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Home | Tag Archives: William Beaumont Army Medical Center

Tag Archives: William Beaumont Army Medical Center

WBAMC Labor and Delivery’s Quick Reaction Saves Newborn’s Life

For most women, pregnancy is an incredible 40-week journey ending with the delivery of baby. But it’s not always that easy or predictable with possible complications threatening the health of mother, baby or both.

Recently, medical professionals at William Beaumont Army Medical Center’s Labor and Delivery section skillfully dealt with a rare complication when a laboring mom experienced an umbilical cord prolapse, leading staff to quickly respond to the obstetrical emergency via an emergency cesarean section.

A cord prolapse occurs when the umbilical cord prolapses, or drops, through the open cervix into the vagina ahead of the baby which may block fetal-placental circulation resulting in loss of oxygen to the fetus and possible stillbirth if not treated immediately.

“(The patient) was already here and admitted because we were inducing labor,” said Diana Ortiz, charge nurse during the shift of the incident. “The doctor went in there to (rupture) the membrane and the cord came out, he was trying to make her go into labor.”

Although the artificial rupture of membranes is a common procedure performed to accelerate or induce labor, there are always risks involved. According to studies by the Cleveland Clinic, about one in every 500 pregnancies may result in an umbilical cord prolapse, increasing the importance of staff readiness.

“Rupturing of the amniotic sack is just part of the process to help a mom who’s not going into labor any other way, and there are risks associated with that,” said Maj. Michael Swift, the obstetrician-gynecologist performing the procedure.

Obstetrical emergencies, such as cord prolapse, are routinely simulated at WBAMC’s L&D section through the use of medical manikins to evaluate staff communication during emergencies, and improve interdisciplinary and clinical performance.

“We do practice simulations but this was beyond simulations, it was just a really, really, solid team,” said Swift. “It was fast, it was extremely fast. Everyone was well organized it was like an absolute perfect orchestra.”

According to the staff, as Swift called for assistance after the prolapse, a team of nurses quickly prepared the operating room for the emergency cesarean section, while another nurse jumped on the gurney with the patient to assist with alleviating pressure on the umbilical cord due to the baby dropping.

“The teamwork was dynamic, and worked out so well,” said Ortiz, a seven-year L&D nursing veteran. “Everybody ran and did something, it synchronized really well, and right at change of shift.”

According to Ortiz, shift changes are usually a more chaotic time during care as outgoing staff are occupied with the transfer of patient information to incoming staff and other activities.

“I’m still catching my breath because everything just fell into place from (umbilical cord prolapse) to (emergency cesarean section),” said Ortiz.

For Swift, who is only two years out of his medical residency, the only other real-world experience with an umbilical cord prolapse was during his residency. He credits the team of nurses for their quick reaction, turning a potentially fatal situation to an otherwise successful delivery.

“These nurses are extremely experienced and have been doing this for years, but it does demonstrate the importance of simulations, because these are practiced routinely,” said swift.

As a result of their actions, staff members were presented commander’s coins following the incident. Staff members include: Santa Ware, Maria Martell, Lisa Obermeyer, Yesenia Ruelas and Jennifer Ruelas.

Within six minutes, the team’s actions went from the umbilical cord prolapse to delivery of the baby with no further complications. Two weeks following discharge, during a follow up appointment the family were content and thankful for the rapid response and teamwork at WBAMC.

“There’s always great crew work, if something happens everybody knows what to do,” said Ortiz.

Author: Marcy Sanchez  – William Beaumont Army Medical Center Public Affairs Office

Bound by Blood, Serving by Choice; Brothers Meet Once Again at Fort Bliss

Eight years since last seeing each other, two brothers from Central Valley, California, cross paths at a remote West Texas location, nestled between mountain ranges and riddled with desert shrub.

The setting is all too familiar for the pair, which have spent more years apart than together, yet they gather whenever given chance.

James and David Mendoza, fraternal twins born five minutes apart, enlisted after high school to find their calling after gradually realizing their own individual identities, as evidenced by their high school athletics clubs, James participated in water sports while David stuck to running.

A desire for something greater drove the brothers toward service after high school, with David enlisting in the Army Reserves while James enlisted in the Army’s active-duty component. Today, Maj. James Mendoza leads manpower and administrative functions for the 79th Infantry Brigade Combat Team, a California Army National Guard unit out of San Diego, California, while Col. David Mendoza heads inpatient services at William Beaumont Army Medical Center, out of El Paso, Texas.

“Last time we crossed paths like this was in May of 2010,” said David, deputy commander of inpatient services at WBAMC. “I was stationed at Fort Hood, (James) was mobilizing for a deployment with the National Guard and we happened to be with each other for a few days before he left.”

Although the brothers occasionally see each other at family functions, such as holidays with their parents back in California, service to country has absorbed the brothers’ time.

“We’re basically two separate worlds now, other than being part of the Army,” said David.

For James, Army service started as an aviation maintenance technician in the 80s.

“As I was progressing through the enlisted ranks I finished up my (college) education,” said James, the older of the brothers. “When I got that completed, a door opened to get commissioned, so off I went in the National Guard and started as a finance, logistics and human resources officer.”

Although James transitioned from active duty to the National Guard, he’s remained Active Guard Reserve, or on full-time National Guard duty, since donning the uniform.

David’s initial Military Occupational Specialty as a combat medic in the Army Reserves inspired him toward earning a nursing degree and commission afterwards.

“I don’t know a whole lot about the medical world and he doesn’t know much about logistics,” said James.

“There’s really not a whole lot that separates us, or that we have in common,” adds David.

While their desire to become their own person drove the brothers toward service, emulating others who served before them was also a factor in serving their country.

“Our dad was a retired Soldier in the National Guard, and we have uncles who served in Vietnam, so we have a family tradition of serving,” said David. “Our family background of service and looking for a way to pay for college, possibly get into a career we could use later on in life were motivators to enlist.”

Their careers have led them through more than a half-dozen deployments, and multiple duty stations for David, but the brothers are still finding time to discuss current and future endeavors with one another.

“Life happens. I move around, he stays (in California), and we don’t ever get the opportunity to cross paths,” said David. “It’s nice to have this window of opportunity to hang out and reconnect, if only for a few days.”

While not having too much in common, both brothers do agree one of the largest challenges they’ve had to overcome during decades of service are families dealing with deployments.

“We share the same sentiments of any military family of having to be gone, (deployments are) a challenge for the spouses,” said David.

“It’s just part of what we do, but it’s time away from family,” said James.

While discussions about life after their service haven’t began, the two are glad to discuss the journey they have been through leading to a rare get together for the brothers.

“It’s great to be at the end of our careers,” said David. “It’s great to have this time to capstone the last 25-30 years to look back and at the same time look forward.”

Author: Marcy Sanchez –  William Beaumont Army Medical Center Public Affairs Office

Study Reveals Compliance of Biomarker Testing for NSCLC at WBAMC

William Beaumont Army Medical Center’s Department of Pathology recently conducted a study to monitor compliance rate and to gauge turnaround times of biomarker testing for non-small cell lung cancers (NSCLC).

