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Medivac Information

March 30th, 2010 | Author: wlomvy

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Thanks to Air Ambulance Service for bringing the following blog post

She heard someone knocking at the door. It was her cousin who had come to pick her up to go do some dollar shopping for the orphanage and the soldiers in Iraq, whom they sent supplies to. As she let Mary in, the phone which had a talking caller ID announced that the call was from Her husband's work. Knowing that something
was wrong, she immediately answered the call.Her husband's boss was on the other end, telling her that she needed to come quickly, to take Will to the hospital.

Mary decided to go back home after promising to pray for them. Then Stacy called their mentor and asked him to pray for them. She called for her son to go with her as she ran to the car.They drove down State Road 574 toward Seffner when they encountered a white, panel van pulling out of a stop from a cross street.

The driver didn't see her little brown omni and she had no horn to warn him with, since Will had disconnected it the week before.She waved her hands in the air and kept moving her car further and further out of her lane, all the way over to the left shoulder of the road. But the van still kept coming straight at them, until it hit the right front of the car.It struck the only part of the car that didn't total the car, nor hurt Andrew since he was in the front passenger seat and at the point of impact.

The force of the crash shoved her car down into a six foot drainage ditch, while she still waved her arms in the air. When the car finally stopped, it was back up on the left shoulder facing the road in the wrong direction.An officer appeared out of nowhere to direct the rush hour traffic that had been absent during the collision.

He told both drivers to park in front of a house that could have been out of a horror movie. Stacy looked around and saw a man standing in the driveway talking on a cordless phone. As she walked toward him, she heard a voice telling her to be careful how she approached him. As she got nearer, she saw that he looked like someone out of a mob movie, with a long ponytail and a physical demeanor that caused her hair to stand up on-end. She borrowed his phone to call her mentor for prayer.Then she called and asked Mary if she would go get Will and meet her at their mentor's house,since she was no longer able to drive to the hospital.

She was talking to the other driver when three more squad cars drove up to the house. One of them was a K-9 unit. As the officers walked through the front door of the house, Stacy and her fellow driver watched as the occupants of the house ran out the back door, climbed over the back fence and ran into the neighboring woods.They didn't see the officers follow them.

After the officers went through the house, the original officer came back to them and finished the accident report, telling Stacy that her car was not safe to drive.Andrew held the his door closed,since it no longer shut on its own, while she drove them home.She called her cousin, who was back home, since she wasn't able to get Will. By the time she arrived in the parking lot,the Firetruck,Paramedics and ambulance had come and were loading Will into a Medivac unit, blocking off the area.

Stacy called one of her best friends, Ann and their mentor to pray for Will, since his work had called and told her that he had an aneurysm and had almost died on the floor of their office.Then Mary took them to Tampa General to see Will

They arrived at the hospital 45 minutes later,since they lived among the strawberry fields.They parked the car and went into emergency and were directed to where Will had been sent.The doctors had already examined him and he was waiting for the results of the xrays and tests they had taken. While they waited, Will told Stacy how God had talked to him while he was in the helicopter on the way to the hospital, about how he needed to examine the direction he had been taking in his life,that he was going to come through this situation,and to trust God to bring him out of it.

The doctor returned with the test results and xrays and found that Will no longer had the aneurysm, but that he needed surgery for a hernia his doctor had missed when sewing up another hernia, the year before. He told them they needed to schedule surgery soon, and released him.They gathered Will's things and walked out of the hospital.

Later:

Will saw his doctor and had the surgery. They also contacted the other driver's insurance and were able to keep their car while also collecting on the damages for the accident. They wired the damaged door shut, filling the gaps around the frame with spray foam insulation and drove the car for another two years.

They were thankful that Will survived, that neither Stacy nor Andrew were hurt or killed in the accident and that they caught the hernia in time.

Their mentor joked that if he hadn't known that this had really happened he would have thought it was a plot from a movie and that the only thing missing from the emergency scene was the National Guard.

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American Air Ambulance Features

March 30th, 2010 | Author: wlomvy

The Following blog post is brought to you by Air Ambulance

One of the morbid attractions of following the efforts of anyone trying to make their way up Mt. Everest isn't doing so with the hopes of hearing that the climbers made it, but rather that they didn't. Let's face it, one of the many problems of climbing a mountain as tall as Mount Everest, is that once you're up there, there's not much help available if things go wrong.

That was the basic theme of Robert Krakauer's classic 1996 Everest epic “In Thin Air” which recounted the less-than-successful exploits of a group of amateur climbers looking to scale Everest and which set the standard for literary coverage of ill-fated attempts up the world's tallest mountain.

A New Zealand helicopter firm hopes to do something about future attempts up Mt. Everest that seem to be concerned more with getting up and less about coming back down.

According to UAV News.com, the New Zealand helicopter firm TGR Helicorp plans to start operational testing of a prototype high-altitude vertical take off and landing unmanned aerial vehicle (UAV) to be used as an air ambulance as part of plans to provide rescue services for climbers on Mount Everest, where the vehicle will be capable of fully autonomous operations at altitudes of more than 30,000 feet.

The Alpine Wasp UAV (see photo) will have six cameras on its fuselage and 10 on its nose — 5 looking forwards and 5 looking down. The pilot sits in a virtual reality environment at a base. Once a stranded climber has been located, the Alpine Wasp communicates with them using an 8.5-meter extendable arm outfitted with a camera and a small speaker.

The Association of Unmanned Vehicle Systems International (www.auvsi.org) says the UAV — which many are now calling the RoboCoopter — has undergone test flights in the mountains of New Zealand's South Island after which it was deployed to Nepal in December 2007 and is commencing in-country testing in March 2008, with fee-for-service rescue operations to begin in April 2008.

According to Compilots.com (www.compilots.com) the extendable arm will also have a Kevlar loop on the end capable of supporting any injured person. The operator at ground level would extend the arm out to the climber using laser distancing equipment and, via the speaker, tells them to slip the Kevlar loop over his head and under his arms.

In theory, after the climber has tightened a simple clamp around themselves, the helicopter can take off again. The weight of the climber detaches the loop from the pole and they swing below the craft, before being winched into a pod that closes behind them.

So why a helicopter anyway?

Trevor Rogers — president of TGR Helicorp – says conventional helicopters struggle at altitudes above about 4300 m (14,100 ft), at which point normal engines suffer from a lack of oxygen and blades experience reduced lift in the rarefied air.

According to an interview with Rogers published on www.newscientisttech.com, the Alpine Wasp will have extra wide blades to provide more lift and an engine modified to cope with thinner air. “…It will also spin its rotors at a lower speed than normal. This is to avoid the rotor blades breaking the sound barrier – which is lower at high altitudes. This could change the airflow and cause potentially catastrophic instability…”

TGR Helicorp and the Everest Trust (www.rescueoneverest.org) have established an alpine rescue base at Namche Bazar, a village sitting at 11,300ft (3,440m) on the approach to Mt Everest in Nepal. This base includes an aircraft hangar and rescue facilities, a prosthetics facility for the Porters and Sherpas in Nepal, and a frostbite prevention facility, providing clothing and footwear. The base provides jobs for the local Nepalese people and all donations will be funneled back into the community.

Check out the Everest Rescue Trust website for information and updates. The site contains real-time news and information and is available to a global audience. This site also hosts an interactive, distance learning schools program, which will further stimulate interest in the project and allow children the world over to learn about Nepal, Everest and the Nepalese people.

Fatalities on Mt. Everest happen all too regularly (check out a related article on the AC Archives). The “robocopter” hopes to make an impact of the lives of climbers hoping to make the ultimate ascent.

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Emergency Response Aircraft Announcements

March 30th, 2010 | Author: wlomvy

This Blog Post is from Associated Content and brought to you by Air Ambulance Service

STATEMENT OF PURPOSE

The purpose of this paper is to discuss the development of the Combat Training Center Program as a response to the U.S. Army’s evolving training needs. The paper will discuss how the Army trained before the development of its four Combat Training Centers (CTCs), the training centers themselves, and the unique capabilities of each. Finally, the paper will conclude with a discussion of the future of the Combat Training Center Program.

INTRODUCTION

Army training has one purpose: to develop a combat ready force that is physically and psychologically prepared to fight and win America’s wars (AR 350-1, 1983, p. 1). For much of the Army’s history, training has been accomplished by individual units focusing on those tasks that are essential to the completion of their wartime missions. Training was, and for the most part still is, accomplished at duty stations around the world. At the vast majority of these Army posts, however, the resources required to conduct realistic, simulated combat training under stressful conditions are simply not available. Until 1973, Army units followed the Army Training Program, which allotted time to specific subjects but did not dictate how well soldiers had to execute specific combat-related tasks.

When General William F. DePuy, the first commander of the U.S. Army’s Training and Doctrine Command (TRADOC), evaluated Army training methods, he realized that it was necessary to expose soldiers to realistic battlefield conditions before they experienced actual combat. General DePuy developed three new training methods: the Systems Approach to Training (SAT), the Army Test and Evaluation Program (ARTEP), and the Combat Training Center Program (Caldwell, 2000). The Systems Approach to Training describes the conditions under which specific soldier tasks are to be performed and sets a standard for how well these tasks must be executed. The Army Test and Evaluation Program establishes training standards for specific-sized elements, from squad (usually 10-12 soldiers) to battalion (usually 700-1000 soldiers) levels. The Combat Training Center Program, which is the focus of this paper, established specific places where units could go to perform force-on-force training in a field environment, under stressful and realistic simulated combat conditions, with established standards and evaluation procedures.

The Army currently has four Combat Training Centers: the National Training Center at Fort Irwin, California; the Joint Readiness Training Center at Fort Polk, Louisiana; the Combat Maneuver Training Center at Hohenfels, Germany; and the Battle Command Training Program at Fort Leavenworth, Kansas. While each CTC is unique in its scope and purpose, all employ certain basic methods of training and evaluation that ensure each Army unit gets the most out of its scheduled rotation.

THE COMBAT TRAINING CENTER PROGRAM

According to the Combat Training Center Program Strategic Plan, “A CTC experience is the closest thing to combat our soldiers, leaders, staffs and units will ever experience. It is a battlefield where they can ‘die,’ come back to life, correct their mistakes, and fight again…” (www.call.army.mil). The CTCs serve many purposes for the Army, including providing commanders with an assessment of their unit’s combat efficiency, validating Army doctrine, and providing challenging training under stressful simulated combat conditions.

The objective of the CTCs is to provide “…highly realistic and stressful joint, inter-service, and combined arms training according to Army doctrine” (AR 350-50, 1995, p. 1). They do this by adhering to the “five pillars” of the Combat Training Center Program: that participating units will be organized as they would for actual combat; that a dedicated, doctrinally proficient operations group control all unit rotations; that a dedicated, realistic opposing force (OPFOR) be employed; that the training facility be capable of simulating combat conditions; and that there be a base infrastructure in place that can support the CTC mission (AR 350-50, pp. 1-2).

The first pillar of the Combat Training Center Program requires that participating units be organized as they would for actual combat. When a unit deploys its forces to one of the CTCs, it brings all of the personnel and equipment that would be assigned to it in the event of an actual combat mission. These assets are required to perform all of their normal logistical and administrative functions during their CTC rotation, including maintaining equipment, feeding troops, fueling operations and water support, ammunition re-supply, and medical support.

The second pillar requires a dedicated, doctrinally proficient operations group. Operations groups, which consist of support personnel, civilian contractors, and observers/controllers (O/Cs), are primarily responsible for all CTC rotations. Support personnel take care of routine administration, operations, and logistical functions. Civilian contractors are predominantly retired military officers and noncommissioned officers who have extensive experience in their respective branches. They assist in the planning, coordination, and execution of each rotation. Observers/controllers are military officers and noncommissioned officers who receive classroom and field training to certify them as subject matter experts in the various areas of combat operations (www.usachcs.army.mil). O/Cs observe individual and collective training and provide impartial evaluations to the training unit. O/Cs also conduct after-action reviews during designated pauses in CTC training. After-action reviews are open discussions that focus on a specific mission or task, identify strengths and weaknesses in its execution, and determine how to fix the things that went wrong.

