Tag Archives: Army Medicine

Burn Flight Team saves lives, breaks records

Read more: NCOs bring injured Soldiers home as members of Army’s Burn Flight Team

By MEGHAN PORTILLO
NCO Journal

The U.S. Army Burn Flight Team has transported patients twice from Singapore back to the U.S. Army Institute of Surgical Research at Joint Base San Antonio – Fort Sam Houston, Texas, and both flights resulted in record-breaking missions.

The Burn Flight Team is a five-person team that flies burned military personnel from anywhere in the world back to the USAISR Burn Center, which is the only burn center servicing the Department of Defense. A team consists of a burn surgeon, a critical care registered nurse, a licensed vocational nurse, a respiratory therapist and a forward operations noncommissioned officer. Four teams rotate call, so that two teams are always ready to deploy.

A burned service member is flown from a foreign medical center back to the U.S. Army Institute of Surgical Research Burn Center at Joint Base San Antonio – Fort Sam Houston, Texas. The U.S. Army Burn Flight Team travels with specialized equipment on a commercial flight to meet patients, then flies them back on a C-17 Globemaster III operated by an Air Force critical care air transport team. (U.S. Army photo courtesy of USAISR)
A burned service member is flown from a foreign medical center back to the U.S. Army Institute of Surgical Research Burn Center at Joint Base San Antonio – Fort Sam Houston, Texas. The U.S. Army Burn Flight Team travels with specialized equipment on a commercial flight to meet patients, then flies them back on a C-17 Globemaster III operated by an Air Force critical care air transport team. (U.S. Army photo courtesy of USAISR)

The team’s first mission to Singapore, on Feb. 22, 2013, was the longest nonstop flight in the team’s history. Because of the patient’s critical status, the Air Force critical care transport team operating the C-17 Globemaster III refueled inflight, allowing the Burn Flight Team to get the patient to the burn center as soon as possible.

“They have a hook up in the front, and then a little fueling plane flies ahead and lets out a little cable, and they have to connect them,” said Sgt. Matthew Anselmo, NCO in charge of the burn team. He is a respiratory therapist who worked as the rear operations NCO for that particular mission.

The team flew for 19 hours straight over 9,850 miles to bring the patient home. As the Burn Flight Team is not part of the plane’s crew, they are not afforded crew rest. But the team members said they didn’t mind the exhaustion. Getting their fellow service member back home safely was the only thought in their minds.

The second and only other time the flight team transported a patient from Singapore was Nov. 9, 2015. This flight also resulted in a record-breaking mission, but for a different reason. It was the first time the team used a kidney dialysis machine to provide continuous renal replacement therapy inflight.

The patient, a Marine who had suffered severe electrical and thermal burns, was experiencing kidney failure, and would not have survived the flight without the procedure, said Staff Sgt. Daniel Zimmerman, the NCOIC of the team at that time and the respiratory therapist on the flight.

Continuous renal replacement therapy, or CRRT, is similar to regular dialysis in that it removes blood, filters it and then replaces it back in the body. It is different, however, in that it is a slow, continuous process. Because CRRT pulls blood at a slower rate, it does not disrupt the patient’s hemodynamics.

“Without CRRT, that patient would have had to stay at that remote hospital, being treated in another country,” said Staff Sgt. David Shelley, a licensed vocational nurse and assistant NCOIC of the flight team. “So the medical director decided we needed to do what it takes, get this service member to the best place in the military to treat burns, and we made it happen.”

“We are always ready,” Zimmerman said. “I was the NCOIC at the time and the only respiratory therapist on the team, so I was basically on call for two years straight. When you get that call, it’s exciting.”

And this time, the team members knew the flight would require them to use equipment they had never before taken on a flight. The team now considers CRRT part of its capabilities and has dedicated transport equipment, but on that flight, the team used equipment from the intensive care unit.

“Everything went as planned in so much as we had never done the CRRT before,” Zimmerman said. “We weren’t sure what complications we were going to run into, but it was overall a pretty uneventful flight, and that is definitely a success.

“Every successful mission comes with a very rewarding feeling,” he said. “To go pick up a critically injured service member who really needs attention that they can only get in the ISR in our unit, to be able to get them back here safely and see them get better — it is a very rewarding feeling.”

U.S. Army Institute of Surgical Research Burn Flight Team members Staff Sgt. Daniel Zimmerman, Capt. Sarah Hensley and Capt. Kirt Cline monitor a patient during a record-breaking mission from Singapore on Nov. 9, 2015. (U.S. Army photo courtesy of USAISR)
U.S. Army Institute of Surgical Research Burn Flight Team members Staff Sgt. Daniel Zimmerman, Capt. Sarah Hensley and Capt. Kirt Cline monitor a patient during a record-breaking mission from Singapore on Nov. 9, 2015. (U.S. Army photo courtesy of USAISR)

Army initiates collaborative effort to address PTSD, TBI

From the Army News Service:

Over the last 12 years, many Soldiers have returned from Iraq and Afghanistan with wounds, some visible and some not, said a leader in Army Medicine.

“The invisible wounds — post-traumatic stress disorder and traumatic brain injury — are just as damaging as the visible ones. They impact the families as well as the Soldiers,” said Brig. Gen. John M. Cho, a doctor, and deputy chief of staff for operations with Army Medical Command.

An Iraq war veteran himself, Cho spoke Saturday outside the Capitol in Washington, D.C., as part of National Post-Traumatic Stress Disorder Day.

Post-traumatic stress disorder, known as PTSD, and traumatic brain injury, or TBI, are not just military-specific issues, Cho said. “They deserve a national discussion.”

A big part of that discussion, he said, needs to focus on reducing the stigma associated with mental health issues.