The study showed that WBAMC is compliant with national evidence-based guidelines.

The study looked at dozens of cases involving NSCLC which required biomarker testing from 2015 to 2018.

“At one of our quarterly Commission on Cancer meetings, it was suggested to perform a study to monitor WBAMC compliance rate of biomarker testing for Non-Small Cell lung cancers. This is one of the Commission on Cancer Standards. With this study, not only we can evaluate our compliance rate of biomarker testing for NSCLC, but also we can investigate the turnaround times (TAT) of these tests that are sent to Reference Laboratories. The turnaround time measures how fast we can get those test results back to the physician who ordered the biomarker tests once we send them,” said Dr. Domingo Rosario, pathologist, Department of Pathology, WBAMC. “Ideally it would be two weeks or less, the study was to evaluate if that is possible or not.”

According to research published by the U.S. Department of Health and Human Services, lung cancer is the leading cause of cancer-related mortality worldwide, with 84 percent of those composed of NSCLC cases. Timely and accurate diagnosis as well as prompt biomarker testing are important factors that will help the medical team decide the best treatment approach for the patient. These samples would theoretically lead to a quicker response to potentially life-threatening cancers.

“What we noticed is that two weeks or less is not realistic TAT, because the sample is tested at different sections of the reference lab, and the average TAT was 24 days,” said Rosario, who authored the study.

While no guidelines exist for turnaround times of biomarker testing for NSCLC, the study does assist pathologists and clinicians provide realistic expectations for test results, in addition to improving communications with patients regarding diagnosis timeframes.

“Once we get (test results), we will communicate those results immediately to the clinician via emails and through addendums,” said Rosario, a native of Jayuya, Puerto Rico. “Different samples require different molecular tests, we do what the clinician asks for once the cases are discussed at tumor boards.”

By keeping communication open with clinicians, the results of biomarker tests are relayed one by one, as they are received, until the complete and final reference lab report is received by the WBAMC Anatomic Pathology Section. “For example PD-L1 immunohistochemical stain results may be available before EGFR and ALK testing, so we will communicate that PD-L1 result first, so there is not a delay in patient management” said Rosario. This allows immediate options for treatment to be discussed with patients, consequently increasing survival possibility.

“We are doing really well in the hospital even with minimally-invasive procedures”. “The study showed that biopsy samples from Interventional Radiology and surgery, and even cytology specimens (by Pulmonology team) are yielding really good material for these tests,” said Rosario. “The trend in patient management is to have a tissue biopsy via minimally-invasive procedures. Based on our study, even tiny biopsies that we got were adequate for testing.”

According to Rosario, because samples from minimally-invasive procedures have proved effective, it may eliminate the need for larger resections to procure samples for biomarkers testing for NSCLC and other diseases. Rosario adds the effectiveness of such testing is a testament to the high-quality patient care clinicians provide in getting a tissue sample.

“Sometimes the patient may not even undergo the resection and they can start treatment based off the tiny sample that we get,” said Rosario. “It’s really good for (patients and clinicians) because if (results show) a positive lymph node which indicates metastatic adenocarcinoma and clinicians know the patient won’t need a resection then they can start treating with chemotherapy based on biomarkers results, just with a few cells.”

More importantly, the study reveals 100 percent compliance, over the past four years, for testing of all NSCLC which require biomarker testing, meaning all samples were adequately tested.

“With this study it shows that no patients slipped through the cracks,” said Rosario. “That’s something really positive for the hospital.”

Future initiatives may result in more diverse studies involving colon, melanoma, and other non-lung cancer cases to study trends in compliance and turnaround times.

Author:  Marcy Sanchez – William Beaumont Army Medical Center Public Affairs Office

William Beaumont AMC Conference Validates Leadership Impact in Medicine

Each year, William Beaumont Army Medical Center holds a medical conference to discuss latest initiatives across its health care footprint, which spans from West Texas to Southern New Mexico.

The conference also offers health care professionals the opportunity for Continuing Medical Education (CME) to maintain competence and learn about new and developing areas in medicine and WBAMC.

This year’s conference welcomed retired Lt. Gen. Eric Schoomaker, 42nd Surgeon General of the U.S. Army and former commanding general of U.S. Army Medical Command, and retired Maj. Gen. Carla Hawley-Bowland, former WBAMC commander (2000-2002) and first female physician general officer in the Army.

“(I want) to encourage people who have talent as senior managers and leaders,” said Schoomaker, who is now the director of the Uniformed Services University of the Health Sciences Leader and Leadership Education and Development Program (USU LEAD). “Soldiers should not pass up the opportunity to lead well and step in to these important roles at this time in the history of WBAMC.”

WBAMC health care providers are required to obtain 50 CME credits to remain credentialed at the hospital, with opportunities available both in-house and through medical conferences abroad. During the conference the importance of leadership in clinical settings was highlighted.

“Both our keynote speakers are general officers and physicians, so we get leaders in the Army and leaders in medicine during the conference,” said Maj. Bin Wang, chief of Nuclear Medicine and director of Continuing Medical Education at WBAMC. “It’s a good day for a lot of medical staff and support staff to optimize training.”

Schoomaker, a practicing hematologist, discussed the impact good leaders may have on an organization and the consequences of challenging oneself.

“Leaders create vision, inspire others and help those they are leading remove obstacles to get to their objectives, that’s what leaders do,” said Schoomaker, who headed the Army’s Medical Command from 2007-2011. “Every doctor, nurse, (physical therapist), (orthopedic) technician, is concerned whatever they came into medicine to do is going to be lost if they take on other challenges (roles). Humans are made to be challenged, to take calculated risks. You can’t do that if you stay in a role you’re comfortable in.”

The event also included discussions on physician self-care, patient safety and experiences, medical ethics and appropriate contracting actions in medical settings. In an overview of current efforts designed to meet Regional Health Command-Central initiatives, which oversees WBAMC operations, WBAMC’s Simulation Center performed a simulated burn casualty scenario with an emphasis on current available forward-thinking capabilities to train health care staff in practices different from normal operations.

The scenario, and others like it, will support RHC-C’s Individual Critical Task List (ICTL), an emphasis to measure wartime clinical readiness of health care providers to better support battlefield medicine.

According to Wang, the conference also served to remind health care professionals to think about their own mental and physical wellbeing, a focus of Hawley-Bowland’s speech.

“If the audience can get some pointers from the presenters who have vast experience not just in the military but in the medical field, they can improve their patient care and their own care,” said Wang.

Over 450 health care professionals attended the conference, an event coordinated by WBAMC staff members: Lt. Col. Eric Weber, acting chief medical officer, Oralia Nido, CME coordinator, John Duggan, audio/visual technician, and Anna Stewart, executive assistant to WBAMC commander.

