Emergency Medicine Service Fellowship Research

Combat casualty care is constrained by logistics, manpower, and the hostile operational environment. In recent military battle, nearly 50 percent of combat deaths have been due to exsanguinating hemorrhage. Of those, about half could have been saved if timely, appropriate care had been available. Head injuries and lung injuries are also major causes of death where proper treatments and training could significantly reduce mortality and morbidity. The treatment of battlefield casualties is exacerbated by the long evacuation times often found in military operations. This requires battlefield medics and physician's assistants to stabilize patients for extended periods and makes battlefield trauma care markedly different from civilian trauma care. Because approximately 86 percent of all battlefield deaths occur within the first 30 minutes after wounding, the ability to rapidly locate, diagnose, and render appropriate initial treatments are vital to reversing the historical outcomes of battlefield injuries. The need to provide such care with a reduced logistics footprint is the cornerstone around which the future of combat casualty care research is built.

The Trauma Institute of San Antonio Texas is the first Congressionally funded, joint military-civilian trauma institute in the United States. TRISAT coordinates academic, community and military resources to most effectively serve trauma victims and their families. The Institute is ensuring the preparedness of the community and country when trauma strikes, both in peacetime and wartime TRISAT combines the expertise of surgeons, nurses and other trauma team members from the University of Texas Health Science Center at San Antonio, University Health System, Brooke Army Medical Center, Wilford Hall Medical Center and the U.S. Army Institute of Surgical Research, which operates the nation's only military burn center. The establishment of TRISAT puts an exclamation point on the strong partnerships already present in these San Antonio trauma institutions. The city is the only one in the country with the distinction of having three Level 1 trauma centers working together with a Congressional mandate. TRISAT member centers see 8,000 trauma patients per year from a 22-county trauma service area and beyond. TRISAT manages a consolidated electronic database of the region's hospital trauma registries and 70 EMS agencies throughout the trauma service area, resulting in greater opportunities for clinical research and injury prevention.

The fellow's research efforts will be focused on point-of-wounding and pre hospital care particularly in one of the Combat Casualty Care Program Areas listed below: