Management of Dismounted Complex Blast Injury Patients at a Role V Military Treatment Facility: Special Considerations

Since 2001, the Walter Reed Army Medical Center in Washington, DC, and the National Naval Medical Center in Bethesda, Maryland, served as military Role V hospitals in the National Capital Area and in 2011 combined to form the Walter Reed National Military Medical Center (WRNMMC). Throughout this time, dismounted complex blast injury patients received comprehensive care at these facilities. This included a team of surgeons, subspecialty consultants, case managers, rehabilitation specialists, medics, corpsmen, and technicians. A dedicated trauma service oversaw the management of all those wounded in combat. This trauma service established a system of quality assurance, safety, performance improvement, and research with the complex surgical patient at the center. The American College of Surgeons verified WRNMMC as a trauma center based upon the institutional successes of the trauma program. The lessons learned from this historic program are presented here.