“What we do in our hospitals every day is a live-fire exercise,” said Schoomaker. “That’s what we do as caregivers.”

Author:  Marcy Sanchez – William Beaumont Army Medical Center Public Affairs Office

William Beaumont AMC Nurses Recognized for Care, Compassion

It’s been one year since the first Light the Way Award was presented to a pair of nurses at William Beaumont Army Medical Center.

Since then, dozens of nominations have been submitted detailing compassionate and heroic tales of nursing encounters by many who appreciate nurses, from physicians to patients.

The award is designed to recognize a broader range of nurses at WBAMC, to include Registered Nurses, Licensed Vocational Nurses, nursing assistants/ aids, medics and technicians.

On November 15, two active-duty Soldiers joined the ranks of Light the Way Award recipients, solidifying the impact nurses have made for Soldiers, families and other beneficiaries across the WBAMC footprint.

“Growing up I lived in a house with a nurse (mother) and I told myself that I would never be a nurse,” said 1st Lt. Christina Chipman, staff nurse, Medical telemetry ward, WBAMC. “It wasn’t something I ever really desired to do, but when I was in college I was in school for human biology and realized I wanted to do something more practical where I could be at bedside with a patient and graduated with a nursing degree. I haven’t looked back since.”

In 2017, Chipman made a large difference in one Soldier’s recovery during his healing process from suffering multiple small-arms fire injuries in Afghanistan while in support of Operation Freedom’s Sentinel. According to the Soldier, in a time of confusion and fear, Chipman took it upon herself to ease family members and explain every medical procedure in detail. Although multiple nurses attended the Soldier during his care at WBAMC, Chipman’s compassion and care stood out.

The second Soldier nominated was Maj. Lena Fabian, certified nurse midwife, Department of Women’s Health, WBAMC. According to Fabian’s nomination, she went above and beyond by helping the Labor and Delivery Section after being done with scheduled work. Fabian’s selflessness made even more of an impact as the section had an influx of patient admissions and was short-staffed.

“(Nursing) is about gaining trust and providing the quality care the patient requires at that time,” said Fabian, a native of Painesville, Ohio. “I work in (obstetrics) so a lot of times there are happy situations. Times when families are expecting their first, second or third child.”

While only two nurses are recognized each quarter, all nominees are credited for their contributions toward providing high-quality patient care. The award is in honor of Florence Nightingale’s use of a lantern to check on patients throughout the night, dubbing her “The Lady with the Lamp.”

“Nursing to me means providing quality, compassionate care to patients in their time of need, that they may not show you they need that care but it’s something that can change a negative situation into a positive one,” said Fabian, who plans to continue a career in medicine until retirement. “I had one incident when a patient came in bleeding early in her pregnancy and subsequently lost the baby. The patient showed up at my clinic again, and it worried me because I knew what had happened before, the outcome. They wanted to see me and remembered me so I made it a point to come into her delivery because we had bonded through previous experiences and also at her request.”

“Being a nurse is definitely something that is who you are as a person, part of your identity, not something you could ever leave behind,” said Chipman, a native of Plymouth, Indiana. “I do have a lot of patients coming back a lot (for treatment), and it makes them feel comfortable to have a nurse who knows their history, knows how they like to be cared for, because being in a hospital is such a scary time.”

Chipman, who was commissioned two years ago, plans to continue a career in medicine with her eyes set on Pediatric oncology.

To receive the award, nurses are judged on six elements: Love of profession and patient, Inspiration (inspiring others through action), Going above and beyond, Heart (demonstrating compassion and empathy), Teamwork and Selflessness. Together, the elements form the acronym LIGHTS.

To nominate a nurse, patients, physicians and other staff members can submit nominations forms found throughout the hospital and through the WBAMC website.

Author: Marcy Sanchez – William Beaumont Army Medical Center Public Affairs Office 

Fort Bliss WTB Physical Therapist Awarded DOD’s Spirt of Hope

Fort Bliss’ own, Louis Cortez, a physical therapist with the Fort Bliss Warrior Transition Battalion (WTB), was honored with the Spirit of Hope Award at the Pentagon, by Col. Erik Rude, commander, William Beaumont Army Medical Center.

The award, named after the late comedian Bob Hope, is presented to one individual or an organization selected by each branch of service as well as an honoree from the Office of the Secretary of Defense who characterize the values Hope embodied: duty, honor, courage, loyalty, commitment, integrity, and selfless dedication.

“Today’s honorees embody that commitment, they embody that spirit, and they embody the best attributes of (Hope),” said Michael Rhodes, Director of Administration and Management, Office of the Secretary of Defense. “You serve those who protect this nation, you serve those who protect the freedoms we enjoy on a daily basis, so it is an honor to publicly thank and recognize these patriots for what they do for our nation to improve the lives of our troops.”

Cortez, an El Paso native who studied physical therapy in the Netherlands, has worked alongside hundreds of wounded, ill and injured Soldiers with the WTB for the past three years, providing Soldiers an innovative and individual-based approach to physical therapy, resulting in many making full recoveries from debilitating injuries and physical combat-related trauma.

Louis Cortez, physical therapist, Fort Bliss Warrior Transition Battalion, assists Staff Sgt. Franklin Beardsley, a California National Guardsman assigned to the WTB recovering from knee surgery, with proper form during the rehabilitative strength and conditioning program at the WTB, Oct. 2. | U.S. Army photo by Marcy Sanchez

“My mission is to help any ill or wounded Soldiers to recuperate or return to the fight, and if they can’t I help them recuperate as much as they can to become productive veterans,” said Cortez. “I show them that they may not be the same person they were before but there’s many more things they are able to do.”

For almost a year and a half, Cortez’ commitment to Soldiers has helped one Soldier’s return to duty, after suffering multiple injuries and surgeries to his shoulder in addition to being diagnosed with asthma.

“(My unit) sent me to the Warrior Transition Battalion, and I met (Cortez) and from day one we started working on the shoulder which only had about two to three percent range of motion,” said Spc. Ricardo Cabrera-Murphy, a Soldier in transition with the WTB. “I couldn’t even do anything (due to his injuries) not even wash myself, my wife had to help.

“When I got here that’s when everything started changing, (the physical therapy team) started rebuilding me to get me back to where I was,” said Cabrera-Murphy, a native of Carolina, Puerto Rico.

While doubting a successful recovery, Cabrera-Murphy and his family began to plan for his separation from the Army, despite his desire to continue service.

“After the first surgery I was still confident, after the second I thought ‘that’s it for me, I won’t be able to go back to work’,” said Cabrera-Murphy. “As time went on, the shoulder got better and eventually got 85 percent range of motion, I passed my (physical fitness test) and getting back in the fight.”

Cabrera-Murphy credits Cortez and the Fort Bliss WTB for his return to the Force, stating the command continuously emphasized proper recovery and determination.

“I’m so excited because if it wasn’t for (Cortez), I wouldn’t be going back to work,” said Cabrera-Murphy. “(Cortez) is dedicated to the Soldiers, giving them that personal care and not letting anything get by him.”

