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Military trauma training at civilian centers: A decade of advancements

Thorson, Chad M. MD, MSPH; Dubose, Joseph J. MD; Rhee, Peter MD; Knuth, Thomas E. MD; Dorlac, Warren C. MD; Bailey, Jeffrey A. MD; Garcia, George D. MD; Ryan, Mark L. MD; Van Haren, Robert M. MD; Proctor, Kenneth G. PhD

Journal of Trauma and Acute Care Surgery: December 2012 - Volume 73 - Issue 6 - p S483–S489
doi: 10.1097/TA.0b013e31827546fb
Original Articles

In the late 1990s, a Department of Defense subcommittee screened more than 100 civilian trauma centers according to the number of admissions, percentage of penetrating trauma, and institutional interest in relation to the specific training missions of each of the three service branches. By the end of 2001, the Army started a program at University of Miami/Ryder Trauma Center, the Navy began a similar program at University of Southern California/Los Angeles County Medical Center, and the Air Force initiated three Centers for the Sustainment of Trauma and Readiness Skills (C-STARS) at busy academic medical centers: R. Adams Cowley Shock Trauma Center at the University of Maryland (C-STARS Baltimore), Saint Louis University (C-STARS St. Louis), and The University Hospital/University of Cincinnati (C-STARS Cincinnati). Each center focuses on three key areas, didactic training, state-of-the-art simulation and expeditionary equipment training, as well as actual clinical experience in the acute management of trauma patients. Each is integral to delivering lifesaving combat casualty care in theater. Initially, there were growing pains and the struggle to develop an effective curriculum in a short period. With the foresight of each trauma training center director and a dynamic exchange of information with civilian trauma leaders and frontline war fighters, there has been a continuous evolution and improvement of each center’s curriculum. Now, it is clear that the longest military conflict in US history and the first of the 21st century has led to numerous innovations in cutting edge trauma training on a comprehensive array of topics. This report provides an overview of the decade-long evolutionary process in providing the highest-quality medical care for our injured heroes.

From the Dewitt-Daughtry Family Department of Surgery (C.M.T., M.L.R., R.M.V.H., K.G.P.), and Army Trauma Training Center (T.E.K., G.D.G.), Ryder Trauma Center, Miller School of Medicine, University of Miami, Miami, Florida; Air Force Centers for the Sustainment of Trauma and Readiness Skills (J.J.D.), University of Maryland Shock Trauma Center, Baltimore, Maryland; Navy Trauma Training Center (P.R.), Los Angeles, California; Centers for the Sustainment of Trauma and Readiness Skills Cincinnati (W.C.D.), Cincinnati, Ohio; Centers for the Sustainment of Trauma and Readiness Skills St. Louis (J.A.B.), St. Louis University, St. Louis, Missouri. P.R. is now with the Division of Trauma, Critical Care and Emergency Surgery, Arizona Health Science Center, Tucson, Arizona. W.C.D. is now with University of Cincinnati, Cincinnati, Ohio. J.A.B. is now with Joint Trauma System, US Army Institute of Surgical Research, Fort Sam Houston, Texas. T.E.K. is in private practice in Grosse Pointe Farms, Michigan.

Address for reprints: Kenneth G. Proctor, PhD, Divisions of Trauma and Surgical Critical Care, Dewitt-Daughtry Family Department of Surgery, University of Miami Miller School of Medicine/Ryder Trauma Center, 1800 NW 10th Ave, Miami, FL 33136; email:

© 2012 Lippincott Williams & Wilkins, Inc.