November 21, 2006 09:45 ET

Sunnybrook trauma surgeon advises on training for military surgeons

Attention: Assignment Editor, Health/Medical Editor TORONTO/ONTARIO--(CCNMatthews - Nov. 21, 2006) - As a trauma surgeon for both Sunnybrook Health Sciences Centre and the Canadian Forces (CF), Dr. Homer C. Tien has unique insight into how military surgeons should be trained in order to best manage the injuries they will see during a deployment to Kandahar, Afghanistan. His paper, published in this issue of the Canadian Medical Association Journal (CMAJ), outlines his observations and recommendations.

"The more time a military surgeon can spend learning in a busy trauma or critical care centre, the more equipped that individual will be to manage the traumatic injuries that Kandahar hospital is currently seeing," says Dr. Tien. "Civilian trauma centres present a wide range of severe injuries, and that kind of exposure is invaluable when you're working in a military field hospital."

Until the mid-1990s, CF surgeons had been training exclusively in tertiary level CF hospitals. However, due to low volumes of complex cases among other reasons, these hospitals closed and military surgeons began completing trauma and critical care fellowships at civilian hospitals. It is Dr. Tien's observation that this type of training is proving to be excellent preparation for overseas deployments. The benefits are even greater if the surgeon remains on staff at a civilian centre, as the individual will stay in practice for the conditions of a military field hospital.

"The current deployment of Canadian Forces Health Services (CFHS) personnel and equipment to Kandahar is the largest since the Korean War," says Dr. Tien. "This is indicative of the volume of severe injuries that the area is experiencing and the need for expert care."

Between February 7 to July 20, 2006, 248 injured patients, most of them Afghan civilians, were treated at the Kandahar hospital and required a trauma team's involvement. Of these patients, most of whom suffered either blast or penetrating injuries, 94% survived.

"Considering the difficult field conditions, long pre-hospital transport times, and other environmental impacts, these survival rates are excellent outcomes," says Dr. Tien. "I would suggest that it is because our military surgeons are consistently training and working in excellent civilian trauma centres before they come to Kandahar that we are able to provide a high level of care."

Based on feedback from other CFHS personnel and first-hand experience, Dr. Tien recommends that the CF should remain focused on this integrated approach with civilian trauma centres for preparation and training. Dr. Tien is a regular force member of the Canadian Forces and was deployed to Kandahar, Afghanistan in February 2006 for two months of service.

Sunnybrook Health Sciences Centre
Sunnybrook Health Sciences Centre is transforming health care through the dedication of its more than 10,000 staff members who provide compassionate and innovative patient focused care. An internationally recognized leader in women's health, academic research and education and an affiliation with the University of Toronto distinguishes Sunnybrook as one of Canada's premier health sciences centres. Sunnybrook specializes in caring for newborns, adults and the elderly, treating and preventing cancer, heart problems, orthopaedic and arthritic conditions and traumatic injuries.
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