title: Transforming an academic military treatment facility into a trauma center: lessons learned from Operation Iraqi Freedom.
abstract: BACKGROUND
  To manage the influx of patients with predominately extremity injuries from Operation Iraqi Freedom (OIF), our center was required to transform from a nontrauma academic hospital to a trauma hospital by using a multidisciplinary approach.
  
  
  METHODS
  A retrospective chart review was performed of casualties from OIF who were received over 14 months.
  
  
  RESULTS
  A total of 313 casualties were received. The average number of admissions was 16 per month, except during November 2004, when there were 88 admissions over 7 days. The mean ISS for all patients was 14.1 +/- 10.3. A total of 113 patients (36%) required admission to the intensive care unit for an average of 7.5 +/- 5.2 days. The mean interval between injury and arrival in the continental United States was 6.5 +/- 4.6 days. Most casualties suffered multisystem trauma, with extremity injuries predominating. The multidisciplinary approach to casualty care consisted of several meetings a week and included everyone involved in caring for these combat casualties.
  
  
  CONCLUSIONS
  A multidisciplinary approach transformed an existing medical center into a trauma receiving hospital capable of managing and maintaining a surge in patient admissions resulting in minimal morbidity and mortality. This model further supports a multidisciplinary approach to trauma care and could serve as a guideline for transforming existing medical centers into trauma receiving hospitals to deal with patient overflow in the event of future civilian mass casualties.
authors.affiliation: Department of Surgery, National Naval Medical Center, Bethesda, MD, USA. eric.elster@med.navy.mil
authors.forename: Eric A
authors.initials: EA
authors.lastname: Elster
authors.forename: Jonathan P
authors.initials: JP
authors.lastname: Pearl
authors.forename: John W
authors.initials: JW
authors.lastname: DeNobile
authors.forename: Philip W
authors.initials: PW
authors.lastname: Perdue
authors.forename: Alexander
authors.initials: A
authors.lastname: Stojadinovic
authors.forename: William A
authors.initials: WA
authors.lastname: Liston
authors.forename: James R
authors.initials: JR
authors.lastname: Dunne
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