Wednesday, April 25, 2007

Bombings: Injury Patterns and Care

Mumbai, India, July 2006

I am still participating in the ACEP Spring Congress in San Diego. Yesterday I had the great privilege of participating in a course co-sponsored by ACEP and the Centers for Disease Control and Prevention (CDC). The Bombings: Injury Patterns and Care curriculum was developed through a grant from the CDC, with ACEP serving as the lead organization. Also participating in the program:

American Medical Association (AMA)
American Trauma Society (ATS)
National Association of EMS Physicians (NAEMSP)
National Association of EMT’s (NAEMT)
National Association of State EMS Officials (NASEMSO)
National Native American EMS Association (NNAEMSA)

The course was designed to be the minimum content that should be included in any all-hazards disaster response training program. It focused on the latest clinical information available regarding blast related injuries from terrorism. Using terrorist bombings from recent history, the course leaders covered the physics of blasts, the pattern of terrorist bombings, the likely patterns of injury, and treatment options for various scenarios. The course included a CD ROM with PowerPoint presentations and a curriculum guide. Future course offerings will include interactive patient simulations designed to reinforce knowledge of the course content.

The most exciting portion of the course for me was the presentation of “Trauma Lessons Learned” by the military during the conflict in Iraq. It seems that everything I know about trauma fluid resuscitation may be wrong. In addition, the new philosophy is that the best way to prevent hemodynamic instability is to prevent blood loss in the first place. To that end, the military is using tourniquets on bleeding extremity injuries. I look forward to the response of the trauma community as some of these concepts are disseminated.

Two excellent emergency physicians led this course, Dr. Kristi Koenig and Dr. Ernest Sullivent, III. Dr. Kristi Koenig, MD, FACEP is Professor of Clinical Emergency Medicine, Co-Director of the EMS and Disaster Medicine Sciences Fellowship, and Director of Public Health Preparedness, Department of Emergency Medicine at the University of California at Irvine. Dr Ernest Sullivent, III, MD is a Medical Officer, Division of Injury Response, National Center for Injury Prevention and Control. They were both extremely knowledgeable and fluent presenters.

This course will be available in other venues soon, and I recommend it highly.

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