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Military and Civilian Joint Research Gaps

COL. Brian Eastridge, MD, FACS, USAISR Stephen Cohn, MD, FACS, UTHSCSA. Military and Civilian Joint Research Gaps. The Top Eight Causes of Death in Americans Aged 1-44 Years. The Civilian Trauma Problem. 61% of the deaths of Americans between the ages of 1 and 44 each year.

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Military and Civilian Joint Research Gaps

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  1. COL. Brian Eastridge, MD, FACS, USAISR Stephen Cohn, MD, FACS, UTHSCSA Military and CivilianJoint Research Gaps

  2. The Top Eight Causes of Death in Americans Aged 1-44 Years The Civilian Trauma Problem 61% of the deaths of Americans between the ages of 1 and 44 each year. More than all forms of cancer, heart disease, HIV, liver disease, stroke and diabetes combined. An American dies every three minutes due to trauma 179,000 deaths every year 29.6 million injuries every year CDC, 2007

  3. The Civilian Trauma Problem • Second most expensive public health problem facing the USA • The leading cause of years of productive life lost • Annual medical costs from trauma $72 billion (AHRQ, 2005) • Second only to heart conditions • True economic burden may be more than $690 billion per year due to cost of disability (National Safety Council, 2011) AHRQ, 2005

  4. The Civilian Trauma Problem • Can research really make a difference? • 50 years of dedicated research into proper diagnosis and treatment of leukemia has led to an 80% reduction in the death rate • A 5% reduction in trauma deaths, injuries and economic burden would: • save the United States $35 billion • prevent 1.5 million injuries • save 9,000 lives • EVERY YEAR

  5. Civilian Trauma Research Gaps • Hemorrhage • Identification and control of non-compressible hemorrhage • Endpoints for resuscitation with hemorrhagic shock • Major hemorrhage from pelvic fractures • Intra-cranial bleeding with coagulopathy • Novel resuscitation fluids for hemorrhagic shock • Hemostatic devices • Control of bleeding in thoracic outlet, groin, retrohepatic area and pulmonary hilum

  6. Civilian Trauma Research Gaps • Intensive Care • Tracheostomy in patients requiring prolonged mechanical ventilation • Prevention of thromboembolic occurrences and complications • Increasing ventilator-free days and lowering costs and complications

  7. Civilian Trauma Research Gaps • Burn • Replacement and off-the-shelf skin • Protecting skin grafts from immune recognition • Pain management

  8. Civilian Trauma Research Gaps • Hospital Acquired Infection and Antibiotic Utilization • Rapid methods for detection and identification of infection • Methods for minimization of transmission

  9. Civilian Trauma Research Gaps • Disaster Preparedness • Procedures or treatment in mass casualty situations • Safe and cost-effective transport protocols for critically injured patients

  10. Civilian Trauma Research Gaps • Technology development • Wireless vital signs monitors • Biosensors • Imaging systems for improved trauma care • Computerized clinical decision support systems • ICU monitoring • Resuscitation • Antibiotic prescription and monitoring • Organ simulation for medical education

  11. Military Civilian Military/Civilian Common Challenges Hemorrhage/coagulopathyHemorrhage/coagulopathy Burn Burn Wound infection Hospital-acquired infection Transportation of the critically ill Disaster preparedness Orthopaedic trauma Orthopaedic trauma TBI TBI Pain management Intensive Care Secondary cell and organ damage Technology development Massive soft tissue injury Eye, ear, craniofacial injury Pre-hospital data

  12. Research Gaps - Conclusion • We’re working on the same problems • Collaboration makes sense • NTI provides a good way to enhance military/civilian partnership/interaction • Powerful impact by working together • Better transfer of knowledge between civilian and military benefits both

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