U.S. hospital work prepares military docs for battlefield injuries

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The phone does not stop ringing at Baltimore’s shock trauma center.

A trauma tech picks up one of the calls.

“Stabbing, 10 to 15 by land,” he yells out in the emergency room, citing how far away the victim is from the hospital.

Every day dozens of trauma patients are wheeled into their trauma bays. Some are accident victims, others are critically ill. But right alongside the civilian trauma doctors, nurses and techs are military personnel.

Dr. John Renshaw checks on one of his injured patients. Jacques suffered massive abdominal injuries at his Maryland factory job when he was caught in a conveyor belt.

"We want him to go ahead and eat today. Get his nutrition up as much as possible. That is going to help his wound heal. So if you could tell him that,” Renshaw says to Jacque’s cousin Peter, who translates into the Creole of their native Haiti.

But Renshaw is an oncologist. He treats cancer. So why is he here?

Dr. John Renshaw is also Major John Renshaw, United States Air Force, and he’s deploying to the front lines of Afghanistan to treat the wounded. But before he goes, he along with other military medical personnel, will complete a tour of duty at the University of Maryland's Shock Trauma Center in Baltimore - sharpening their ability to deal with critical trauma patients.

Colonel David Powers, a surgeon, ran the military training program here. He has since retired.

"The injuries that I have treated here, that I see here at this hospital, are the closest thing to the injuries I saw in Iraq, that I have experienced in the continental U.S.,” Powers says. “I got an individual who has now been involved in a motor vehicle accident that has intracranial injuries where I have to recreate the cranial vault and the frontal sinus exactly like I have to do with an IED blast."

Air Force Major Joseph Dubose teaches other military colleagues at the trauma center his specialty, trauma surgery and surgical critical care.

DuBose says many deploying military personnel from stateside bases don't regularly see critical trauma cases. Before heading to the war zone, he says, they will learn “all of the basic skill sets that they are going to need in the early phases after injury and the ability to manage that patient airway, treating hemorrhage and bleeding, treating intracranial injury."

Lt. Col Allan Ward is an Air Force flight surgeon who normally certifies air crews are healthy enough to fly.

"Even as a flight surgeon I am expected to be a jack of all trades but really in garrison when we are not deployed I am an outpatient internal medicine guy,” says Ward.

Before getting to Afghanistan he says this will help him learn to prioritize multiple critical patients under battlefield conditions and hone his ability to make rapid decisions.

“I expect to see gunshot wounds. I expect to see traumatic brain injuries from explosive devices, burns as well, a lot of orthopedic injuries, and really some horrific stuff. And what I am doing here is getting exposure to a lot of things I’ll be seeing over there,” says Ward. “It’s an immersion really in a high volume trauma center.”

And it’s skills that will come back home with them. DuBose says the war has led to advances in controlling bleeding, monitoring fluids and caring for brain injuries.

“All these things are lessons that we're learning, hard fought lessons on the battlefield of Afghanistan and Iraq, that can now be translated to civilian care."

Treating the war wounded has long been a source of knowledge for all doctors.

“There has been a century long interplay between civilian and military care. In many ways trauma surgeons have learned from military conflict more so than any other component of care,” says DuBose.

As Major Renshaw's patient Jacques continues to recover the doctor says the training he receives here is vital.

"This has given me exposure to the trauma mindset to know what to look out for, pitfalls to avoid, procedures that I need to get my skills back up on."