The US healthcare system’s ability to respond to mass casualty events, including warfare-related injuries, is predicated on the preparedness of every surgeon and hospital system.
In today’s Excelsior Surgical Society (ESS)/Edward D. Churchill Lecture, “Damage Control, Surgical Leadership and National Readiness,” at 9:45 am in Room W-178c, William Schwab, MD, FACS, a retired US Navy Commander, will discuss best practices for developing and implementing trauma education training.
“You can't keep your head in the ground. You can't ignore this,” said Dr. Schwab. “We may, and likely will be at some point, on the front line of saving the lives for our troops. Surgeons are the strength and the voice behind the call for national readiness.”
Conflicts with peer or near-peer adversaries could lead to large-scale fatalities during the initial phase, with estimates suggesting the repatriation of 1,000 to 3,000 casualties to the US per day for the first 100 days of combat.
Dr. Schwab helped pioneer and promote “damage control” surgery in combat settings, an approach initially developed in urban trauma centers, which focuses on stabilizing severely injured patients in stages through hemorrhage control, followed by resuscitation in the ICU, and then reoperation. The core goal of this abbreviated surgical intervention is to prioritize life over anatomy.
An article written by Dr. Schwab and Michael F. Rotondo, MD, FACS, in 1993 titled, “Damage Control: An Approach for Improved Survival in Exsanguinating Penetrating Abdominal Injury,” is widely recognized as a seminal publication because it formalized this approach in trauma surgery.
“That article really changed the way we treat people who have exsanguinating vascular injury,” Dr. Schwab said. “Instead of doing definitive care, you control bleeding. You do quick things to re-establish the flow and drainage of blood—which drastically decreased mortality for the war wounded and those injured in civilian populations.”
Dr. Schwab will acknowledge the legacy of Dr. Churchill, for whom this lecture is named, during his presentation. Dr. Churchill—a renowned surgeon who served as a consultant to the US Army in the Italian Theatre during World War II—delivered the keynote address at the first meeting of what became the ESS.
“Colonel Churchill was a legend,” said Dr. Schwab. “He is remembered for his strength of character and his determination to prevent morbidity, which was at the highest level of what he wanted to achieve.” Dr. Churchill was a driving force for improving medical care for US and Allied troops, particularly in the area of wound management and whole blood transfusions.