For Cortez, who has been practicing physical therapy for 20 years, the award was unexpected and came as a surprise after he was selected, but Cortez gives full credit to the Fort Bliss WTB and his coworkers who share a common objective: to make a difference.

“I think the whole WTB deserves recognition because we all do a great job and have a part in taking care of the Soldier,” said Cortez. “This award was unexpected but what gives me the greatest pleasure in my job is making a difference in the Soldiers’ lives and that’s what’s most important to me.”

According to the award citation, Cortez’ reputation as a competent, passionate and effective physical therapist gained the attention of installation leaders and was sought after by the 1st Armored Division to assist with improving the rehabilitative strength and conditioning programs across Fort Bliss, significantly increasing the readiness posture of 1st Armored Division and the U.S. Army as a whole.

“I push the Soldiers to better themselves physically, but when I see them bettering themselves and working harder, it motivates me to work harder for them, it’s back and forth with me,” said Cortez. “The best part of my job is when a Soldier says ‘Thank you. You have helped me through this hard time and you gave me some sort of hope that I can do something with myself’.”

The Spirit of Hope Award was established in 1997 and has been presented to various service members, civilians, organizations and even celebrities such as Kelly Pickler, Toby Keith and Gary Sinise.

“In the past, our honorees have been national or international organizations, possibly world recognized. They’ve been regional or local organizations that maybe only those around them know by name. But, what they all had in common is the fact that they recognize the critical importance of supporting the quality of life of our military personnel and their families,” said Rhodes, during the awards ceremony. “(Hope) and his family will always hold a special place in this Nation and especially in the hearts of the men and women who wear the uniform, who are willing to risk their lives for whatever the Nation may require of them.”

The Department of Defense awarded five individuals and one organization with the Spirit of Hope Award during an awards ceremony at the Pentagon, September 28.

Author: Marcy Sanchez–  William Beaumont Army Medical Center Public Affairs Office

New Audiology Booth Supports East Bliss Readiness

“Say again… Over.” “Say again… Over.” Radio static may be the culprit for some miscommunication, but at times hearing loss may be to blame.

As part of the U.S. Army Hearing Program, Soldiers are required to take a hearing test, attend a hearing conservation briefing, and get fitted for hearing protection annually. To increase Soldier readiness on Fort Bliss, William Beaumont Army Medical Center’s East Bliss Health and Dental Clinic is slated to debut a new eight-station hearing booth, October 1.

The hearing booth will allow Soldiers assigned to the clinic, approximately 5,700, to conduct hearing exams near their Area of Operations while relieving congestion at other clinics through the Fort Bliss footprint.

“The brigade here was going to (Spc. Hugo V. Mendoza Soldier Family Care Center), this will alleviate the strain of trying to get everybody into that one clinic,” said Capt. Lydia Malloy, an audiologist and chief of the Fort Bliss Army Hearing Program. “Access to care is going to be better, hearing readiness is going to be better, all around a good thing.”

According to the Army Public Health Command, Soldiers may be subject to impact noise topping decibel (dB) levels at 175 – 180 dB, a range well above the safe limits of 85 dB for continuous noise and 140 dB for impact noise.

“The reason for the Army hearing program is to prevent noise-induced hearing loss, if we can identify shifts (in hearing capability) early then we can change the behavior to keep it from becoming a problem,” said Malloy. “Eventually that problem may affect someone’s career when you hit a certain point.”

The East Bliss Clinic offer a full spectrum of services from dental to behavioral health but has lacked audiology services since opening its doors six years ago.

“(The addition of the booth) will allow Soldiers to complete their physicals, enhance medical deployability while facilitating a much needed service within walking distance and in their medical home,” said Jackie Beard, clinical nursing officer in charge, East Bliss Health and Dental Clinic. “The booth will also alleviate some of the demands on the other test sites and meet missions.”

The eight-station booth joins two other hearing conservation booths already in use in other primary care clinics throughout Fort Bliss.

The Army Hearing Program consists of four components: hearing readiness, operational hearing services, clinical hearing services, and hearing conservation.

According to Malloy, survivability and lethality also drive hearing conservation amongst Soldiers, to maximize human potential during stressful situations such as combat.

In addition to safeguarding Soldier’s hearing, the new addition to the clinic also improves unit readiness by reserving more time for mission requirements in lieu of medical examinations.

“This booth will have a positive effect on Soldiers’ clinical needs, the installation and overall missions,” said Beard. “We are always forward thinking with new innovative ways to deliver excellent clinical care to our soldiers.”

Author: Marcy SanchezWilliam Beaumont Army Medical Center Public Affairs Office

Gallery+Story: Ft. Bliss Soldiers Earn German Proficiency Badge

Fort Bliss soldiers tested their fitness levels and soldier skills while getting a chance to earn a prestigious honor from a key partner nation.

About 130 soldiers went through a series of mental and physical challenges over five days and tested for the German Armed Forces Badge for Military Proficiency, or German Proficiency Badge for short.

One hundred and six soldiers made the cut and earned the badge, which comes in three classifications – bronze, silver and gold, with gold being the highest.

For U.S. soldiers, it was a way to shake up their training and also learn how the German military operates and trains. The proficiency badge is one of the foreign military badges that American soldiers can wear on their dress uniforms.

For the German Air Force, it is a way to say thanks for decades of hospitality and support at Fort Bliss.

Spc. Sarah Hernandez, from El Paso, said it was an amazing experience to be able to compete for the badge. Hernandez, a graduate of Santa Teresa High School, is a combat medic by trade and works at William Beaumont Army Medical Center in the surgical recovery ward.

Going through the testing for the German Proficiency Badge was a great way to sharpen up her soldier skills and get back to basics, Hernandez said.

“It is great. I love it,” Hernandez said. “In the hospital, you go through phases where you feel a little less like a soldier — doing more civilian-type medical procedures.

“And to be given this opportunity, it gives you a reminder that this is who I am first,” Hernandez said.

Candidates for the German Proficiency Badge went through four varied tests of skills.

They started out doing a 100-meter swim in uniform, but without boots.

German organizers say this is often the toughest test for American soldiers.

They then were challenged during a German physical fitness test – which consists of a shuttle sprint, a timed hanging event from a chin-up bar and a 1,000-meter run.

Next, they were tested on their marksmanship skills using German pistols.

They finished up with a ruck march carrying more than 30 pounds. The length varied – from around 4 miles to 7.5 miles — depending on which classification of the badge they were going for.

The testing was held during regular physical training hours in the morning, so it didn’t interfere with soldiers’ everyday duties.

The German air force conducts testing at Fort Bliss for the proficiency badge and a separate marksmanship badge several times a year.

It is a way to say “thank you” to their American hosts for more than 60 years of partnership at Fort Bliss, said Command Sgt. Maj. Michael Zantis, the senior enlisted leader for the German air force at Fort Bliss.

