title: Use of neurosurgical decision-making and damage-control neurosurgery courses in the Iraq and Afghanistan conflicts: a surgeon's experience.
abstract: A shortage of Coalition neurological surgeons in the Iraq conflict prompted a creative approach to standardized neurosurgical care in 2007. After formulation of theater-wide clinical pathway guidelines, a need for standardized triage and neurological resuscitation was identified. The object was to establish a simple, reproducible course for medics, forward surgical and emergency room personnel, and other critical care providers to quickly standardize the ability of all deployed health care personnel to provide state-of-the-art neurosurgical triage and damage-control interventions. The methods applied were Microsoft PowerPoint presentations and hands-on learning. The year-long project resulted in more than 100 individuals being trained in neurosurgical decision making and in more than 15 surgeons being trained in damage-control neurosurgery. At the year's conclusion, hundreds of individuals received exceptional neurosurgical care from nonneurosurgical providers and a legacy course was left for future deployed providers to receive ongoing education at their own pace.
authors.affiliation: Division of Neurosurgery, Brooke Army Medical Center, Fort Sam Houston, Texas 78234, USA. richard.teff@yahoo.com
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Teff
mesh_terms: D055826:Afghan Campaign 2001-; D002983:Clinical Competence / Q000592:standards; D003657:Decision Making; D056424:Decompressive Craniectomy / Q000009:adverse effects / Q000193:education; D020197:Head Injuries, Penetrating / Q000601:surgery*; D006772:Hospitals, Military; D006801:Humans; D019586:Intracranial Hypertension / Q000601:surgery; D054542:Iraq War, 2003-2011; D008887:Military Medicine / Q000193:education; D009493:Neurosurgery / Q000193:education* / Q000379:methods*; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000193:education / Q000379:methods; D010820:Physicians / Q000600:supply & distribution; D014218:Triage; D014481:United States; D000078329:Workforce