Casualties of War

Dorothy_0025k Casualties of War Toy SoldiersThis week I had my mind blown. Insights into the world of Trauma, Mass Casualty, Disaster Response and Military Medicine, opened up a whole new world at the Trauma and Disaster Management event hosted at the Princess Alexandra Hospital in Brisbane and supported by Laerdal Medical.


Dr David Cooksley (FACEM from RBWH and Reservist Military Medic) – talked about the breakthroughs in trauma management with dedicated discussion on hypotense resuscitation, experiences from his time with London HEMS (later referred to as the ‘Bodysnatchers’ by Major Jim Macklin) and his gruelling experiences  of being the first Australian Reservist to complete the UK Military MERT training.

Major Jim Macklin – spoke about his time coordinating macro simulation to assess entire deployment hospitals before there drop into Afghanistan. Amazing 72hr full hospital warehouse based simulation, with live real time cases. A simualtion delivery revelation for me was the concept of Russian Doll envelopes. These were packaged documents one inside the other with directions to open at specific times and used to update patient information and clinical records at precise times running live throughout the simulation.

Dr Ian Norton (Director of Nation Trauma and Critical Care Response Centre) – my favourite speaker, hands down! Ian took things beyond mass casualty and talked about systemic responses to disasters. Over three presentations, Ian taught about the origins of the NTCCRC in Darwin, the links throughout Australia, responses to civilian disasters and lessons learned from Haiti and Ashmore Reef. It was amazing to be hearing about coordination and deployment of civilian based field medical teams from the mouth of the man who has literally written the guide (WHO Field Medical Team Standards – about to be published in next couple of weeks).

There were a host of other amazing presenters, but the three about were the stand outs for my personal learning.

Accompanying the event, was an absolutely brilliantly choreographed Mass Casualty simulation at the Queensland Combined Emergency Services Academy training facility, Whyte Island. This was bucket list stuff. The scene was set throughout the day, with mock news casts of a Presidential assassination attempt in a fictional country, resulting in a mass riot with huge numbers of injuries. A trauma response from Darwin was activated and the PA Hospital team was deployed to backfill Royal Darwin staff (an active construct designed to meet needs for surge capacity). The story culminated in a bus filled with staff and family members, bound for Brisbane Airport, colliding with a sedan and resulting in a large number of casualties.


The emergency services teams were comprised of 2nd and 3rd year paramedic students and fire and rescue students and provided an awesome display of the high calibre of training delivered at Whyte Island by Tony Hucker and his team.


The insight into this world was visceral, audible and truly impressive.

So, like always after your learning and interests have been piqued, you go searching for more and that was when I found this amazing two part series from a couple of years ago. A brilliant BBC documentary presented by Michael Mosley on ‘Frontline Medicine’.

Part 1 is delivered from the Afghanistan and explores the interface between civilian and military medicine and how extraordinary increases in survival rates have informed new research and two years later we have now seen many of these changes come into mainstream civilian emergency management of trauma.

Part 2 explores the innovations being driven in rehabilitation, prosthetics and reconstructive medicine funded by the US military.

I would encourage anyone with an interest in innovation, self education, emergency, critical care or just good television to watch these. Enjoy.


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