The third pillar of the Combat Training Center Program requires a dedicated, realistic opposing force (OPFOR). OPFOR units are designed to represent a particular level of capability rather than a particular country. As such, these forces are organized to replicate elements of infantry, armor, mechanized infantry, airborne, and special operations units. These units are well-trained and well-equipped, using equipment and weapons systems that are visually modified to represent the types of systems that U.S. forces are likely to encounter in combat. In some cases, OPFOR units have actual equipment from the former Soviet Union. OPFOR units are free to move, attack, and defend as they see fit, in accordance with the capabilities, strengths, weaknesses, tactics, and doctrine of the armed forces of potential adversaries (AR 350-1, p. 1). Finally, the Combat Training Center Program dictates that the size of OPFOR units must be at least equal to and preferably greater than the size of U.S. forces participating in training (AR 350-1, p. 3). This forces to U.S. units to attempt to accomplish their wartime mission against a numerically superior, non-cooperative enemy force.

The fourth pillar requires that the training facility be capable of simulating combat conditions. This means that each CTC must have controlled airspace, a large operational area (commonly referred to as “the box”), live-fire facilities (where units can use live ammunition against realistic targets in a simulated combat situation), and an advanced instrumentation system to record critical combat-related data.

The most important piece of the instrumentation system is the Multiple Integrated Laser Engagement System, known as MILES. The MILES is a series of eye-safe laser devices that simulate casualties for both personnel and equipment (www.jrtc-polk.army.mil). MILES transmitters are placed on all weapons systems; receivers or sensors are placed on all personnel and equipment. When a MILES-equipped weapon is fired, it emits a laser beam that is picked up by a receiver or sensor if a soldier or piece of equipment is “hit.” The sensor then emits a distinctive tone that indicates that a soldier was wounded or killed, or that a piece of equipment was disabled. Units are then forced to requisition replacement soldiers or equipment as they would under combat conditions in an actual theater of operations. Anne Chapman, the TRADOC Military History Office historian, attested to the importance of the MILES when she stated, “I believe that a major reason that the training is so effective at the CTCs can be attributed to the development of MILES…where soldiers can ‘shoot’ each other to gauge their effectiveness” (Caldwell).

The fifth and final pillar of the Combat Training Center Program requires that there be a base infrastructure in place that can support the CTC mission. To fulfill this requirement, each CTC facility must have sufficient barracks space to house the soldiers of participating units, an airfield capable of handling large cargo and passenger aircraft, large open spaces for unit aircraft and vehicles to stage prior to deploying into “the box,” and after-action review/briefing centers capable of accommodating entire units.

At the conclusion of each CTC rotation, the participating unit receives a take-home package (THP). The THP is a compilation of all O/C comments, unit performance data for all aspects of combat operations (including casualties, re-supply, maintenance, efficiency, etc.), and videos of the various after-action reviews. These take-home packages provide training tools for the unit’s chain of command to improve their home station individual and collective training programs.
The Army’s Combat Training Centers provide the Army with one of the most important elements in training for possible future missions. The National Training Center, Joint Readiness Training Center, and Combat Maneuver Training Center, collectively known as the maneuver CTCs, are each custom tailored to a different theater of operation in which the Army may have to conduct missions. The Army goal is to have all commanders of active duty combat maneuver brigades, battalions, and special forces battalions receive at least one rotation at NTC, JRTC, or CMTC during their command tour (www.usachcs.army.mil). The Battle Command Training Program is the Army’s capstone CTC, designed for the senior commanders who will direct the Army’s future operations. Commanders at the division and corps level execute a BCTP rotation during the first year of their command tour (TR 350-50-3, 1999, p. 2).

THE NATIONAL TRAINING CENTER

The National Training Center is located at Fort Irwin, in the California desert. The NTC provides training for brigade and battalion task forces and is geared primarily toward heavy (armor or mechanized) units. Occasionally, selected light (infantry, airborne, special forces, etc.) units participate with a heavy unit to provide mixed mobility and joint training. The NTC encompasses 640,000 acres and provides participating units with combat scenarios in a mid- to high-intensity environment applicable to Europe, Asia, or the Middle East (CTC Program Handbook, 2000, p. 3-D-6). Fort Irwin offers over 1,000 square miles for maneuver and live-fire ranges (www.irwin.army.mil).