“We get so much from Americans at Fort Bliss,” Zantis said. “They help us with everything we need. This is one of the things we can give back.”

The Germans have had a presence at Fort Bliss since 1956. In recent years, they have been downsizing. The German Air Force shut down its North American command center at the post in September 2013.

The Germans have continued to operate their air defense center, but have plans to eventually move that to Germany. The air defense center, however, will stay at Fort Bliss to at least 2022.

Staff Sgt. Patrick Lopez, of Shelton, Wash., said he had a great time while testing for the German badge.

“It is awesome,” said Lopez, who is part of the 1st Training Support Battalion, 364th Regiment.

“I am totally honored to be here and be a part of this,” Lopez added. “It is amazing. It is a lot better than I thought it would be. I didn’t know what to expect. I’m having a great time.”

Lopez’s unit is based out of Joint Base Lewis-McChord, Wash., but is here at Fort Bliss for a yearlong assignment.

Second Lt. Jerome Jones, of Baltimore, said the testing was a lot tougher than he expected.

“Honestly, it is difficult,” said Jones, a member of the 93rd Military Police Battalion.

“I thought we could come out here and do this with no difficulties, that it would be easy. It’s not,” Jones continued. “The Germans have a difficult test. I am glad to be able to participate in it.”


Author: David Burge – Special to the Herald-Post | Photos by Steven Cottingham – El Paso Herald-Post

David Burge is a news producer at ABC-7 in El Paso. He has more than three decades of experience writing for newspapers in California, New Mexico and Texas. Covering the military is a particular passion.

WBAMC Soldier Aims to Improve Readiness of Fellow Soldiers

Marksmanship qualification courses are rare opportunities at Army Medical Centers where 24/7 operations essential to the health, and at times lives, of service members, their families and retirees, take top priority.

At William Beaumont Army Medical Center, a Military Treatment Facility which treats nearly 100,000 beneficiaries to include civilian traumas, a patient-filled schedule is an unacceptable excuse for disregarding Soldier duties.

To help Soldiers qualify on “the range,” one Soldier is increasing Soldier readiness at WBAMC through Primary Marksman Instruction (PMI), aimed at improving overall weapons proficiency and range scores in the Army’s Weapons Qualification Course.

“As soon as I showed up here (Troop Command, command sergeant major) tasked me (to provide marksmanship instruction),” said Staff Sgt. Stephen Van Eps, noncommissioned officer in charge, Urology Clinic, WBAMC. “He knows I’m a weapons guy, a gunsmith and he lives right by me.”

In his seven months assigned to the hospital, Van Eps has assisted in coaching dozens of Soldiers. Over his military career, Van Eps estimates he has coached over 100 qualification courses and oversaw at least 50 of them as the noncommissioned officer in charge.

The Master Marksmanship Training Course, a pilot program for marksmanship instructors in the Army, was recently launched. However, Van Eps, who hasn’t attended the course, credits his service as an infantryman in the Marine Corps for four years with launching his knack for shooting iron.

“To me (marksmanship instruction is simple), it’s just the standard,” said Van Eps, a graduate of the Marine Corps’ Primary Marksmanship Instructor (PMI) school, which develops marksmanship coaches to assist and instruct in small-arms fire. “I don’t do anything different, I just do what I do when it comes to any type of training.”

Recently, Van Eps was presented a token of appreciation from the German Air Force Air Defense School at Fort Bliss, Texas, for providing instruction on the M16 rifle and M9 pistol qualification courses to several German Air Force members, resulting in all 10 shooters placing in the sharpshooter or expert levels on the M16 and 70 percent of shooters qualifying with the M9 pistol.

“(Being recognized) was a huge honor, I was shocked to hear about it,” said Van Eps, a native of Morris, Minnesota. “There’s not that many opportunities for them to qualify on these weapons, so we taught one on one and small group instruction helping them identify deficiencies.”

While Van Eps, who holds an associate of science in firearm technology, has brought a wealth of marksmanship knowledge to WBAMC Soldiers, he credits other Soldiers for the increase in proficiency.

“I started recruiting within the hospital for coaches immediately after the first range,” said Van Eps. “I assessed who knew what they were doing, how they were shooting, and put together a comprehensive training plan to build safety and coaching mentalities in these coaches.”

According to Van Eps, a combat veteran with multiple deployments as a flight paramedic, marksmanship training at Military Treatment Facilities (MTFs) is unique because of the emphasis on patient care. While some Soldiers are assigned to front-line units throughout their careers, others may not be afforded the opportunity, possibly compromising basic Soldier skills, such as marksmanship.

“If you don’t have (marksmanship) knowledge like this (qualifying) becomes complex,” said Van Eps. “(Noncommissioned officers at WBAMC) are trying to develop those skills in young Soldiers, across the board, not only in marksmanship. We’ve seen results the last few ranges with more than 95 percent qualifying, something unheard of in the medical community.”

A husband and father of three, the firearm enthusiast has extended his training to family members and enjoys watching them progress with different weapons systems.

“I’m an avid hunters, and have gone through several types of weapons courses,” said Van Eps.

Van Eps has qualified on weapons courses as an expert multiple times and hopes to one day qualify for the President’s Hundred Tab, a badge awarded to the top 100 civilian and military shooters in prestigious shooting competitions.

“I’m not an expert coach, I’m not an expert in marksmanship, but I am an expert in the basics,” said Van Eps, humbly. “As long as you master the basics you can do anything.”

Story by Marcy Sanchez – William Beaumont Army Medical Center Public Affairs Office

WBAMC’s Addiction Medicine Intensive Outpatient Program Shifting Culture, Stigma at Fort Bliss

From tanks and fighter jets to grenades and cadence, the public’s perception of the military as an institution and the culture varies.

Perceptions within the ranks also extend to service members who fear reprisal if asking for help, a stigma the staff at Fort Bliss’ Addiction Medicine Intensive Outpatient Program (AMIOP) are working to end.

Since opening doors to Fort Bliss service members just over a year ago, over 150 service members have completed a six-week program at the AMIOP to sober up and break free from addiction. But, according to the experts, the AMIOP is only the beginning of recovery.

“Initially (service members) start at (Substance Use Disorder Clinic Care, or SUDCC) for most cases,” said Gisela Carter, program director, AMIOP / Partial Hospitalization Program (PHP). “A lot of times they get sent fairly quickly to us if they have higher needs.”

The AMIOP, the only one of its kind at Fort Bliss, offers intermediary rehabilitation for service members and provides a level 2.5 level of care based on the American Society of Addiction Medicine’s (ASAM) continuum of care which describes treatment as a continuum marked by four broad levels of service and an early intervention level. The lowest level of care, according to ASAM, is at level 0.5, early intervention, with the highest being at level 4, medically managed intensive inpatient services. The six-week-long program differs from SUDCC by approaching addiction with a full schedule of therapy modalities designed to keep patients engaged and practicing methods toward rehabilitation.

