Photo By Douglas Stutz | For Naval Hospital Bremerton MRI technologists Ms. Johanna Fanara and Mr. Matthew...... read more read more
It was during a jarring time some dozen years ago in volatile southern Afghanistan when Naval Hospital Bremerton supported from afar in treating traumatic brain injuries.
When the Concussion Restoration Care Center (CRCC) with a MRI (Magnetic Resonance System) was established at Camp Leatherneck, then part of Joint Operating Base and British-run Camp Bastion in Helmand Province, Afghanistan, there was a constant need to care for combat-related concussions.
During the first year of operation alone - August 2010 to September 2011 – there were approximately 700 new patients with some sort of head injury.
According to Cmdr. Peter Lundblad, NHB Family and Sports Medicine physician who deployed as the officer in charge of the CRCC, “It was designed (back then) to care for concussions, the number one most common combat related injury, and for non-surgical orthopedic patients, the top non-combat related injury.”
Arranging to have the sizable MRI machine down range was a huge logistical undertaking. Yet there was more to it than just connecting to a power source and flipping a switch to use.
With a mix of personal ingenuity and professional initiative to hasten the setup process, Lundblad reached back to his parent command for timely assistance to simply plug in advanced technology programs and standard operating procedures to effectively run the machine.
“An MRI without appropriate examination protocols is like a computer without an operating system; it just does not work. Optimized examination protocols allow for MRI examinations that are appropriately tailored to each patient,” explained Lundblad.
Which is where the expertise of NHB MRI technologists Mr. Matthew Hodgson and Ms. Johanna Fanara came into the scene. Lundblad reached back to NHB’s Radiology department asking for their timely support to provide developed MRI programs to save time and help address the need for specialized evaluation and treatment of concussed service members.
“I was able to successfully send our exam [protocol] cards over for use on their system in Afghanistan. They downloaded to run without having to go through the trouble of building a database from scratch,” related Hodgson, adding that exam protocols are really a series of complex sequences that enable a technologist to acquire diagnostic data on specific anatomy details and a number of pathologies.
“We had already built the protocols here,” continued Hodgson “The majority we sent down-range concerned the primary types of bodily injuries they were dealing with, such as brain, spine, upper and lower extremities, and abdomen.”
Along with the protocols, NHB also forwarded essential forms on such subjects as quality control and environmental compatibility. All the documents were created by Fanara, including comprehensive standard operating procedures and detailed patient screening forms necessary to ensure patient safety.
By providing the timely support, the CRCC team use the MRI to instantly evaluate and treat mild TBI patients instead of having to send the service members out of theater to Landstuhl Regional Medical Center, Germany.
According to a 2014 study posted in the Association of Military Surgeons in the U.S., among 4,947 military personnel evaluated at the CRCC between August 2010 and May 2013, 97.9 percent were returned to duty and retained in theater.
During Operation Enduring Freedom and Operation Iraqi Freedom, TBI was one of the leading wounds among troops in Iraq and Afghanistan. In large part, this was due to the enemy’s widespread use of improvised explosive devices, such as roadside bombs. Examples of a TBI ranged from an actual blow to the head to blast wave(s) penetrating brain tissue.
However, back then as now, it was not in a combat zone or deployment status that the most TBIs happened to service members.
It’s the exact opposite.
“The majority of service members and veterans experience traumatic brain injuries in a non-deployed setting, due to the nature of their training or participation in sports and leisure activities,” Lundblad said.
“We do see a fair share of mild TBI/concussion here on a continuous basis,” said Hodgson. “If there is a patient with perhaps a more severe concern, we’ll send them to Madigan Army Medical Center MRI annex with a more specialized MRI capability.”
What exactly is a TBI? The Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury defines a traumatic brain injury as the result of a jolt to the head that disrupts the normal function of the brain.
However, not all blows or jolts to the head result in a TBI, and can range in severity from mild to moderate to severe. The most common form of TBI, especially in the military, is mild TBI, usually referred to as a concussion.
Compiled statistics from the Centers for Disease Control and Prevention show more than 430,000 service members were diagnosed with TBI from 2000 to 2020.
“The reality is that awareness is everything in dealing with any type of head injury. A traumatic brain injury is not visible. But it is significant and can’t be minimized. Just taking aspirin is not going to really help,” said Lundblad.
| Date Taken: | 03.10.2022 |
| Date Posted: | 03.10.2022 13:30 |
| Story ID: | 416203 |
| Location: | BREMERTON, WA, US |
| Web Views: | 203 |
| Downloads: | 0 |
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