The NTC conducts ten rotations per year, with each rotation averaging approximately 5,000 soldiers (www.call.army.mil). Rotational units include active duty heavy maneuver forces, attack helicopter battalions, armored cavalry regiments, and divisional cavalry squadrons (FR 350-50-1, 2002, p. 3). Additionally, reserve and National Guard units sometimes participate in NTC rotations. Participating units deploy to Fort Irwin for twenty-eight days. The first few days are spent on Reception, Staging, Onward Movement and Integration (RSOI) operations, which include air deployment to the NTC, drawing equipment from pre-positioned stocks, and deployment into the operational area. RSOI operations are followed by approximately two weeks of tactical operations against the 60th Guards Motorized Rifle Division (the 11th Armored Cavalry Regiment OPFOR).
Tactical operations include force-on-force training and live-fire exercises, as well as all of the support functions necessary to the sustainment of combat operations. Finally, the rotational units conclude with recovery and re-deployment operations in which equipment and personnel are returned to their home station.

THE JOINT READINESS TRAINING CENTER

Building on the success of the National Training Center, the Army developed a Combat Training Center for its infantry, airborne, and special operations forces. The Joint Readiness Training Center, located at Fort Polk, Louisiana, covers 96,000 acres and provides realistic, simulated combat training for brigade and battalion task forces (CTC Program Handbook, p. 3-C-6). Ten rotations (eight active duty, one special operations, and one National Guard) are conducted per year (CTC Program Handbook, p. 3-C-10). The JRTC provides units with a unique training experience because it incorporates the United States Air Force, civilian role players, media on the battlefield, and fictional host-nation forces. Each scenario is based on a U.S. task force deploying to a mythical island nation to assist in repelling a hostile invader.

Each unit deploying to Fort Polk begins with Intermediate Staging Base (ISB) operations. The ISB is the location within a particular theater of operations where a unit would prepare for tactical insertion into a combat zone (FR 350-50-2, 1998, p. 110). ISB operations provide the participating unit with an opportunity to train on deployment procedures, organization, planning, and pre-combat actions at a forward staging area. ISB operations are followed by tactical operations that include force-on-force and live-fire training, and the integration of Air Force assets in aerial re-supply, casualty evacuation, and close air support of ground forces. JRTC offers an additional tool to training units: Military Operations on Urbanized Terrain (MOUT). Fort Polk has a state-of-the-art $13.2 million MOUT facility that includes a mock city, an airfield facility, and a military compound that provide realistic training in third world urban warfare scenarios (www.jrtc-polk.army.mil). Additionally, the JRTC’s OPFOR (1st Battalion, 509th Infantry Regiment) possesses actual equipment from the former Soviet Union, including helicopters and fixed-wing aircraft. Finally, rotational units conclude with re-deployment out of “the box” and back to their home station.

THE COMBAT MANEUVER TRAINING CENTER

The Combat Maneuver Training Center, located at Hohenfels, Germany, is the European equivalent of the National Training Center and Joint Readiness Training Center. The CMTC provides combined arms training for heavy, light, and special operations units based in Europe. Fifteen U.S. units, three German units, and if time permits, other NATO units train on CMTC’s 44,000 acres each year (CTC Program Handbook, pp. 3-B-7, 3-B-9). The CMTC prepares units to fight in European combat scenarios, peacekeeping operations, and combinations of the two.

Each standard 25-day CMTC rotation begins with three days of RSOI operations (www.call.army.mil). Units then move into the tactical operations phase, which includes five days of company- and team- level situational exercises followed by fourteen days of battalion force-on-force training (www.call.army.mil). Force-on-force training includes live-fire exercises at Grafenwoehr, Germany, and a MOUT facility that represents a small European village, against the 1st Battalion, 4th Infantry Regiment OPFOR. The CMTC rotation concludes with three days of recovery from the field environment and re-deployment to the unit’s home station (www.call.army.mil).