Besides a national discussion, Cho said agencies need to come together, both inside and outside the military, to learn more about identifying and treating PTSD and TBI, as well as preventing it in the first place.

As part of its collaborative effort, the Army is participating in a $60 million research study for TBI, sponsored by the National Football League, General Electric and Under Armour, he said.

Read more →

Innovative programs transform wounded Soldiers into elite athletes

By ELAINE SANCHEZ,
Brooke Army Medical Center

Staff Sgt. Michael Lage may be loyal to his Army green, but he’s hoping to add some gold to his uniform next week when he vies for medals in cycling and shooting at the 2013 Warrior Games.

It’s a quest he never imagined taking on six years ago when he first arrived at Brooke Army Medical Center at Joint Base San Antonio–Fort Sam Houston, Texas, the sole survivor of a blast in Baghdad that killed four others. The explosion took Lage’s left hand, part of his nose and ears, and caused third-degree burns to nearly half his body.

Still, the avid athlete never lost his competitive edge or determination to excel. Last month, Lage not only breezed through a 300-mile ride with the Ride2Recovery cycling tour, he also qualified to compete in the elite Warrior Games for the first time.

Staff Sgt. Michael Lage readies for a 15-mile ride on Fort Sam Houston, Texas, recently in preparation for the 2013 Warrior Games. (Photo by Robert Shields)
Staff Sgt. Michael Lage readies for a 15-mile ride on Fort Sam Houston, Texas, recently in preparation for the 2013 Warrior Games. (Photo by Robert Shields)

Next week, the Soldier will join more than 200 other wounded service members in Colorado Springs, Colo., where they’ll prove their prowess in sports such as archery, cycling, shooting, wheelchair basketball, swimming, track and field and sitting volleyball.

“I’m ready for the competition and looking forward to winning two gold medals.” he said.

Lage is one of the many service members who has transformed from wounded warrior into elite athlete — a journey that, for many, begins at BAMC. From the moment they arrive until the day they depart, the focus is on fostering abilities and discovering new potential, said Lt. Col. (Dr.) Donald Gajewski, an orthopedic surgeon and director of the Center for the Intrepid, BAMC’s state-of-the-art rehabilitation center.

The Army takes a four-phase approach to physical rehabilitation, Gajewski explained. Early on, providers focus on “protective healing,” which involves caring for wounds as they build mobility and strength.

Patients then move on to pre-prosthetic training at the Center for the Intrepid, where they concentrate on strengthening, balance and cardiovascular training. They also begin community reintegration together, which may involve a dinner or attending a sporting event downtown, he added.

Soldiers greatly benefit from working together as a group, Gajewski noted.

“The ability to rehabilitate all of these heroes in one place is invaluable, not only from a motivational standpoint, but also from a sharing of best practices standpoint,” he said.

Soldiers then receive and adjust to their new prostheses, while learning how to take on everyday tasks. They practice picking up objects from the floor, and stepping off and on stairs, curbs, ramps and uneven terrain. They also work on mastering a new gait.

The final phase involves the “fun stuff,” Gajewski said, such as recreational sports and activities, drivers training, vocational evaluation and training, and if needed, military specific drills.

“There has been much research that shows adaptive sports play a huge role in the recovery of our patients,” he said.

Patients who participate in sports, he added, have been shown to have less narcotic medication dependence, less depression, higher quality of life scores, smoother community reintegration, and improved cardiovascular fitness and psychological well-being.

For the Center for the Intrepid staff, the sky is the limit in this phase. They tailor their programs to Soldiers’ goals, which may include everything from skydiving and scuba diving to sled hockey and cycling.

For some Soldiers, the goal is to simply regain the ability to first walk, then run. Center for the Intrepid prosthetists go to every length to make this happen, Gajewski said, citing the Intrepid Dynamic Exoskeletal Orthosis as just one example.

Center for the Intrepid prosthetist Ryan Blanck designed this device for Soldiers who had suffered lower leg injuries and were unable to comfortably walk, let alone run. The carbon-fiber device, which comprises a cuff, carbon-fiber rod and footplate, delivered nearly instantaneous results. Now, most Soldiers who wheel or limp into his office walk out a short time later pain-free and with a normal gait.

Another prosthetist, Bob Kuenzi, created a one-of-a-kind prosthesis for a patient who, despite a devastating injury, was desperate to run again.

Spc. Eduard Lychik was clearing bombs in Afghanistan when the vehicle he riding in was hit with a recoilless rifle, taking out his entire left leg. While many above-the-knee amputees are able to return to sports and activities, Lychik’s challenges were compounded by a hip disarticulation, which involves an amputation at the hip joint.

Unwilling to give up, Kuenzi created a new prosthesis — basically just a hip fitting, pylon and running blade — that was an immediate success. Within days, Lychik was moving around a track, and he was soon running an 8-minute mile. He recently took on, and succeeded at, a seemingly impossible goal: the 12-mile, 28-obstacle Austin Mudder. Since then, he’s run two half marathons and the Austin Marathon, which he finished in 4:28.

“Having a patient with a hip disarticulation like Ed, doing the things that he’s doing, is so rare,” Gajewski said.

BAMC has a comprehensive physical therapy program and the most cutting-edge equipment on hand, but Gajewski attributes success stories like Lychik’s to one key factor: people.

“Most important are a motivated staff, peer support from fellow service members and a motivated patient,” he said. “The last is of the ultimate importance, because without a motivated patient, none of the other things matter.

“And we are blessed to have a highly motivated patient population,” he added.

Gajewski will follow the Warrior Games next week and root for the six BAMC warriors participating, including Lage, as they vie for gold.

But no matter the outcome, in his mind, he said, they’ve already won.