Reservists Train for Trauma: An Emergency Unit in Miami is a Critical Stop for War-Bound Medics

Apr. 1--MIAMI -- The Friday night lull ends minutes before 10, when the emergency radio crackles with three rescue calls, galvanizing the Army reservists who had commandeered the Ryder Trauma Center.

Pulling gowns over scrubs, surgical masks over faces and paper booties over sneakers, members of the 948th Forward Surgical Team prepare for the incoming casualties: a 16-year-old pedestrian hit by a car, a woman knocked unconscious after falling from a speeding golf cart and a bicyclist who catapulted into a vehicle.

With all its big-city mayhem, Miami's world-class emergency unit is the ideal home for the Army Trauma Training Center. It's the critical stop for Army surgeons, nurses and medics before they leave for the front lines of Iraq and Afghanistan.

On this Friday, 22 members of the 948th from Southfield, Mich., will run the show for 24 hours before deploying to Iraq.

As fate would have it, all three patients arrive rapid-fire, uncaging the frenzy that the soldiers come to the trauma center at the University of Miami/Jackson Medical Center to learn to combat.

Their No. 1 mission is to banish chaos from their thoughts, their actions, their hospital tents outside of Baghdad or Ramadi. They cannot freeze. They must not squander a minute of a fellow soldier's or an Iraqi national's "golden hour," the critical treatment window for resuscitation after serious injury.

Everyone has a job to do, and they must do it quickly, precisely and as an airtight team if they are to stabilize combat injuries and improve the chances of survival.

'Quite a symphony'

"You know the plan," says Capt. Chris Mullen, a flight nurse and paramedic from Michigan, to the tangle of soldiers clogging the hallway when the first rescue chopper lands on the roof. "Make it happen."

As the moaning 16-year-old girl is wheeled into a resuscitation room, the confusion melts away, and five reservists converge, swiftly executing the duties they had practiced in simulations and with real patients during 12-hour clinical rotations in the preceding 11 days.

Lt. Jason Frantz, 35, a nurse anesthetist from St. Louis, listens to the girl's chest and makes sure her air passages are open. Capt. David Jewitt, 38, a cardiology nurse in Michigan, hooks up the monitors. The medics, Spc. Porfirio Montes III, 33, an airport security agent, and Sgt. Jeremy Johnston, 25, a paramedic, both from Michigan, pair up to cut off her clothes, start an IV and draw blood, rushing the syringe to the lab for tests.

"Hold it up and say, "Sharp!" reminds Staff Sgt. Naydean Rhodes, the practical-nurse instructor on the Army center's 11-person staff.

All the while, Maj. Jason Walsh, 35, a general surgeon from Scottsbluff, Neb., scans the girl's battered body with an ultrasound, searching for pockets of air or blood. He also peppers her with questions:

Can you move everything? Do you have any medical problems? Allergies? Previous surgeries? When was your last meal?

"It's quite a symphony," observes the 948's commander, Lt. Col. Robert Monson, 56, a nurse anesthetist who usually spend his days in Provo, Utah, sedating patients for dental and cosmetic surgery. "It looks like chaos, but it's very focused."

Rapid-fire casualties

There would be only a brief interlude before the symphony's next movement. Again, Mullen keeps an eye on traffic.

"Hey, sarge," he calls to Staff Sgt. Johann Worch, 34, a school nurse from Columbus, Ohio, who is more accustomed to skinned knees and head lice. "I'd start clearing the hall. You've got another bird on the deck."

Within minutes, the second and third casualties arrive, the woman thrown from the golf cart and the catapulting bicyclist. They are wheeled into separate resuscitation rooms and different five-person Army teams descend, repeating the same drill.

The new patients are followed shortly by two Miami-Dade police officers who crashed into a pole when their cruiser swerved to miss an oncoming motorist, and an old man who took a nasty tumble in his apartment.