C-STARS: Intensive medical training saves lives

Published March 5, 2009
By Airman 1st Class Andrew Davis, 375th Airlift Wing Public Affairs
and Laura Mays, 88th Air Base Wing Public Affairs

SCOTT AIR FORCE BASE, Ill. -- It's utter chaos: a child injured by a roadside bomb is wheeled into surgery, another woman with half of her face charred black comes flying in on a stretcher, and a small boy with his bone sticking through his pant leg comes hobbling into the room. Who do you treat first? Who can help out? What medical supplies are on hand?

These are the questions deployed medical personnel are taught in training by the Centers for Sustainment of Trauma and Readiness Skills program at the newly revamped C-STARS training site in St. Louis, Mo. The site recently opened a highly realistic Emergency Medicine Trauma simulation lab. It is one venue where medical personnel can sharpen their trauma care skills.

St. Louis is one of three C-STARS locations where intensive medical training takes place. The other two sites at Baltimore and Cincinnati, like the one in St. Louis, reflects a partnership between the Air Force and a civilian trauma hospital.

Each C-STARS site fulfils a unique training niche, program officials said. In Baltimore, trauma skills of physicians, nurses and technicians -- mostly active duty members -- are honed during three weeks of training. The St. Louis mission is similar, tailored for Guard and Reserve members and lasts two weeks.

Meanwhile, at the University of Cincinnati, C-STARS trains Critical Care Air Transport Teams, trains three-man crews over two weeks on the safe aeromedical evacuation of critically-ill patients. Its simulation room, unlike the other two centers, is modeled to represent the back of a C-17 Globemaster III aircraft that has been transformed into a flying intensive care unit.

Lt. Col. Patricia Alvoet, director of C-STARS at the United States Air Force School of Aerospace Medicine in San Antonio, said the training and research program helps the Department of Defense safely treat and transport very seriously ill combat casualties through high-tech simulation and intensive care clinical experiences.

The experiences are essential for military medical personnel to have a complete and thorough understanding to respond quickly and effectively in situations where the lives of critically injured servicemembers hang in the balance.

"The [emergency medicine trauma] lab can simulate multiple patient trauma and help medical personnel make the decision on what to do with a patient, whether to airlift them out, perform surgery or come up with an alternative plan," said Capt. Scott Fallin, C-STARS administrator at St. Louis.

The lab features life-like mannequins and provides an urban warfare training environment.

"The mannequins can simulate physiology, blood pressure, heart rate and other various vital signs," said Captain Fallin. "Through a centralized computer system, the trainers can change the vital signs of the patient to simulate a digression in health."

The mannequin has the replicated anatomy of a human being. Because of the technology built in the human patient simulator, it comes to life and can die too. It can breathe, talk, choke and scream. The eyes dilate and blink. The heart beats. It even has bodily functions such as urination. The mouth can drool and the eyes and ears can secrete fluid.

As an added enhancement to the scenarios, the instructor can control the mannequin's voice and even follow the vital signs of the patient. When treatment is correct, the mannequin's condition improves. If incorrect, the patient's condition will worsen. "Medication" (made of water) can also be injected and a computer will tell if the correct medication was prescribed.

With chest tubes, IV hookups and hundreds of possible conditions and capabilities, the lab makes for a graphic, realistic and emotional encounter.

Maj. Eric Burdge, a student attending the course, raved about the advances in technology and how it will help him when he deploys.

"Floating between patients and learning how to delegate tasks in a trauma situation, I believe, is invaluable training," he said. "This simulation is much more advanced than normal. I think this will help me gain the necessary skills and experience I need for my upcoming deployment."

Physicians, physician's assistants, nurse practitioners, nurses and medical technicians scheduled to deploy are identified and then are selected to train in the hospital. The program pairs Air Force medical personnel with hospital trauma doctors and nurses to help the team care for real patients with injuries.

"Simulation is a great thing but there is nothing that can match up to the real thing, and that is a majority of what students do here," said Captain Fallin.

To further enhance the quality of the training, many of the instructors have first-hand experience performing medicine in a deployed environment.

"The great thing we offer is that a majority of our instructors have been to either Iraq or Afghanistan," said Captain Fallin. "This gives the students a chance to train for what they will see in a deployed environment."

The goal of C-STARS is to produce "ready medics," according to the Air Force Medical Service. The program falls under the Air Force Research Laboratory's 711th Human Performance Wing at Wright-Patterson Air Force Base, which oversees the U.S. Air Force School of Aerospace Medicine.

The workload and clinical experiences sharpen and refresh medics' trauma care currency, increase their knowledge base and help them become even more competent and confident.

Some information courtesy of Tech. Sgt. Phyllis Hanson "Diverse trauma
training saves lives."