“We provide the tools during that six-week program and collaborate with patients (after completing the program) to see how they are using the tools,” said Maj. Marlene Arias-Reynoso, AMIOP medication provider/ SUDCC consultant and chief of 1st Brigade Combat Team, 1st Armored Division Embedded Behavioral Health. “The earliest they come and get help, the more effective the treatment will be. If they don’t come until a DUI later, there’s already things in place. Although the Soldier may want to recover, their career may likely be over.”

For one Soldier, a self-referral helped set up the Soldier to continue in the Army before the addiction took over.

“I had personal issues that escalated and I started going to Embedded Behavioral Health to get help then I was introduced to the program,” said the Soldier. “I was off-track very badly, everybody saw a change in me, even (senior leaders) before going through AMIOP.”

The Soldier, who wishes to remain anonymous, initiated his recovery at SUDCC and eventually found himself at the AMIOP for elevated care.

“For the first two weeks, like most people, I thought this was a bunch of BS. We’re going to come in here and sing Kumbaya, a lot of people are just going to say, ‘this is what you should do…’ but after we got past that particular phase, I had a few emotional days. They started to peel the layers off the onion to figure out what makes us turn to using substances,” said the Soldier. “It provided an open forum, where you can actually speak to others going through the same thing, because back in the unit you can’t speak to others freely. The group is where everybody opened up, in that forum, with a bunch of strangers and I put my business out there, but to this day we still have that group that we had.”

The Soldier’s perception of stigma surrounding Soldiers who ask for help is one the AMIOP staff is working to transform.

“There’s still a huge stigma about people who are recovering. There are still negative connotations with it,” said Carter. “Sometimes the value of the Soldier decreases and becomes negative because of the stigma, people refer to them as ‘bad for the unit’.”

In 2016, the Army Public Health Command’s Health of the Force report, a force-wide annual report discussing factors impacting Soldier readiness, lists five percent of active-duty Soldiers across the Army as being diagnosed with substance use disorder. The report consolidates the misuse and abuse of alcohol with prescription medication and other drugs.

“The longer you keep struggling with whatever substance, the worst the outcome is going to be. Habits are hard to break, so addicts may go back to (abusive) behaviors,” said Arias-Reynoso. “This is only six weeks, after that are the challenging times. The certificate (for completing the AMIOP program) is not the end, it’s the beginning.”

According to the Soldier, one activity at the AMIOP helped him realize the importance of scheduling and keeping him active to deter him from negative behaviors.

“I’m back to the (Soldier) who (other Soldiers) knew. I had stopped going to the gym, I loved being outdoors and I had gotten away from all of that because of depression, anxiety, and crazy thoughts going through my head,” said the Soldier. “I needed to eliminate the drinking, because at first I just wanted to minimize. But, (at the AMIOP) you have breathalyzers, urinalysis, AA meetings, which are eye-openers, just to see the long-term effects of what alcohol was doing.”

By starting treatment, the Soldier was also able to reconnect with a daughter who was beginning to notice the changes.

“I have no problem talking, but I wasn’t reaching out to my family as much (when the Soldier started drinking heavily). Once I opened up to family, it became easier to speak more about (addiction). Now our conversations are back to normal,” said the Soldier.

“When we have graduation in six weeks, I always tell (patients), this is genesis, this is the beginning, this is the initial start of the recovery,” said Carter. “There’s after-care at the SUDCC, in addition they come back to us on Fridays for several weeks to see how they are doing. It is like a recovery group for patients that have attended the AMIOP, and on the outside they continue that external support system like Alcoholic Anonymous or Narcotics Anonymous.”

According to AMIOP staff, continuity of treatment is essential in recovery and staying sober, with many programs designed to continue care three to six months after completing the program, to include family counseling.

“The program definitely gave us different tools to deal with the triggers, I don’t even go out to clubs anymore, I go do my activity and back to the house,” said the Soldier. “It’s helping me deal with everyday life and motivate me not to drink. As long as you have like-minded people and someone who has been through a similar experience, then you can relate. And that’s one of the best things about the program.”

Two cohorts of eight service members occupy the program year round, with each cohort’s participants starting at the same level of recovery.

“Recovery is not just something that happens, it’s a process and people have to continue to work on it,” said Carter. “Sometimes we have patients here until the day they walk out the gate (are out of the military), if a patient is willing to stay and work with us then we’re willing to admit them.”

“The tools that they learn here, even as civilians they can potentially apply them to their lives,” said Arias-Reynoso. “Being sober is not recovery. Have you changed your lifestyle? Not just stop your substance.”

Each September is Recovery Month, a Substance Abuse and Mental Health Services Administration-sponsored observance to increase awareness and understanding of mental and substance use disorders and celebrate those who recover. This year’s theme is: Join the Voices for Recovery: Invest in Health, Home, Purpose, and Community.

In efforts to increase awareness of addiction symptoms, the AMIOP recently provided training to primary care providers at Fort Bliss to help identify addictive behaviors, during regular exams to help service members before it becomes a habitual juggernaut.

“Anybody that actually needs help, no matter what your rank, don’t be afraid to stand up and say something,” said the Soldier. “Just speak up, don’t try to handle all issues by yourself. I always thought I was one of those people where it won’t happen to me and I had my stuff together but I didn’t… and it all came crumbling down.”

Today, the Soldier is back at his unit and working toward bettering himself while continuing counseling during recovery.

Multiple referral options exists for service members seeking treatment including self, physician and command referred. All patients are required to enroll in SUDCC prior to seeking higher levels of care.

Author: Marcy Sanchez William Beaumont Army Medical Center Public Affairs Office

El Paso-Based Reserve Unit Boosts Medical Readiness at Fort Bliss

Approximately 30 Soldiers with the 7248th Medical Support Unit (MSU), based out of El Paso, conducted an Annual Training event at William Beaumont Army Medical Center, providing additional healthcare support to Soldiers, retirees, families and other beneficiaries in the area.

The unit, which falls under the 7454th Medical Backfill Battalion out of San Antonio, is comprised of different medical professionals from patient administration specialists and combat medics to nurse practitioners and physician’s assistants.

“Our mission was to support the hospital in various departments,” said Maj. John Buen, a Certified Registered Nurse Anesthetist and officer in charge of the detachment. “We had Soldiers supporting (laboratory services, labor & delivery, and medical, surgical and behavioral health inpatient wards) for two weeks. The training helped supplement our own training to keep (reserve-component Soldiers) competent in their skills.”

The locally-based MSU provides medical support to Military Treatment Facilities throughout the Army through personnel backfills to sustain uninterrupted medical operations. Because the unit is mostly comprised of medical professionals, Soldiers are spread throughout WBAMC to provide premium training opportunities related to their Military Occupational Specialty (MOS) and provide a real-world experience.

“It was a good learning experience,” said Spc. Levi Raygoza, patient administration specialist, 7248th MSU. “I learned more (at WBAMC) than I did at (during initial MOS training).”