THE BATTLE COMMAND TRAINING PROGRAM

The U.S. Army Battle Command Training Program at Fort Leavenworth, Kansas, is the Army’s only mobile Combat Training Center, bringing CTC training to the unit’s home station. The BCTP provides command and battle staff training for brigade, division, and corps commanders, and their staffs (ww.bctp.leavenworth.army.mil).

A BCTP rotation consists of an Initial Planning Conference (IPC), a Battle Command Seminar (BCS), a Start-of-Exercise Conference (STARTEX), and a Warfighter Exercise (WFX) (TR 350-50-3, p. 5). The IPC is a planning conference that establishes the framework for the Battle Command Seminar and begins the planning process for the BCTP rotation. It is conducted at the unit’s home station and is designed to familiarize the commander with the BCTP methodology. The BCS, which is held at Fort Leavenworth, Kansas, assists the commander in building his command and staff team in preparation for the BCTP rotation. Initial exercise instructions are provided and the commander’s staff uses the Military Decision Making Process to coordinate and plan their BCTP rotation. The STARTEX is conducted at the unit’s home station. It establishes the framework for the entire exercise and details the starting conditions for the Warfighter Exercise. Finally, the WFX is a multi-echelon, tactical exercise conducted at the training unit’s home station. Brigade, division, and corps headquarters units deploy to local field sites to “wargame” various combat scenarios against the OPFOR using computer simulations.
The BCTP OPFOR simulates the Northland Republic, an armor-based force patterned after various former Soviet Union models (www.bctp.leavenworth.army.mil). The OPFOR replicates the doctrine and tactics of potential adversaries using computer simulations. The OPFOR is completely “free-thinking” and fights to win.

A unique aspect of the BCTP is its senior observers. Senior observers are retired senior general officers who are personally appointed by the Chief of Staff of the Army. They coach and mentor the rotational unit’s senior leaders and staff while also providing feedback to the Army’s senior leadership (www.bctp.leavenworth.army.mil).

THE FUTURE OF THE CTCs

The Combat Training Center Program has been extremely valuable in helping the Army meet its evolving training needs. Recognizing that most future military operations will require cooperation among the various branches of the armed forces, the Department of Defense plans to build a Joint National Training Center by October 1, 2004 (Gilmore, 2002).

CONCLUSION

Through the use of realistic, simulated combat conditions, technologically advanced simulation equipment, professional observers/controllers, and dedicated opposing forces, the Combat Training Center Program provides challenging, realistic training that is as close to combat as a unit can get without actually being there.

The Combat Training Centers offer a training opportunity that cannot be replicated at a unit’s home station. The training is all encompassing, from preparing personnel and equipment for deployment to a theater of operations, to pre-combat actions at a forward staging base, to conducting tactical combat operations, to re-deploying from a combat theater. Commanders can receive unbiased feedback that is free from command influence and offers a realistic evaluation of the unit’s readiness for deployment and combat operations. The training value is without equal, and the development of the Joint National Training Center will only serve to further improve the combat capabilities of the U.S. armed forces.

WORKS CITED
Army Training. (1983). Army Regulation 350-1. Retrieved August 29, 2002, from the World Wide Web: http://www.usapa.army.mil.
Caldwell, J. (2000, June). Commentary: After 225 years, U.S. Army is world’s best-trained. Army News Service. Retrieved August 31, 2002, from the World Wide Web: http://www.dtic.mil/armylink/news/Jun2000.
Center for Army Lessons Learned Web Site (www.call.army.mil).
Combat Training Center Program. (1995). Army Regulation 350-50. Retrieved September 10, 2002, from the World Wide Web: http://www.usapa.army.mil.
Combat Training Centers Web Site (www.usachcs.army.mil).
Joint Readiness Training Center Web Site (www.jrtc-polk.army.mil).
Battle Command Training Program. (1999). TRADOC Regulation 350-50-3. Retrieved September 14, 2002, from the World Wide Web: http://www.tradoc.army.mil.
Combat Training Center Program Handbook. (2000). Retrieved September 6, 2002, from the World Wide Web: http://www.ctc.army.mil.
Training at the National Training Center. (2002). FORSCOM Regulation 350-50-1. Retrieved September 9, 2002, from the World Wide Web: http://www.forscom.army.mil.
Training at the Joint Readiness Training Center. (1998). FORSCOM Regulation 350-50-2. Retrieved September 9, 2002, from the World Wide Web: http://www.forscom.army.mil.
Battle Command Training Program Web Site (www.bctp.leavenworth.army.mil).
Gilmore, G. (2002, September). Joint National Training Center in DoDs Future. American Forces Press Service. Retrieved September 25, 2002, from the World Wide Web: http://www.defenselink.mil/news/Sep2002.

