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Home | Tag Archives: William Beaumont Army Medical Center’s Neurology Clinic

Tag Archives: William Beaumont Army Medical Center’s Neurology Clinic

Revamped Curricula at WBAMC’s Sim Center Aims to Increase Safety, Readiness

William Beaumont Army Medical Center’s Simulation Center kicked off the first of a series of revamped medical programs for medical students, staff, nurses and physicians at the hospital as part of the recently provisionally accredited center’s goal to achieve outcomes in medical simulation processes implemented at the center.

The center introduced a newly-revised curriculum for suturing and wound closures to students of the hospital’s Interservice Physician Assistant Program (IPAP), one of six Graduate Medical Education programs at WBAMC, during a scenario-based training, March 9.

“A credentialing body wants to see what the credentialing is for. So the more complete the course we can show them is, the better,” said Thomas Soto, simulation technician, WBAMC. “They don’t want to come in and credential random training.”

The step toward standardizing processes in the new curriculum will evaluate students based off scenario-based training, with students required to accomplish objectives during evaluation.

“(Faculty and students) have been (engaged in didactics) but they weren’t covering (scenarios) in detail and putting it into application,” said Joe Lloyd, interim nurse educator, Simulation Center. “Basically this is our (new) policy and we present scenarios and (situations to medical staff and students) where they have to act on the situation.”

The Simulation Center recently presented scenario-based training during an Emergencies in Clinical Obstetrics course aimed at providing OB-GYN staff training on situations from shoulder dystocia, hemorrhage to breech deliveries.

According to Soto, this type of training will not only prepare healthcare professionals for different patient situations but also increase patient safety.

“Whatever (students) end up doing (at the simulation center), when they actually go see the patient they’ll be more prepared for it because they’ve came in here and have done the repetitions,” said Soto.

Aside from increasing patient safety and staff readiness, the center’s upgraded curricula will also minimize the need for training outside of WBAMC. The center expects to recapture training currently performed at other health centers in the region, due to the increased trauma cases at the community hospitals.

“(Medical education programs at the hospital) have to get so many students to perform certain medical procedures, and there isn’t enough patients (requiring those procedures), so they have to do simulation,” said Lloyd. “We have all these different (medical education) programs that want to practice so to give exposure to everyone we have to simulate the environment.”

Future revamped training curriculum is anticipated to continue engaging staff and students throughout all of the medical education programs at the hospital. The center also hopes to incorporate role players in future simulations to educate and evaluate patient engagement and communications.

“(Students) will have to talk to a patient, do their assessment as part of their procedure, and perform that wound closure on a (mock) patient and a simulation model,” said Soto, discussing the IPAP suture/ wound closure scenario in particular. “(The scenario-based training) will improve patient care and make our simulation center premier.”

Author: Marcy Sanchez – WBAMC

WBAMC Neurosurgeon Helps Soldiers Return to Duty

William Beaumont Army Medical Center’s Neurology Clinic is taking a different approach to beneficiaries suffering from neck pain.

Neurosurgeons at the clinic are combating cervical disc disease, a common condition among the military population, by performing cervical disc arthroplasty (CDA), or disc replacement surgery, on beneficiaries who may be experiencing the painful effects of the wear-and-tear condition.

“I believe in the procedure because it promotes faster recovery, and reduces the chance of degenerating the disc above and below,” said Dr. Pedro Caram Sr., senior neurosurgeon, WBAMC.

The joint replacement surgery involves replacing damaged cervical disc(s) with prosthetic disc(s). The treatment may provide relief for patients by decompressing or relieving pressure on the spinal cord or nerves and restoring stability and alignment.

Other symptoms from a degenerative disc may include increased pain in shoulders, arms and in some cases may even lead to migraines.

Dr. Pedro Caram Sr. (left), senior neurosurgeon, Neurology Clinic, William Beaumont Army medical Center, performs a multilevel hybrid cervical disc arthroplasty on a patient suffering from multilevel cervical disease during a surgery at WBAMC. (Photo Credit: Marcy Sanchez)

“I’ve treated people with what they thought were migraines but really their necks were causing the problem,” said Caram, a native of Houston. “(Staff) examines patients very carefully in the clinic. I don’t let them get away without an exam and look to find out what they’ve done from a conservative (management) standpoint, find out if they’ve had any trauma and go over medications.”

The initial examination also includes a look over pain history, spasms and a test of strength, the results of which alarms most patients.

“(Caram) proved I was a lot weaker strength-wise on my first visit,” said 1st Sgt. Joseph Phillips, C Company first sergeant, 1st Battalion, 6th Infantry Regiment, 2nd Brigade Combat Team, 1st Armored Division. “The pain limited my ability to do pushups, sit-ups, wear body armor for long durations, it would hurt.”

When he began noticing a consistent pain in his neck and shoulders, Phillips, a native of Prince Frederic, Maryland, began seeking medical attention and was eventually referred to the Neurology Clinic. Phillips was also suffering from tingling of the hands, numbness of the arms and the aforementioned loss of strength.

“It was pretty consistent, everyday all day like a five or six (on a pain scale of one to 10),” said Phillips.

After a visit with Caram, Phillips, an 18-year Calvary Scout veteran, was recommended for surgery.

Caram favors CDA over the traditional treatments which may lead to delayed recovery.

A prosthetic cervical disc is shown (Photo Credit: Marcy Sanchez)

In 2007, the Food and Drug Administration approved CDA as an option for treating cervical disease. In 2009, Caram spearheaded the procedure at WBAMC and has since performed dozens of surgeries.

According to an article Caram and colleagues published in the Journal of Surgical Orthopaedic Advances, in a study of 34 single-level CDA patients, 30 returned to duty with an average 8.5 weeks of recovery time. In a multilevel cervical disc disease study with a hybrid approach to treating the disease, meaning CDA and cervical spinal fusion applied, out of 30 patients, 24 were able to return to active duty with an average 15.6 weeks of recovery.

For Phillips, a 37-year-old father of two, results were immediate following his multilevel hybrid cervical disc arthroplasty.

“I had no more issues, no more tingling and my strength came back immediately,” said Phillips.

Prior to the surgery, Phillips would struggle to throw a ball and play with his two daughters, said Phillips. Six weeks into his post-operation recovery, Phillips is able to participate in more physical activities at home than before.

“It proves that us older guys should have got fixed a lot sooner, we should have paid a little more attention to our bodies over the last 18 years,” said Phillips.

“(Phillips) will be fit for duty. That’s what our goal is: to make them fit for duty,” said Caram.

Author: Marcy Sanchez – WBAMC / DVIDS

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