Military training at civilian trauma centers: the first year's experience with the Regional Trauma Network.

The Regional Trauma Network was launched in 1996 to provide trauma training opportunities for Army surgeons in the Southeast Regional Medical Command. Training directors at eight civilian level I trauma centers agreed to allow military surgeons to function at the fellowship level of responsibility for up to 30 days at a time. In the first year, 7 surgeons participated in rotations at five different centers and 13 surgeons attended nationally recognized trauma symposia. The response from participating civilian and military participants has been overwhelmingly positive as confidence and enthusiasm for treating seriously injured patients are refreshed. Significant lessons were learned in providing good clinical training experiences, administering a regional program, and measuring the costs and benefits of additional readiness training. Although the data collection processes were devised to capture both the actual and the opportunity costs of training at civilian centers, more participants are needed before a conclusive analysis can be made. A joint services effort on a regional basis and support throughout the chain of command are key to strengthening the surgical readiness training program.

The peacetime trauma experience of U.S. Army surgeons: another call for collaborative training in civilian trauma centers.

OBJECTIVE: To document the ongoing trauma experience of U.S. Army surgeons during peacetime clinical practice. METHODS: Surveys were mailed to the trauma directors of military surgical services worldwide. Questions focused on numbers of operative cases and availability of trauma resources. Laparotomy, thoracotomy, and vascular repair for trauma were considered index cases and simple means were computed based on numbers of cases per general surgeon. RESULTS: Seventy percent of worldwide Army surgical services responded to the survey. In 1992, on the average, a general surgeon in the Army performed 1.3 trauma laparotomies, 0.3 thoracotomies, and 0.3 vascular repairs for trauma. Only 6 of 28 surgical services had an organized "trauma team," 3 held regular trauma conferences, and 1 service kept a registry and could calculate an average injury severity score. CONCLUSIONS: Our data support perceptions concerning lack of an ongoing trauma experience for military surgeons and reinforces the need for collaborative education and training in busy civilian trauma centers. A regional approach is suggested as a viable solution.

Trauma fellowship training: the insiders' perspective.

Trauma care is in a period of transition from care given by surgeons at the closest community hospital to care given by trauma specialists at trauma centers and within emergency medical systems. It has thus become increasingly important for the educational goals of trauma fellowship training to reflect the needs of the future system as well as the views of future practitioners. These views differ from those of surgical colleagues practicing trauma surgery, and the views of future trauma specialists should be considered during the formulation of training guidelines. This survey appears to be the first attempt to interpret the views of trauma fellows: 48 of the 83 fellows (57.8%) in the 1991-1992 national cohort responded. They made suggestions about their own training, including ways to increase surgical experiences and opportunities for academic pursuits, but gave no insight as to an appropriate mix of critical care training. Although critical care certification is a major attraction for fellowship training, the cohort does not want to be thought of as nonoperating surgical intensivists. A second year of fellowship training is seen as necessary for research and trauma systems-related studies.

[New types of virus infections of domestic animals in the German Democratic Republic. 4. Tahyna virus infections--a review]. / Für die DDR neuartige Virusinfektionen der Haustiere. 4. Mitteilung: Die Tahyna-Virusinfektion--ein Uberblick.

A general account is given in this paper of history, incidence, pathogen properties, morphogenesis, isolation, and culturing of Tahyna virus. Reference is also made to methods for detection, host spectrum, immunity, epizootiology, pathogenesis, and clinical symptoms in man and animals and also to aspects relating to pathological anatomy as well as to regular and differential diagnosis.