Courtesy Photo | U.S. Navy Cmdr. Scott Trask, a general surgeon, performs an external fixation of a...... read more read more
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By Cmdr. Scott Trask
Expeditionary Medical Facility (EMF) Djibouti is the Navy’s only standing forward-deployed Role II military trauma center on the African continent. It provides care for the personnel stationed on Camp Lemonnier and acts as an evacuation and referral hub for down range forces throughout the U.S. Africa Command (AFRICOM) area of responsibility (AOR).
The Navy surgeon at EMF Djibouti also serves as the trauma medical director (TMD) for the AFRICOM AOR, which is strategically located on the Red Sea and near the Bab-el-Mandeb straits in the Horn of Africa. Typically, Navy surgeons selected for the AFRICOM TMD role are either general or trauma/critical care surgeons with prior forward Role II deployment experience.
One patient I took care of exemplifies unique aspects of Navy surgery. During my deployment as the sole surgeon on Camp Lemonnier in 2020, I was notified of an incoming casualty with a non-combat related gunshot wound to the leg. The trauma assessment revealed a single gunshot wound to the leg with a femur fracture without major vascular injury. It was a small caliber round causing minimal soft tissue injury, but a displaced and comminuted femur fracture. After placing the leg in a traction splint, I contacted an orthopedic surgeon at the Role IV Landstuhl Regional Medical Center (LRMC) to discuss the care of the patient.
The orthopedic surgeon recommended external fixation given the prolonged medical evacuation times to LRMC and he gave me some pointers on the surgery. I had never performed an external fixation before, but it was part of my pre-deployment training in the two-day Advance Surgical Skills for Exposure in Trauma (ASSET+) course, designed specifically to prepare military surgeons to manage combat trauma. Early on in my deployment, I had inspected the ex-fix set and gear and knew that I had the necessary equipment to complete the operation. I was able to successfully reduce the fracture and place the ex-fix to stabilize the patient’s leg for medevac. Ultimately the patient was successfully evacuated to LRMC where he underwent internal fixation and recovered well.
While I had never performed an external fixation before, Navy Medicine prepared me for this contingency though my pre-deployment training including the ASSET+ course. I highly recommend the ASSET+ course to any deploying surgeons. While it is technically required every three years, surgeons should seek out the training before deployment. The course is offered at multiple defense health agency military treatment facilities.
Not only does this dry “sea story,” highlight the importance of pre-deployment training, but it highlights an important principle of military surgery – know your equipment including consumables and surgical sets. If bringing your gear and equipment with you upon deployment, go through it thoroughly before deployment. If you are deploying to a place where the equipment is already in theatre, like EMF Djibouti, I recommend spending the first several days of any deployment familiarizing yourself with the equipment to ensure you understand what your capabilities are.
For available courses and locations please go to the health.mil website and look at course offerings from the Defense Medical Readiness Training Institute (DMRTI) at https://health.mil/Military-Health-Topics/Education-and-Training/DMRTI/Course-Information/Emergency-War-Surgery-Course.
| Date Taken: | 09.07.2020 |
| Date Posted: | 05.22.2025 13:05 |
| Story ID: | 498716 |
| Location: | CAMP LEMONNIER, DJ |
| Web Views: | 68 |
| Downloads: | 0 |
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