USIC: UNCONVENTIONAL SURGICAL IMMERSION COURSE

Direct Action Resource Center

Austere Medical Program

USIC: UNCONVENTIONAL SURGICAL

IMMERSION COURSE

Educational grant funds by

April 14-17, 2011

An educational activity provided by!

WWW.AUSTEREMEDICINE.COM

http://www.austeremedicine.com


APRIL 14-17, 2011*DIRECT ACTION RESOURCE CENTER

NORTH LITTLE ROCK, ARKANSAS

COURSE DESCRIPTION:The Unconventional Surgical Immersion Course (USIC) is a

live-tissue, scenario-based Humanitarian Assistance/Disaster

Relief training program. Participants are immersed in a

simulated disaster with limited resources and infrastructure

for the duration of the program. Leadership, communication

and complex problem-solving are constant themes

throughout the course while delivering advanced surgical

care to various patients under adverse conditions. This course

is not a seminar. All participants should be in reasonable health and

expect various physical and mental stressors throughout this “hands-

on” immersion course.

DATES: APRIL 14-17, 2011**14 April is day of arrival. Course begins @ 12:01 am on 15 April and the course participants graduate at lunchtime on 17 April.

ACCOMMODATIONS:Accommodations are provided as part of the scenario based training. All participants will be staying on site, in a simulated austere environment, such as one might find following a natural disaster or complex emergency. Facilities will be intentionally lacking. Please contact DARC for details.

TRANSPORTATION:All local transportation provided to course participants.*

COURSE LOCATION:Direct Action Resource Center (DARC)6302 Valentine RoadNorth Little Rock, Arkansas 72117Phone: 501-307-9031

*Unless other arrangements have been approved prior to

course commencement.

OBJECTIVES:At the conclusion of the course participants will:

• Be able to function as an integral and contributing

member of a disaster medical relief team across a

broad spectrum of mission essential tasks.

• Recognize the challenges and key components, both

external and internal, to the function of a disaster

relief team.

• Have experience with many factors of providing

disaster relief care through simulation and the use of

live-tissue in multiple, comprehensive scenarios.

• Be resourceful in a primitive medical environment

while providing an acceptable level of care consistent

within the context of disaster severity and scope of

impact.

• Increased capacity in unfamiliar medical terrain under

suboptimal conditions with an expanded fundamental

medical knowledge.

• Have a better understanding of human and social

capital in complex and unstable emergencies.

• Adaptability and solution based reasoning during an

evolving and dynamic medical crisis under various

conditions.




UNCONVENTIONAL SURGICAL IMMERSION

COURSE AGENDA

APRIL 14, 2011

Arrive afternoon/night to Little Rock National (airport code: LIT) and move to course assembly area. Course

participants should arrive NLT 1030 PM to ensure they are in the assembly area prior to the course launch.

APRIL 15, 2011

0001-0010 – Arrive at Disaster Medical Relief and move by foot to sleeping area

0600-0630 – Wake-up & daily briefing

0630-0700 – Orientate to camp

0700-0730 – Key components to establishing camp

0730-0930 – Establish medical relief camp (limited personnel & resources)

0930-1100 – Water purification

1100-1130 – Improve personal sleeping & hygiene areas

1130-1200 – Meal

1200-1300 – Waste plan

1300-1400 – Security

1400-1500 – Personal security/safety

1500-1600 – Cultural Awareness

1600-1900 – Clinic with ambulatory patients

1900-2100 – PTSD, baseline, group dynamics

2100-2200 – Improve surgical area

2200-2300 – Triage discussion

2300-2315 – Q/A of days events, released for rest & personal time

APRIL 16, 2011

0530-0600 – Wake-up & daily briefing

0600-0730 – Patient washing & improvised transport

0730-1030 – Live-tissue trauma stabilization

1030-1100 – Meal

1100-1600 – Live-tissue general/trauma surgical lab

1600-2130 – Live-tissue CMF/OMF surgical lab

2130-2200 – Prep to receive disaster patients

2200-0300 – Surgical culmination exercise with live-tissue, etc.

APRIL 17, 2011

1000-1030 – Relief work scope/spectrum interactive discussion

1030-1100 – Course critiques

1100-1230 – Informal & interactive graduation lunch

1230-UTC – Movement to Little Rock Airport for return home




DR. HOLLIER: “International relief efforts in response to global medical crises are becoming more common. Some of the motivation is purely humanitarian. However, increasingly this response is becoming one of a practical nature. With the intricate web of socioeconomic relationships that has developed, one country's crisis can quickly become our own if not dealt with expeditiously. While from a medical standpoint responders typically have the expertise to deal with these crises, from a practical standpoint they are often found lacking. How does one deal with the realities of the austere environment to actually deliver care?DARC is developing the first-ever training program to address just this concern. This trailblazing course will set the standard in preparing surgeons and other medical providers to overcome the obstacles to medical care found in these situations. The need for this is rapidly expanding, and the time is now.”

