Medical personnel train at Mayo's 'Sim Center'

ROCHESTER, Minn. (AP) — Military medical personnel have visited Rochester's Mayo Clinic Multidisciplinary Simulation Center to hone their skills before an expected deployment to Afghanistan.

Army Reserve Col. Walter Franz III, commands the 945th Forward Surgical Team, which includes more than a dozen medical military specialists, about half from Minnesota and half from other states. He is also a family physician at Mayo in Rochester.

His tight-knit medical team has served previously in Iraq.

To prepare for the Afghanistan deployment, Franz selected the "Sim Center" as it's known to Mayo staff, because he wanted his personnel to get some hands-on experience with pediatric trauma.

Franz recognized that his counterparts already in Afghanistan are treating far more children than they did during the Iraq war. Many military-reserve medical personnel have jobs outside of medicine in the civilian world. For example, they might work in law enforcement or other trades. So it's especially important that those individuals be exposed to the types of cases they might face during deployment.

They get classroom training, in-service time treating patients at U.S. medical centers and, now, experience with simulation center scenarios.

Staff Sgt. Michelle GeeFrazier served as a licensed practice nurse during Afghanistan deployment from 2009 to 2010 with the 452nd Combat Support Hospital, Alpha Company, also out of Fort Snelling (like Franz's group).

"We did see pediatric traumas come through our hospital when I was deployed over there," she said. "They were more geared toward taking care of the adult patient. But when things arise and come about, we did have the occasional pediatric trauma come through."

Military medical personnel must be prepared to treat bullet wounds and blast injuries that include burns, amputations, blunt-force trauma, head injuries, crushing bone injuries and breaks, and severe blood loss with fragmented shrapnel, grit and other material in the wounds.

Adults tend to face potential heart failure when severely injured, the soldiers noted. Kids, by contrast, are more at risk from respiratory failure than from heart failure. A child who who nears respiratory failure is at imminent risk of death.

On Sept. 11, 2009, soon after GeeFrazier and her company arrived on deployment, an improvised explosive device exploded in a bag of pears a child was given to deliver. Other children happened to be nearby.

"So we got like seven pediatric traumas that came in, along with the shop owner. We got a full-on dose of pediatric care," GeeFrazier said.

The children arrived, but there were no family members with them. That meant U.S. military personnel had to figure out how to identify and alert next-of-kin using translators, local Afghan law enforcement and Afghan military personnel so a male family member could stay with each patient, according to local social custom.

One child was treated and released. Another was transported to a higher level of care at Bagram Air Base. But five boys stayed at the U.S. military hospital for about a month.

"Out of the five kids that we had, four of them had some form of amputation," GeeFrazier said. All five were eventually discharged to go back home.

"The families were extremely appreciative of the medical care they were getting," GeeFrazier said. That experience is why she's a fan of the sim center training organized by Franz as a pilot project.

During the training, soldiers who serve as doctors, nurses, medics and technologists observed how to drill through bone in order to stabilize a broken femur. The procedure is delicate, because slipping off the bone into surrounding tissue can have unfortunate results.

The soldiers got to practice on tubing used to mimic the body. One even experienced a slip and then practiced getting the drill to go all the way through the bone. The trainer explained that it takes significant effort to drill through the bone, but that the practice material feels very similar to real bone.

During planning for the simulations, officers discussed their most-pressing needs. They wanted students to recognize the importance of childhood medical differences, security measures and tools that can help stabilize patients.

"It's sort of simulating what really happens in Afghanistan," said Col. Joaquin Cortiella, who sat in on planning while gathering information about simulation training for Brig. Gen. Bryan R. Kelly. As Franz used a white board to map out the exercises, every so often someone would mention a real-life Afghanistan example.

Franz said his team will get hands-on trauma training at the University of Miami. But he also wants simulation training.

Soldiers practiced with a real ventilator on a kid-sized mannequin, so they could practice assessing blast-injury to a child. Soldier-mimicking mannequins to improve essential communication and situational awareness skills.

"They're getting better and better and better. It shows that it's working," said Kim Moore, a civilian family nurse practitioner at Mayo Clinic and master trainer for a U.S. Department of Defense-based health care teamwork-training program, as she led one of the sessions


Information from: Post-Bulletin, http://www.postbulletin.com

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