Treats all patients evacuated from both combat theaters


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Treats all patients evacuated from both combat theaters

  • Treats all patients evacuated from both combat theaters

  • The only ACS trauma center outside the US

  • 65,000 patients evacuated from U.S. CENTCOM (from 45 coalition nations)

  • 12,000 combat casualties (2004-2010)

  • Responsible for treatment of 245,000 U.S. military personnel and families within Europe



Fully accredited (JCAHO, ACS, etc)

  • Fully accredited (JCAHO, ACS, etc)

  • Staffing: 2,837 including 1,161 Army, 309 Air Force, 304 Navy, 12 Marines, 1,279 civilians and 4 VA civilians

  • 149 inpatient beds

  • 218 beds in its Medical Transient Detachment













Oct –Dec 2003 at LRMC

  • Oct –Dec 2003 at LRMC

  • Mar- May 2006 at LRMC

  • Mar- May 2008 at Vilseck : working with families and with the WTU (Warrior Transition Unit)





Priority #1: OIF/OEF patients with blast injuries.

  • Priority #1: OIF/OEF patients with blast injuries.

  • Priority #2: OIF/OEF patients with non-blast injuries.

  • Goal: Every patient receives a triage assessment and psychological first aid.



Introduction “I’m a psychiatrist working with your medical team. Every patient gets ‘top to bottom care.’”

  • Introduction “I’m a psychiatrist working with your medical team. Every patient gets ‘top to bottom care.’”

  • Pain assessment

    • 1) pain level using the pain scale 1-10.
    • 2) “At what level do you call the nurse for help?”
    • 3) Catching the pain early can reduce the amount of pain medication required.






Room temperature

  • Room temperature

  • Hydration

  • Nutrition

  • Sunlight

  • Privacy



Knowledge of medical information

  • Knowledge of medical information

  • The trauma story.

    • Filling in the missing pieces.
    • Post trauma symptom assessment.
    • PTSD education


Quantity and quality of:

  • Quantity and quality of:

    • IED attacks
    • Small arms fire
    • Mortar attacks
    • Suicide bombers
    • Exposure to dead bodies
    • Returning fire


Normalize the response to trauma as universal, using the metaphor of tissue injury.

  • Normalize the response to trauma as universal, using the metaphor of tissue injury.

  • Healing of the mind requires a mastery of the event.

  • Dreams, flashbacks, emotional flooding are normal psychological reactions to trauma.



A common reaction to trauma especially if others have been killed or wounded.

  • A common reaction to trauma especially if others have been killed or wounded.

  • The belief they have let their unit down.

  • Treatment approach includes getting the facts of the incident, reviewing their role and response, arranging communication with unit downrange.

  • After Action Report model



A common anxiety is when they will fly and where they will be transferred to.

  • A common anxiety is when they will fly and where they will be transferred to.

  • Reinforce soldier’s ability to communicate needs (pain, comfort, anxiety, etc.)

  • Follow up e-mail or phone call to CONUS for those patients demonstrating Acute Stress Disorder symptoms.













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