DR. LIEBLICH: “Although many surgeons are well trained and experienced in dealing with acutely injured patients their experience in the hospital setting does not prepare them for this situation in an austere disaster setting. Recent tragic events in Haiti and Chile have demonstrated the need for acute medical care in these trying environs. The development of a unique course in disaster relief surgery is one way that a higher level of care can be given in this situations as well as giving some sense of preparation for those interested in serving. An appreciation for the external issues associated with these situations may also provide an increased level of safety for these volunteer care providers. The opportunity for this unique collaboration between health care providers, experienced battlefield medical care instructors and industry is certain to set a new ‘gold standard’ for this type of training.”

DR. CRABTREE: “The surgical community is often called upon to deliver life and limb saving care in austere, under resourced settings. The ability to function in such an environment - to think clearly, to make decisions, to operate, to thrive - is not a given. It takes experience and training. Without this experience and training even the most accomplished surgeons often find their skills underemployed in disaster relief and complex humanitarian emergency scenarios. People suffer who should not have to. This does not need to be the case. Instead, with proven training scenarios and practice, humanitarian surgical volunteers can reach a level of comfort that maximizes their impact and effect. The planned DARC effort addresses this critical need. The military disaster relief world has long sought ‘real world’ training in controlled settings to validate individuals, equipment and plans. Their civilian counterpart seeks the same. I would anticipate this curriculum becoming a credentialing benchmark for health care workers in this field. No similar opportunity exists for either group at this time. Perhaps most importantly, this course will also create a nexus for these two communities - military and civilian - to appreciate the challenges, requirements and solutions HA/DR events demand.”

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“As you know, there will always be tragedies, catastrophes

and disasters that will strain our resources and our ability

to respond. !There are people that run away or get in the

way, and then there are people that move in to help no

matter what. !I am incurably a member of the last class

(God preserve me!).! As a surgeon, I can’t express to you

enough how important training like this is in order to

prepare our medical/surgical community for dealing with

crises at home and abroad.”!

Dr. Sal Napoli, University of Medicine & Dentistry of NJ,

Department of Oral & Maxillofacial Surgery

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“As a first year, I am limited on the

amount of surgeries that I get to perform.

The OMF/CMF cases were awesome since

I was able to do the case from start to

finish with senior residents and attending

guiding me through the entire surgery. I

gained much more confidence with my

ability to bend plates and use the Stryker

instruments. I've never seen an external

fixator used before and I can imagine that

this system would be invaluable in a

disaster scenario.”

“The instructors made the course such a success. The history that each of them brought to the table in regards to survival, medicine, and situational awareness brought to life real issues that most don't think about.”

Quotes without attribution came from anonymous online survey sent to September 2010 Course Graduates

UNCONVENTIONAL SURGICAL IMMERSION COURSE

FEEDBACK FROM COURSE GRADUATES




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“One of the most valuable (If not the most valuable) experiences of my life. Faculty were amazing teachers, with enormous experiences.”

“Allows the participants to become self reliant and creative in providing medical care”

“On behalf of Steve, Mahiban, myself, the

Board and members of IAOMS I want to thank

you, Caitlyn and the entire DARC staff for

including us in the course this past weekend. !

To say that it was an awesome experience

would be an understatement….”

Dr. Donald F. Booth, Boston University!"""#$%&'($))'*%+,-./$0',-0'1),--$0'*23'

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“Completely unique and essential to

anyone interested in practicing in

resource-poor settings.” !!!

“Great course. A must do for

any physician deciding to

participate in relief medicine”






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“I feel as though I now know what to expect when traveling to a disaster scenario such as what to

pack, how to survive on my own for a several days with limited supplies, personal security, how to set

up a hospital, how to triage patients and determine the severity of their injuries, and how to lead a

group. The live tissue was essential for the course.

It was great that you didn't give us too much information. I think the unknown is what made it so

realistic. I was totally disoriented and was not familiar with my surroundings.”

“I considered it to be the best medical course I have been to, and the key to that was your technique of "extreme" situational based learning.! It is the fastest learning curve I have ever experienced in my career.! The combination of such a real simulation, live tissue, the Special Forces medics teaching styles, and the repetition I think all played integral roles in taking us from timid trauma docs to a confident team in 61 hours.! This may sound odd but it will help me in confidence in the operating room and in other emergency situations as well.” David Shaye, UC Davis

"This course provides a total "immersion" in

disaster medicine, which is unique and vital

to deploying physicians - the same way being

immersed in the operating room prepares a

surgeon for surgery."

Sean McKisic, UVA

“The course exceeded all my expectations. !I

learned invaluable skills that will follow me

not only my professional career, but in my

personal life. Highly recommend the DARC

Surgical Immersion Course.”