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Emergency Response Aircraft Features

March 30th, 2010 | Author: wlomvy

The Following Story is brought to you by Air Ambulance

Outline of Paper
Introduction-Traumatic Brain Injury (TBI) and how it affects everything in one's life.
I. Causes For TBI
A. Car Accidents-Head blows, collisions, violent head movement(whiplash).
B. Other Causes-Falls, sport accidents
II. How do I know if I have a TBI?
A. Symptoms of a TBI
B. How the brain is hurt
III. Treatment
A. Hospital/Medical Help, and or procedures to help TBI
B. Different Therapies to help the brain
C. Anatomy of the Brain
IV. Problems
A. Everyday tasks-self-maintenance (showering,etc.)
B. School-learning disabilities caused from brain damage
C. Work-difficulties doing tasks, remembering tasks
D. Relationships
1.Family/Friends
2.Love
V. Coping with a TBI
A. The processes following
B. Getting on with everyday life as functional as you can
C. Acceptance and Recovery
======================================================
Imagine having to relearn everything all over again, from talking, to everyday tasks like showering, or eating. You finally find out from a doctor that you have had a traumatic brain injury. You feel confused and frustrated that you have no recognition of how you got into your current state. Your memory is impaired and as a result, your whole lifestyle changes. With a traumatic brain injury (TBI), you will go through therapeutic treatment to help you with the multiple problems you will face in the future, and will find difficulty stepping back into the “normal” everyday lifestyle that you lived prior to your accident.
When I was 17 years old, on June 17th, 2002, I was injured in a car accident that left me badly injured. Following the accident, I was helicoptered to San Jose Medical Hospital. I was unconscience and was in a coma for a 10 days. Through much medical testing (CT scan and MRI), I was diagnosed with a TBI.
Before the accident, I never had heard of traumatic brain injuries, nor did I understand what it was, or how one could get such an injury. On Nueroskills.com states that brain injury is the most frequent cause of disability and death among children in the United States. The site also states that more than one million children sustain brain injuries every year and approximately 165,000 require hospitalization. These threatening injuries are caused by various situations.
So, how can you get a TBI? Well, these brain injuries can be caused from a number of factors. There are too many causes to list, but one of the most common causes are car accidents, where people can hit their head in a violent motion resulting in hitting a dashboard or glass windows, which leads to a brain injury. The rate or speed of the car doesn't have to be fast in order for one to be severely injured, many people do not understand this.

Elderly people are also effected by TBIs. Another common cause of a TBI is people falling down; this usually happens with the elderly. If an elderly person cannot maneuver very well, the way one falls can determine how severe the injury is. Especially in this age group, there are many health issues, but everyone, both young and old should be aware of the circumstances of and after a TBI.
People can put themselves into risky situations in sports, where they have no idea what kind of risk they're at. For example, a person could have a TBI from a bad snowboarding/skiing, or hockey, football, rugby accident. You could have a bad fall while going down a hill for snowboarding/skiing and get a head injury. The same applies to all of the other examples-you could be pushed or fall down and get badly injured in the brain. This is usually a situation that a younger, more athletic person would be in.
So, how can you tell if you have a TBI? Well, you need to be aware of the causes and symptoms of a TBI to properly diagnose the specific case. Common indicators for a brain injury are: unconsciousness, headaches, dizziness, memory problems, word-finding problems, fatigue, concentration problems, etc. The list goes on, but with a TBI, you will face all of those problems and much more, due to the intensity of the trauma and how it effects your brain.
Well, if you have a TBI, your brain will be somewhat injured. Depending on the circumstances, your brain could be damaged, and the asperity will vary. That leads to explain the different types of injuries that the brain can have; from bruising(bleeding), tearing, and swelling in the brain.
If your brain is bruised, or bleeding, there is no room for the extra blood, and pressure builds up in your skull. Your skull is a very hard substance and it cannot expand without extra pressure, so the pressure goes elsewhere. This becomes a problem when blood begins to press on your brain tissue. Brain tissue is very fragile and can be damaged very easily, it can stop working properly and perhaps die off. A strong blow to the head may damage or rupture one of the blood vessels inside the brain, leading to heavy bleeding. Brain lacerations (tearing of brain tissue) can be a cause for bleeding as well(Brain Injury).

