tise of the hospital’s med­ical staff– enlight­ened through the joint reg­istry is mak­ing a dif­fer­ence. Nine­ty-eight per­cent of wound­ed troops who live to receive care at the Bagram facil­i­ty ulti­mate­ly sur­vive, Tellez said.

“I would rival our care to [that offered at] any large ter­tiary-care cen­ter in Amer­i­ca,” he said.

Lessons learned here are extend­ing beyond the com­bat zone, and are being embraced by civil­ian med­ical cen­ters, Tellez not­ed.

“The things we are doing here have been adopt­ed by many of the trau­ma cen­ters in the U.S. and around the world,” he said. “They are look­ing to us to improve the way they pro­vide trau­ma care.”

U.S. Depart­ment of Defense
Office of the Assis­tant Sec­re­tary of Defense (Pub­lic Affairs)

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