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Current Marine Corps Medical Operations

Current Marine Corps Medical Operations. Director, Health services, Headquarters, U. S. Marine Corps RADM Richard R. Jeffries. IED. !!Corpsman Up!!. JOHNSON, MICHAEL V HM3 03/25/03. MENDEZ – ACEVES, FERNANDO A HM3 04/06/04. WOODS, JULIAN HM3 11/10/04. HOUSE, JOHN D HM3 01/26/05.

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Current Marine Corps Medical Operations

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  1. Current Marine Corps Medical Operations Director, Health services, Headquarters, U. S. Marine Corps RADM Richard R. Jeffries

  2. IED

  3. !!Corpsman Up!!

  4. JOHNSON, MICHAEL V HM303/25/03 MENDEZ – ACEVES, FERNANDO A HM304/06/04 WOODS, JULIAN HM311/10/04 HOUSE, JOHN D HM301/26/05 KENT, AARON A HN04/23/05 WIENER, JEFFREY L HM305/07/05 BAEZ, CESAR O HM206/15/05 YOUNGBLOOD, TRAVIS L HM307/15/05 MARTENS, ROBERT N HN09/06/05 THOMPSON, CHRISTOPHER W. HM3(FMF/SW)10/21/05 SARE, CHARLES 0 HN10/23/05 ESPIRITU ALLAN, M. CUNDANGA HM2(FMF/PJ)11/01/05 PADILLA-ALEMAN, GEOVANI HN04/02/06 NETTLES, MARCQUES J. HM304/02/06 DEAL, HAMILTON LEE HM305/17/06 JAENKE, JAIME HM206/05/06 ALDAY, ZACHARY M. HN06/09/06 KENYON, CHADWICK T. HN08/20/06 WALSH, CHRISTOPHER G. HM209/04/06 ANDERSON, CHRISTOPHER A HN12/04/06 NOLEN, KYLE A HN12/21/06 CONTE, MATTHEW G HN02/01/07 MINJARES JR., GILBERT HM102/07/07 RUIZ, MANUEL A. HM302/07/07 EMCH, LUCAS HM3(FMF)03/02/07 NOBLE, DANIEL HN(FMF)07/24/07 Iraq 2003 - Present 26 Hospital Corpsman KIA

  5. BOURGEOIS, MATTHEW HMC03/28/02 BURNETT, DUSTIN K HN06/20/08 TAYLOR, JEFFREY S HM1(SEAL)06/28/05 ANTHONY CARBULLIDO HM2(FMF)08/08/08 FRALISH, JOHN T HM302/06/06 STRICKLAND, EICHMANN HM309/09/08 MILAM, CHARLES L HM2(FMF)09/25/07 GARCIA, ANTHONY C.HM305/08/09 CASTIGLIONE, BENJAMIN HM3(FMF)09/03/09 CANNON, MARK R HM3(FMF)10/02/07 RETMIER, MARC A HN06/18/08 LAYTON, JAMES R HM309/08/09 Afghanistan 2001 - Present 12 Hospital Corpsman KIA

  6. GLOBAL FORCE DISPOSITION (AS OF 17 SEP 09) Active Duty 203,505 Activated Reservists 8,762 Active Reserve 2,172 Total 214,439 + = + PACOM: ~3,000 OTHER CENTCOM: ~2,800 AFGHANISTAN: ~10,100 IRAQ: ~11,900 COMBINED ENDEAVOR LOYAL MIDAS MPF OFFLOAD 09 M2M NAVAL INFANTRY BN ASSESSMENT M2M BASIC OFFICERS COURSE-EUROPE GEORGIA DEPLOYMENT PROGRAM-ISAF MORTUARY AFFAIRS TRAINING USEUCOM MEB-A ANA ETTs MSOCs AFGHANISTAN INTEL DET NCO DEVELOPMENT SEC FOR OEF-P II MEF (FWD) VMAQ-3 VMAQ-4 IRAQ MOJAVE VIPER WTI JTF-EX CONUS HEAVY HELO DET USAFRICOM 31ST MEU USPACOM 22D MEU USCENTCOM PANAMAX 09 SMALL UNIT TACTICS COLOMBIAN ROE/RUF PERU MEDRETE USSOUTHCOM M2M OEF TRANS SAHARA LOG ASSESS M2M NCO DEVELOPMENT TCT MIBOC-A M2M LOGISTICS/EMBARK TCT USAFRICOM EOD DET GOLD EAGLE MARINE LEADERSHIP DEV KOREA INTER OP USPACOM MSOT USSOUTHCOM USCENTCOM FAST PLTS USEUCOM USCENTCOM USPACOM USSOUTHCOM OEF / OIF / COMBAT EMBARKED WITH USN NORTHCOM: 0 AFRICOM: ~100 CONUS: ~2,200 SOUTHCOM: ~200 EUCOM: ~400 USMC DEPLOYMENTS

  7. Iraq Today – Sustainment and Security operations 11,900 Marines Currently in Iraq

  8. Legend Area with heavy Taliban/ Insurgent activity Area with substantial Taliban insurgent activity Area with light Taliban/insurgent activity Main Road Secondary Road Tanjii Valley, Taliban Base Major supply route in and out of Afghanistan Afghanistan Today 10,100 Marines Currently Fighting in Afghanistan Current Focus of Marine Corps Combat Operations RC SOUTH

  9. Our World Has Changed • General Magnus at CMC Staff Meeting • “How are we doing medical care in Afghanistan today – with small teams far forward with no air cover or CASEVAC after dark – in the valleys and mountainous terrain in the winter, with limited comm (satellite at best) – and in the enemies geography?”

