{"id":23628,"date":"2019-04-17T11:42:25","date_gmt":"2019-04-17T17:42:25","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=23628"},"modified":"2023-04-20T14:07:18","modified_gmt":"2023-04-20T20:07:18","slug":"fbi-learn-from-cadavers","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/fbi-learn-from-cadavers\/","title":{"rendered":"FBI at CSI (not that CSI) to train on saving lives"},"content":{"rendered":"
<\/div>

To grasp that this was not a typical training cohort at the University of Colorado School of Medicine\u2019s Center for Surgical Innovation (CSI<\/a>), one needed to look no further than the locked closet in which the 20 or so participants had deposited their 40-odd guns.<\/p>\n

No, these were not the board-certified surgeons, residents, and medical students who typically pass through the CSI to learn new tools and techniques at this internationally recognized surgical center of excellence. This group, predominantly male and thoroughly muscular, was comprised of FBI agents from all over the country.<\/p>\n

\"many
FBI SWAT-team emergency medical technicians observe as Peltz goes to work. Photo by Katherine Scott, for UCHealth.<\/figcaption><\/figure>\n

They were members of Special Weapons and Tactics (SWAT) teams that specialize in responding to active shooters, hostage crises, airline hijackings and terrorist attacks, among other emergencies. Every FBI SWAT team has at least one certified emergency medical technician (EMT). They came to CU to learn, through hands-on training with CU School of Medicine\/UCHealth trauma surgeons and emergency medicine specialists, about what to do when weapons like the ones they\u2019d just locked up leave the lives of victims \u2013 good guys or bad \u2013 hanging in the balance.<\/p>\n

\u201cIn a moment, we go from law enforcement to saving somebody\u2019s life,\u201d said one of the agents, who will remain anonymous because they sometimes work undercover.<\/p>\n

Extended mission<\/strong><\/h3>\n

While happy accident played a role in the FBI School of Operational Medicine spending a day of its three-day Colorado workshop on the Anschutz Medical Campus, the program was part of a deliberate extension of the CSI\u2019s longstanding training mission.<\/p>\n

\"FBI
UCHealth\/CU School of Medicine Emergency Medicine specialist Dr. Danny Willner explains the finer points of opening up airways to the FBI group. Photo by Katherine Scott, for UCHealth.<\/figcaption><\/figure>\n

The happy accident involved Dr. Shannon Sovndal, the City of Boulder Fire Rescue\u2019s medical director, reaching out to the UCHealth University of Colorado Hospital Trauma Program about the possibility of leading training sessions for an FBI group. Sovndal did so because he knew that a CU team of doctors and other trauma specialists had been developing a curriculum that used real human cadavers \u2013 rather than the typical mannequins \u2013 to train ambulance crews and other first responders on trauma care.<\/p>\n

The program focuses on opening the airway, maintaining breathing, stanching bleeding and ensuring blood flow. The first training session, for street paramedics from Aurora, Northglenn, Eagle County and elsewhere, happened Feb. 20. The training is part of UCHealth\u2019s mission of taking care of trauma patients and providing the highest level of trauma training in the region, said Robbie Dumond, senior director of trauma services at UCHealth University of Colorado Hospital at the Anschutz Medical Campus (UCH).<\/p>\n

\u201cIt\u2019s about doing everything we can to save as many lives as possible,\u201d Dumond said. \u201cOur goal is to offer the course three or four times a year, at minimum, to the front-line people who really need it.\u201d<\/p>\n

And so a central facet of the FBI School of Operational Medicine\u2019s quarterly training landed at the Anschutz Medical Campus on the second Tuesday in April. In a conference room, Dumond led a moment of silence to honor the donors and families whose generosity stands to save future lives. Then the FBI men and women suited up in scrubs, plastic bibs, masks, hair nets, and clear glasses and entered the CSI\u2019s Surgical Bioskills Lab at around 8:30 a.m.<\/p>\n

Hands-on<\/strong><\/h3>\n

Dr. Erik Peltz, a CU School of Medicine trauma surgeon and assistant director of the UCH Trauma Center; his fellow trauma surgeon Dr. Laura Harmon; and UCH Emergency Medicine specialist Dr. Danny Willner had been prepping the cadavers and doing additional setup since 6 a.m. The three of them, Dumond, and Scott Bookman, UCHealth\u2019s director of emergency medical services, had collaborated on creating the training curriculum.<\/p>\n

\"three
UCHealth\/CU School of Medicine trauma surgeons Dr. Laura Harmon, left and Dr. Erik Peltz, right, work with an FBI SWAT-team emergency medical technician. Photo by Katherine Scott, for UCHealth.<\/figcaption><\/figure>\n