Derrick Flint UCSF



“I was amazed at how quickly interns and residents with little or no trauma management experience were able to not only learn and effectively perform advanced surgical techniques that kept patients alive, but that they did so in an austere environment and in a field hospital that they had built themselves just hours before a mass casualty event.”




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“It was an unbelievable experience for me and

something I will never forget as I plan on using my

experiences there in my life going forward.! It was

amazing to me to see how much each of the

participants grew in their confidence and skill level

in the 61 hours they were there.! I have been to a

lot of medical training courses in my long career

with Stryker and Leibinger, but I have never seen

anything like the training we experienced at

DARC.! It was a tremendous opportunity for real

life learning.”!

“Thank you. The time and effort that went into this course will never be fully appreciated by the participants. Please know that you all touched every participant and please know that your

knowledge and skills have set in motion a group of individuals who will pay it forward.”

“This was an incredible experience.!

It was everything I wish I had known before I went to Haiti – I was a

complete liability; now I am an asset.!

Thank you to Stryker for stepping out of your comfort zone to support this

type of training.! It will make a huge difference in the world.”

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“The course met and exceeded all of my objectives. My prior experience in medical disaster relief is

limited but taught me I could have been much more effective if I was physically and mentally

prepared. After Haiti, I did not know what to do…. When I read the objectives of the Austere

Medicine course, I felt this may be an opportunity to gain some of the missing knowledge and

experience. I was excited. I appreciate the value of mock drills for emergencies as we run them

frequently. The course did it. It challenged me physically and mentally. It kept on coming. It was

orchestrated beautifully. Everything that happened was for a reason. Inserted, tasked, assigned to

teams, quickly moved out of our comfort zone, had to figure it out as a team, teams changed, team

leaders changed, difficult logistics, had to build where we lived and worked, intermittent and

incomplete supplies, caught off guard, need to hydrate and many other sub-scenarios.

I have only the utmost respect for you and the faculty. Your professionalism and dedication became

quickly evident. You gained my trust and respect and that was a major motivator for me throughout

the course. It was evident that all the faculty had experience and endurance - the two things that

cannot be faked. The opportunity to hear and be taught by experts who patiently hammered home

some of the gold standards of medical care in disasters

were not wasted on our group. I am confident everyone

will pay it going forward. It will be fun to watch how.

I have my list of clothes and equipment that I can refer

to for the next opportunity. The comments made by the

faculty that if you pack everything you need to survive

for a week and know where it is will give you the

confidence to fully engage in goals of the mission. Two

verbs that are important in all aspects of life but

perhaps more so in a disaster are stand up and ask. We

were urged, reminded and learned the value of both by

being rewarded for both. I learned a set of skills that I

know and feel that the next time I am in a first

responder situation, I can step up.

... I left with a sense of self accomplishment, but more

so the feeling that I have had the opportunity to learn

from professionals and if I remember what they taught

me, I can survive and contribute.”

Dr. Steve Roser, Emory




DARC AUSTERE MEDICAL PROGRAM:UNCONVENTIONAL SURGICAL IMMERSION COURSE

N. LITTLE ROCK, ARKANSAS ~ APRIL 14-17, 2011

NAME (please print name exactly as it should appear on your certificate)

MAILING ADDRESS

EMAIL ADDRESS

(confirmation letters will be sent to this address- please print legibly)

DAYTIME PHONE EVENING PHONE

FLYING FROM (Airport Code) DRIVING FROM (Zip Code)

HOW DID YOU HEAR ABOUT THE COURSE? T-SHIRT SIZE:

EMERGENCY CONTACT INFO

NAME RELATIONSHIP

ADDRESS


PRE-EXISTING HEALTH CONCERNS/ CONDITIONS

ALLERGIES

PROGRAM DIRECTOR:

The Program Director of your Residency must sign this form in order for you to be eligible to attend this course.

DIRECTOR’S NAME (please print)

DIRECTOR’S SIGNATURE DATE

INSTITUTION/ HOSPITAL NAME

CITY, STATE PHONE

RESIDENT’S SIGNATURE DATE

SPECIALTY

DO YOU CURRENTLY HAVE A HA/DR TRIP SCHEDULED IN THE NEXT 12 MONTHS?

WITH WHO? POC: PHONE:

REGISTRATION PROCESS:

1. If you have reviewed the course information and agree to comply with the Course Policy, please complete the registration form on this page and submit it, along with your essay and a copy of your credentials to Caitlyn Mason at DARC.

2. You will be notified upon receipt of your registration packet (form, essay & credentials). Once you are accepted, a letter of confirmation will be sent via email. All decisions will be made by 12:00 PM CST on Thursday, March 31, 2011. Reminder: All registration correspondence will be via email.