  10. Our Enemy

  11. Evolution of Surgical Capability Al Khanjar, Saudi Arabia – Feb 91 1st Med Bn Chu Lai – 1968 FRSS -2003 Mobile Trauma Bay - 2009

  12. First Responders

  13. Resuscitative Care: BAS GMO – Now BAS Surgeon - Future

  14. To Other Facility ERCS CASEVAC LRR (200mi minimum) BAS STP FRSS MEU LHA/LHD CASEVAC SR (up to 200mi) FEBA USMC Level I/II Medical THE BIG PICTURE

  15. Level 2 – Resuscitation STP Team FRSS En-Route Care Team

  16. FRSS – The Answer Expeditionary Maneuver Warfare • Small medical footprint • Time and distance from wounding to definitive care can be markedly increased • Need for surgical care in close proximity to battle • Need for agility, flexibility and rapid mobility • Need for movement of critical patients quickly and rapidly • Must be modular and easily transportable New Surgical Company Concept March 2007 HS-I&L OAG Dynamic, Asymmetrical, Rapidly moving Battlefield Austere site Obj FOB 200 nm

  17. GATEKEEPER • Afghanistan vs. Iraq • Expanded Company Operation • CASEVAC

  18. Mobile Trauma Bay

  19. Traumatic Brain Injury Guidelines……..return to duty. Misguided. CJCS Gray Team Education Dosimetry Diagnosis Treatment

  20. Far Forward Resuscitation FLET Mobile Trauma Bay

  21. En-Route Care Capability Movement of stabilizing critical casualties Essential for forward surgical capability Performed by Critical Care Nurses Austere to adverse conditions with limited resources By rotary wing, fixed wing and ground transport One of the newest and most significant advances in combat casualty care

  22. What is OSCAR? • OSCAR embeds mental health professional teams as organic assets in operational units • Why should mental health professionals be organic? Because stress problems are: • Common • Hard to detect • Hard to admit (stigmatized) • Treatable (respond best to early intervention) • Potentially disabling • Possibly preventable

  23. Expected OSCAR Rollout • Existing assets at GCE and MFR will be converted to OSCAR T/O in FY09: • 3 MH providers and 3 psych techs at each GCE (Division Psychiatrist) • 1 reserve MH provider at MFR • To be replaced by full-time assets in FY11 • OSCAR will add to the above, 26 Mental Health providers and 29 Psych Techs on the following timeline: • FY09: • 3 MH providers and 25 psych techs to the GCE • 4 psych techs to MFR • FY11: • 19 MH providers to the GCE • 4 MH providers to MFR Updated 09 Apr 09

  24. OSCAR Extenders • OSCAR Extenders will provide OSCAR functionality down to battalion and company level • Will utilize existing battalion physicians, corpsmen, chaplains, RPs, and selected Marine officers and enlisted • Will be trained and certified in basic OSCAR competencies • Will assist commanders to implement the COSC program to maintain readiness • Will assist Marines and Sailors to deal with combat stress reactions, injuries, and illnesses • Prevention • Early identification • Referral • Reintegration • Peer support

  25. Traumatic Brain Injury Secretary Gates “The military now has more thorough reporting mechanisms, requiring that any one affected by a blast or blunt trauma in theater go through and evaluation and screening. We have a single TBI registry and a single point of responsibility – the Defense and Veterans Brain Injury Center – to consolidate all TBI-related incidents and information.” 5 June 2008

  26. DVBIC Regional Care Coordination Program • Provide 100% follow-up to identified Service Members with Traumatic Brain Injury (mild, moderate, severe and penetrating) from 13 regional catchment areas across CONUS. • Identify and connect Service Members to available TBI resources within DoD, VA and civilian communities • Regional Database of Services and Facilities • Provide education and support-serving as a TBI subject matter expert to all involved in the care and support of the Service Member and family. • Identify barriers and/or gaps in service delivery for TBI Service Members as they transition between systems and settings • Functional outcomes picture to look at quality of life issues related to home, work and social environments

  27. Where TBI Screening Occurs • In-Theater • Landsthul Regional Medical Center (LRMC) • CONUS, during Post Deployment Health Assessment (PDHA) and Post Deployment Health Re-Assessment • VA Medical Centers

  28. Tele-TBI Highlights Virtual TBI Clinic – Expanding to 10 sites throughout NARMC Tele-consultation from theater Increasing usage of tbi.consult Awareness included in Deployed CPG Materials Instituted clinical VideoTeleCon program to support medical transfer of acute TBI patients between MTFs and VAs, including family involvement Provided TBI education to 500 providers serving National Guard and Reserve Service members via video teleconferencing

  29. HBOT Study Requirements Investigation of Innovative Treatments Hyperbaric Oxygen Treatment (HBOT) • DCoE as Sponsor (Facilitating in few months process of > 1 yr) • Air Force (AF) as Research Executive Agent** to include IRB • Army with Product Development (USAMMDA) and Logistical Actions • Navy as Scientific Review, Data Safety Monitoring Board (DSMB) and FDA Agent • Study Launch: April 09 • Rate-Limiting Step: FDA IND Complementary and Alternative Medicine (CAM) • Included in DCoE Warrior Wellness Innovation Network • Samueli Institute as Partner

  30. Critical Current Issues • Vice Chiefs Third TBI/ PH Meeting 17 Sep 2009 • ACMC’s Blue Ribbon Meeting Aug 2009 • DCOE TBI/PH Collaboration • ACMC’s Direction to HS and C4I 21 Sep 2009 • USMC Growth 202K/ NavMed Growth FY12 • Mil to Civ Buy Back • QDR $22Billion Shortfall DHP • Medical Lay-down Afghanistan

  31. Shock Trauma Platoon 2nd Battalion/ 7th Marines After Action Report CDR James Hancock Why is this brief important to you?

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