This is the first annual training Raygoza, an El Paso native, has been assigned for. A college student while out of uniform, Raygoza, who enlisted in the Army two years ago, said he believes the two-week exercise will prepare him for potential assignments in the future.

“(The staff) covered pretty much everything of what our job entails,” said Raygoza. “By the fourth day I was already on my own. With a little more training I would (feel comfortable) being activated.”

For several Soldiers, like Buen, the mission is an extension of their civilian occupations, providing added training for their civilian occupations and adding diverse work experience at WBAMC work areas.

“If we can provide manpower to help the hospital and promote (Soldier) skillsets at the same time,” said Buen, who also works as a civilian CRNA in the El Paso Community. “It’s a win-win for both institutions.”

The annual training event was held from July 8-20.

Col. Shawna Scully (left), deputy commander for medical services, William Beaumont Army Medical Center, and Sgt. Maj. Dina Pang, chief clinical noncommissioned officer, present reserve-component Soldiers with the 7248th Medical Support Unit commander’s coins for their service during an annual training event at WBAMC, July 20. |
Photo by Marcy Sanchez

Story: Marcy Sanchez – William Beaumont Army Medical Center Public Affairs Office

WBAMC ‘Mystery Shopper’ Aims to Gauge Patient Experience

William Beaumont Army Medical Center’s Patient Assistance Office recently kicked off a program to measure quality of outpatient encounters and provide immediate feedback to providers, clinics and other hospital staff.

The program, similar to retail-industry mystery shopper programs, entails patient advocates randomly questioning consenting patients who have recently completed a medical appointment at any of WBAMC’s primary care or specialty care clinics.

“The intent is to give patients the opportunity to give us (immediate) feedback of their experience, positive or negative,” said Thomas O’Dea, patient advocate, WBAMC. “From the beginning of their appointment to the end, we want to know what they thought.”

Patients have always had an opportunity to provide feedback concerning their experiences through traditional means such as Interactive Customer Evaluations (ICE) comments and the Military Health System’s recently launched Joint Outpatient Experience Survey (JOES). Outpatients can expect a JOES survey a few days after appointments and may return the survey via mail or electronically.

In addition to allowing patients to provide instant feedback, the mystery shopper program allows for WBAMC patient advocates to correct or address concerns on the spot.

“We want (patient’s) information, their name, phone number, so that if we do get a negative feedback we can address the situation and that’s where we want to go with it, we want to be able to reach back to (the patient),” said O’Dea. “It’s to add that personal factor to (patient’s experience), and the survey can provide us with a lot of good information, such as: are we doing the right thing, are we becoming complacent, that feedback is valuable overall for the organization as it carries over to JOES.”

The Military Health System’s patient satisfaction survey, JOES, assesses outpatient beneficiary experiences at Military Treatment Facilities (MTFs) allowing the MHS to compare results to the civilian benchmarks. Patient advocates plan to launch a similar mystery shopper program directed at inpatient experiences to supplement the TRICARE Inpatient Satisfaction Survey (TRISS), aimed at gauging inpatient experiences.

Providing high-satisfaction rated feedback on surveys like JOES and TRISS also impact medical operations directly through monetary incentives for increased medical resources such as staff and equipment as well as patient amenities such as recent mobile device charging stations available in select wait rooms.

For patients such as Sgt. Emmanuel Rivera, customer service is essential to meeting objectives.

“It’s not about doing the job faster but improving customer service,” said Rivera, a culinary specialist with 1st Battalion, 36th Infantry Regiment, 1st Stryker Brigade Combat Team, 1st Armored Division. “Good customer service helps keep customers.”

As an employee in the food service industry, guest relations are essential to daily operations for Rivera, who says he’d prefer to give instant feedback on his experience over waiting for a survey.

According to O’Dea, patients can provide feedback on any part of their WBAMC experience, from the first interaction while making an appointment to picking up any prescribed medications at pharmacies.

“It begins with first interaction with our facility which could be the appointment line, whether patients couldn’t get through (to schedule an appointment) or if there’s a certain number that is not working. We’ll alert those who can fix it,” said O’Dea. “It’s the whole experience, until they finish. We’re excited about it. We care about your experience and we care about our facility.”

Primary care clinics throughout the WBAMC footprint will also participate in mystery shopper surveys. For more information, contact WBAMC the Patient Assistance Office at 915-742-2692.

Author: Marcy Sanchez –  William Beaumont Army Medical Center Public Affairs Office 

WBAMC’s Child, Adolescent and Family Behavioral Health Service Hosts ‘Camp Wonder’

William Beaumont Army Medical Center’s Child, Adolescent and Family Behavioral Health Services welcomed 17 school-age children to a week-long camp designed to discuss experiences in a safe and supportive environment at Fort Bliss.

The summer camp, dubbed “Camp Wonder,” included four half-day sessions comprised of three counselor-led sessions targeting self-esteem, empowerment, depression, anxiety, behaviors, coping skills and social skills. Children completing kindergarten through fifth grades from Milam, Bliss and Colin L Powell Elementary Schools, were divided into age-appropriate groups to encourage interaction and uniform progression with peers.

“This is a great program for my son to participate in dealing with emotional and socioemotional feelings,” said Ebonie Sanchez, a military spouse at Fort Bliss and mother of three. “I thought it would be really good for him because he is young, so any aspect that can help him with his maturity level and growth, I’m all about it.”

In collaboration with Army Community Services, the camp also engaged parents with workshops addressing behavioral reward systems, medication management, family strengthening, and special education services available at Fort Bliss schools. During the camp, children were introduced to a reward system, earning small prizes for accomplishing daily goals. Parents were encouraged to continue the reward system at home, utilizing leisure activities such as video games and cell phone usage as rewards.

“Since he first found out he was going to the camp he asked question after question,” said Sanchez. “After coming home that first day he was ecstatic, he had so much fun he showed me a reward system they implemented and that gave him motivation to do more positive things to gain rewards.”

“Because school behavioral health is embedded within schools, during the summer they don’t have any children (assigned to programs) so they host camps and groups,” said Lashonda Bogan, outreach coordinator, Child, Adolescent and Family Behavioral Health Services, Department of Behavioral Health, WBAMC. “(The workshops) incorporate parenting classes into what the kids are learning, so (parents could continue to engage at home).”

According to Bogan, the short groups and camps offered during the summer allow eligible children to participate in programs before committing to services during the school year. Programs are aimed at increasing understanding and awareness of special-needs children to better prepare military families for challenges such as deployment of service-members, adding to unit readiness.

The program introduced Sanchez’ six-year-old son, DeAaron, to social settings outside of school while also addressing feelings, bullying and respecting others and themselves.

“It might be their first time being around other kids they could identify with,” said Bogan. “Knowing everyone in the camp (is unique), made campers more comfortable being themselves.”

“(DeAaron) has (Attention-deficit/hyperactivity disorder) so sometimes sitting down and calming down to get all the instructions (at school) is difficult for him,” said Sanchez. “He is learning about being courteous and those life skills parents want them to have to be successful.”