REGISTRATION DEADLINE

IS 11:59 PM CST, MONDAY, MARCH 28, 2011

Email or E-Fax Registration Packets to: [email protected] or f. 866-690-7447

If you have questions please call Caitlyn Mason @ 501-307-9031

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mailto:[email protected]



DARC AUSTERE MEDICAL PROGRAM:UNCONVENTIONAL SURGICAL IMMERSION COURSE

N. LITTLE ROCK, ARKANSAS ~ APRIL 14-17, 2011

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PP

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IONNAME

(please print name exactly as it should appear on your certificate)

MAILING ADDRESS

EMAIL ADDRESS

(confirmation letters will be sent to this address- please print legibly)


SPECIALTY

INSTITUTION/ HOSPITAL NAME

ADDRESS

CITY, STATE PHONE

DO YOU CURRENTLY HAVE A HA/DR TRIP SCHEDULED IN THE NEXT 12 MONTHS?

WITH WHO? POC: PHONE:

HOW DID YOU HEAR ABOUT THE COURSE? T-SHIRT SIZE:

METHOD OF PAYMENT

SIGNATURE DATE

EMERGENCY CONTACT INFO

NAME RELATIONSHIP

ADDRESS


PRE-EXISTING HEALTH CONCERNS/ CONDITIONS

ALLERGIES

REGISTRATION DEADLINE IS

11:59 PM CST, MONDAY, MARCH 28, 2011

Email or E-Fax Registration Packets to: [email protected] or f. 866-690-7447

If you have questions please call Caitlyn Mason @ 501-307-9031

REGISTRATION PROCESS:

1. Please complete the registration form on this page and submit it, along a copy of your credentials to Caitlyn Mason at DARC.2. You will be notified upon receipt of your registration packet (form & credentials). HCP/ Non-Residents will be accepted on a first come, first

serve basis. In the event no slots are available, you will be placed on the wait list and on the pre-registration list for the next scheduled course. Once you are accepted, a letter of confirmation will be sent via email NLT 12:00 PM on Thursday, March 31, 2011.

3. You will have until 12:01 AM CST on Wednesday,April 6, 2011 to confirm your slot in the course. If we do not hear from you within this time, you run the risk of losing your slot for this course and you will be notified via email.

4. Please do not plan to bring a spouse/guest, since we cannot accommodate these individuals at the site, nor will there be time outside of training.






USIC: RESIDENT EDUCATIONAL GRANT POLICY AND PROCEDURES

The purpose of this policy is to provide instructions to Residents who are interested in attending the course entitled: DARC Austere Medical Program: Unconventional Surgical Immersion Course, April 14-17, 2011 at DARC.The USIC Course is open to all HCPs, medical logisticians, military medical personnel and Humanitarian/Disaster Relief Organizations. If you do not qualify for the educational grants and would like to attend through other means, please contact Caitlyn Mason at [email protected].

THE EDUCATIONAL GRANT WILL COVER THE FOLLOWING:

1. Tuition for the course.2. Lodging3. Roundtrip airfare (nonrefundable coach) or reimbursement for mileage, tolls, and parking.4. Meals and refreshments at DARC during the scenario based training and a luncheon on April 17, 2011.5. Group transportation will be provided to and from the airport for the duration of the course.

THE EDUCATIONAL GRANT WILL NOT COVER THE FOLLOWING:

1. Incidental expenses at the airport, during travel, or during the course. This includes excess baggage fees.2. Transportation to and from the home city airport.3. Meals, food and beverage expenses not listed in the grant above.

COURSE REGISTRATION PROCEDURE:

1. Complete the Resident registration form included in this brochure. Your Program Director must sign the registration form prior to submitting it to DARC.

2. Residents are required to submit an essay, 500 words or less, describing why they want to participate in the training and why we should let them attend. If you have a planned HA/DR trip within the next 12 months please provide the details of your trip.

3. Submit your registration packet (form, essay & credentials) to Caitlyn Mason at DARC via email or fax.

Registration closes at 11:59 PM CST on Monday, March 28, 2011

4. You will be notified upon receipt of your registration packet. 5. All essays will be submitted to the DARC AMP Faculty Board for review and selection with the Board

Chairman, Dr. Larry Hollier, having final authority over any tie or dispute.6. Once you are accepted a letter of confirmation will be sent to your email. All decisions will be made by

12:00 PM CST on Thursday, March 31, 2011. 7. You will have until 12:01 AM CST on Friday, April 1, 2011 (36 hours) to confirm your slot in the course.

If we do not hear from you within this time, your slot will be given away to an alternate.8. Please do not plan to bring a spouse/guest, since we cannot accommodate these individuals at the site, nor

will there be time outside of training.9. Acceptance priority will be given to any resident applicant who has a planned HA/DR trip within the next

12 months.

Reminder: All registration correspondence will be via email.






USIC: UNCONVENTIONAL SURGICAL IMMERSION COURSE

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