The FBI agents clustered around a cadaver on each of two tables brightly lit with overhead articulating surgical lights. Peltz served as guide at one; Willner did so at the other. Three big flat screen monitors projected prepared slides, the first of them having to do with ways to open airways \u2013 the i-gel supraglottic airway<\/a> and the King LT-D<\/a>. Peltz went over pros and cons of each of these emergency intubation tools and walked through mnemonic acronyms (\u201cRODS\u201d and \u201cMOANS\u201d) to remind of challenges with establishing a good mask seal on an unconscious patient \u2013 beards, obstructions such as a big tongue, a lack of teeth, and mask stiffness among them. Then, one after the next, the FBI agents intubated the expired bodies using both nasal tubes and masks.<\/p>\n

After his turn, an agent from Los Angeles explained, \u201cBeing able to interact with a cadaver \u2013 real tissue \u2013 is invaluable, priceless training.\u201d<\/p>\n

He added that the weight, resistance and anatomy of an actual human body versus that of a mannequin were all vastly different. \u201cYou have real bones and functional movement \u2013 real bones, real tissue. And it\u2019s dead weight: if somebody\u2019s unconscious, they can\u2019t help you. It\u2019s very similar to working with someone who\u2019s unconscious.\u201d<\/p>\n

Said another, \u201cThe mannequin\u2019s rigid plastic. There\u2019s no feel. There\u2019s not tongue that gets in the way. You\u2019re not looking them in the eye. When I do this, I think about my kids: How am I going to save one of their lives?\u201d<\/p>\n

Not just how, but also why<\/strong><\/h3>\n

If intubation through nose or mouth can\u2019t be done due to injury or swelling, one must cut a new opening through the neck. Two surgical residents were corralled from a neighboring training session to perform tracheostomies on the cadavers as Peltz, Willner and CU School of Medicine\/UCHealth trauma surgeon Dr. Franklin Wright<\/a>, who had come by to volunteer his expertise, explained how it\u2019s done, where to go in, and what to avoid (in particular the thyroid gland and vocal cords).<\/p>\n

Field tracheotomies are rare, but, as Wright put it, \u201cIf you need an airway and they\u2019re going to die without it, everything is negotiable.\u201d<\/p>\n

The training moved on to using four-inch needles to release pressure from something called tension pneumothorax<\/a> (a.k.a. collapsed lung) which happens when air from a lung punctured by a bullet or shrapnel escapes into the chest cavity and can\u2019t get out. Victims die not from suffocation, but from a lack of blood flow as veins leading to the heart become kinked as the pressure pushes the heart to the opposite side of the chest cavity. Again, the agents took turns inserting needles through particular ribs in two spots medical science has shown to be both effective and safe.<\/p>\n

\"man
An FBI SWAT-team emergency medical technician poised to practice the pressure release of the chest cavity. Photo by Katherine Scott, for UCHealth.<\/figcaption><\/figure>\n

\u201cPutting a needle in the heart is less than ideal,\u201d Peltz told the group; Willner added, \u201cBetter high than low: if you go low, you\u2019re giving him a liver or spleen biopsy.\u201d<\/p>\n

After lunch, the training shifted to stopping blood through using pressure or tourniquets. The aim, Dumond said, was to show not only how to stop the bleeding, but also the nature of the damage that bullets, shrapnel, blast injuries and other grave physical insults do and where in the body the bleeding typically comes from.<\/p>\n

Michael Biamonte, the FBI School of Operational Medicine\u2019s program director, interjected here and there based on his 32 years of work as a paramedic with the FBI and elsewhere. He described cadaver-based training as \u201ca luxury.\u201d<\/p>\n

\u201cThese people who have donated their bodies to science have done us a great service by allowing us to use their bodies to learn and save lives out in the field,\u201d he said. \u201cThese opportunities are so hard to come by, and it\u2019s so, so important for a facility like this to open its doors and avail their team and their cadre. Look at the cadre they\u2019ve provided us with \u2013 they\u2019re fantastic. We\u2019re frankly honored that they\u2019ve allowed us to come in and learn from them.\u201d<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

To grasp that this was not a typical training cohort at the University of Colorado School of Medicine\u2019s Center for Surgical Innovation (CSI), one needed to look no further than the locked closet in which the 20 or so participants had deposited their 40-odd guns. No, these were not the board-certified surgeons, residents, and medical […]<\/p>\n","protected":false},"author":23,"featured_media":23633,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[8],"tags":[235,702,565,2047],"class_list":["post-23628","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news","tag-emergency-care","tag-surgical-care","tag-trauma-services","tag-uchealth-university-of-colorado-hospital-memory-disorders-center"],"acf":[],"yoast_head":"\nFBI learn from cadavers at the CU Center for Surgical Innovation - 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