The camp wrapped up with a closed performance for parents featuring children singing as a choir about bullying and respect and swimming at the Fort Bliss Aquatics Training Center.

When asked what he enjoyed about the camp, DeAaron answered “the song,” while also adding he had fun during the camp.

“I’ve seen changes,” said Ebonie Sanchez. “I’m very involved in every aspect of his life, as much as I can be. (Camp coordinators) did have a mandatory meeting for the parents where bullying and coping with certain emotions were discussed, which I felt was a really great aspect of the camp.”

For the soon-to-be first grader, DeAaron says he’ll take what he learned and apply it to school, a goal Sanchez yearns.

“I feel like this was a positive camp that allowed children to work in an environment they felt was fun but also gained the skills of cooperating with others, showing respect and learning about bullying,” said Sanchez. “I look forward to him continuing using the skills he learned here and help him be successful in the next grade level.”

“All of us have our own things that make us different, but we shouldn’t treat anyone differently,” said Bogan.

The summer camp was held June 18 through 22.

Author:  Marcy Sanchez  – William Beaumont Army Medical Center Public Affairs Office

WBAMC Doctor Transplants Ear “Grown” on Soldier’s Forearm

Plastic surgeons at William Beaumont Army Medical Center successfully transplanted a new ear on a Soldier who lost her left ear due to a single-vehicle accident.

The total ear reconstruction, the first of its kind in the Army, involved harvesting cartilage from the Soldier’s ribs to carve a new ear out of the cartilage, which was then placed under the skin of the forearm to allow the ear to grow.

“The whole goal is by the time she’s done with all this, it looks good, it’s sensate, and in five years if somebody doesn’t know her they won’t notice,” said Lt. Col. Owen Johnson III, chief, Plastic and Reconstructive Surgery, WBAMC. “As a young active-duty Soldier, they deserve the best reconstruction they can get.”

The revolutionary surgery has been over a year in the making for Clarksdale, Mississippi native, Pvt. Shamika Burrage, a supply clerk with 1st Battalion, 35th Armored Regiment, 2nd Brigade Combat Team, 1st Armored Division.

In 2016, while returning to Fort Bliss, Texas, after visiting family in Mississippi, a tire blowout changed Burrage’s life in an instant.

“I was coming back from leave and we were around Odessa, Texas,” said Burrage, who was travelling with her cousin. “We were driving and my front tire blew, which sent the car off road and I hit the brake. I remember looking at my cousin who was in the passenger seat, I looked back at the road as I hit the brakes. I just remember the first flip and that was it.”

The vehicle skidded for 700 feet before flipping several times and ejecting the Soldier. Burrage’s cousin, who was eight-months pregnant at the time, managed to only suffer minor injuries while Burrage herself suffered head injuries, compression fractures in the spine, road rash and the total loss of her left ear.

“I was on the ground, I just looked up and (her cousin) was right there. Then I remember people walking up to us, asking if we were okay and then I blacked out,” said Burrage, whose next memory was waking up in a hospital.

She was later told by doctors if she would not have received medical attention for 30 more minutes, she would have bled to death. After several months of rehabilitation, Burrage began to seek counseling due to emotions caused by the accident and its effects on her appearance.

“I didn’t feel comfortable with the way I looked so the provider referred me to plastic surgery,” said Burrage.

“She was 19 and healthy and had her whole life ahead of her,” said Johnson. “Why should she have to deal with having an artificial ear for the rest of her life?”

When explained her options for reconstruction, Burrage was shocked and initially resistant to go through with the total ear reconstruction.

“I didn’t want to do (the reconstruction) but gave it some thought and came to the conclusion that it could be a good thing. I was going to go with the prosthetic, to avoid more scarring but I wanted a real ear,” said Burrage, who is now 21. “I was just scared at first but wanted to see what he could do.”

In order to avoid any more visible scarring, Johnson selected prelaminated forearm free flap, which involved placing the autologous cartilage into the patient’s forearm to allow for neovascularization, or the formation of new blood vessels. This technique will allow Burrage to have feeling in her ear once the rehabilitation process is complete.

“(The ear) will have fresh arteries fresh veins and even a fresh nerve so she’ll be able to feel it,” said Johnson.

In addition to the transplant, epidermis from the forearm, while attached to the ear, will cover up scar tissue in the area immediately around Burrage’s left jawline.

“I didn’t lose any hearing and (Johnson) opened the canal back up,” said Burrage, whose left ear canal had closed up due to the severity of the trauma.
“The whole field of plastic surgery has its roots in battlefield trauma,” said Johnson. “Every major advance in plastic surgery has happened with war. This was trauma related.”

With only two more surgeries left, Burrage states she is feeling more optimistic and excited to finish the reconstruction.

“It’s been a long process for everything, but I’m back,” said Burrage.

Author: Marcy Sanchez – WBAMC/US Army

New Simulator Preps WBAMC Staff for OB Emergencies

A new simulation system at William Beaumont Army Medical Center’s Labor & Delivery Department aims to improve patient care and safety through advanced training simulations.

The state-of-the-art simulator provides WBAMC staff up to various cutting-edge training scenarios which are documented and transmitted to allow for instant feedback on the exercise, increase communication during emergencies, and improve interdisciplinary and clinical performance.

“We have been doing monthly simulation training for years. However, the (new simulation system) is a more advance simulator that will provide feedback to the team regarding their performance” said Maj. Laquincyia Key, clinical nurse specialist, Maternal-Child Health Services (MCHS), WBAMC. ”

The new simulator follows standardized guidelines from the American College of Obstetricians & Gynecologists, which not only provides health care staff with instant feedback from the exercise according to their performance, but also collects and transmits the data to the Defense Health Agency to advance and standardize training platforms. According to Key, the new simulator also meets required DHS’s biennial training mandates.

“The (previous simulation system) needed updating and wasn’t able to collect training data and track clinical outcomes,” said Key. “The (new simulation system) has pre-programmed scenarios with Internet curricula available.

Because most patients at WBAMC’s L&D are low risk, the simulator helps train and prepare staff for emergency cases. Scenarios such as postpartum hemorrhage, umbilical cord prolapse, shoulder dystocia, eclampsia, breech vaginal delivery and operative vaginal delivery are feasible with the simulator to provide staff opportunities to improve obstetric emergency skills.

“Communication and organizational culture are the root causes of most cases of perinatal death and injury,” said Key. “Simulation-based training allows the team to practice high-risk, low-volume obstetric emergencies in preparation for when these events actually occur. They are able to identify areas of improvement and evaluate their team’s performance with non-judgmental debriefing.”

Scenarios also supports WBAMC Simulation Center’s continuing mission to produce measureable outcomes from scenario-based training.

Added features include a medical manikin capable of birthing an infant manikin which allows staff to conduct neonatal resuscitation training. Over 100 newborns are delivered each month at WBAMC.

Author: Marcy Sanchez – U.S. Army/WBAMC

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