Tearing is a complete different subject, the brain can be torn in a forward/backward motion (most likely in car accidents). When the brain is torn, it is a very serious subject. In the brain, everything is connected, and there many neurons which are like wires which make the brain function properly, but with tearing, these wires can be 'cut', and things can't function normally. The brain has approximately 100 billion of these wires, and it's hard for doctors to determine if tearing has occurred, even with various medical tests. To indicate if tearing has happened, one would have to take a sample of the brain and look at it under a microscope; but taking a sample itself would cause additional damage.
In the brain, there is no extra room for anything, and when pressure builds up internally, swelling occurs. The pressure is so strong that it can cause damage in the brain. Doctors can install a valve for relief so that the excess pressure(intra-cranial pressure) can be released in order to try and fix the problem so that no extra damage is done. The doctor may need to drill a hole in the skull to relieve the excess pressure-(ICP) from building up.
There are many possibly injuries that can occur when you have a TBI, and you will need medical help. You might even need to have surgery depending on the severity of the situation. The procedures will vary from being as simple as getting a check up, to having brain surgery. There are endless medical procedures to help one with a TBI, the therapeutic treatment will vary.
When you have a TBI, there will be many medical issues that you need to work on. You will have a variety of specialty therapists to help you to recover. The first type of therapist that I'm going to talk about is an occupational therapist(O.T.). An occupational therapist helps a patient with physical rehabilitation as well as social skills(Hill 37). An O.T. helps with a variety of things, ranging from cooking to dressing yourself. They help patients to become more independent and functional in everyday life.

Another type of therapist that I'm going to talk about is a speech pathologist. When I was still recovering, I had to see a speech pathologist because I had learning problems in school due to the TBI. Speech pathologists help with speech and language and also they individualize a program for their patients to help improve concentration, articulation, memorization techniques, and listening skills.
The next type of therapist that I'm going to talk about is a psychotherapist, they help you with the mental recuperating process. A psychotherapist assists you with emotional, or psychological problems that you will face throughout the healing process. Due to chemical brain imbalance, you might need to start taking medication to help your emotional problems if they're severe enough. There are many other custom specialists as well who will help you along your recuperation procedures, they are individualized for the patient's needs.
So you have all these problems after your injury, what's really happening physically inside your brain? Well, The brain is a very complex organ in your body, it is the most important part for functioning on all levels. There are various degrees and severities of how damaged your brain is.
First off, the left hemisphere of the brain controls the right motor functions of the body, and vice versa. Depending on which side of the brain is injured, it will effect how your body is injured. Your brain is very fragile, so it needs some other layer to protect it, so, we have the human skull. The skull is made out of bone, which is calcified tissue; it is a very hard substance. The brain itself, is more like a soft, squishy, delicate substance, much like that of an egg. The brain is like the yolk of an egg and the shell is like the skull; in reality, the brain has the same consistency as an egg yolk. Directly beneath the skull are three thin membranes called meninges, they hold pockets of air and about a cup's worth of cerebrospinal fluid, that cushions the brain.

There are three cell layers beneath the skull and above the brain, they are as follows: (top) Dura matter, (middle) Arachnoid matter, and (bottom) Pia matter(Alcamo 114,115). These cell layers are there to protect the brain if anything would happen, but with a TBI, the impact is so intense, that these cell layers can bring further damage by applying additional pressure. Directly beneath that is the meninges is the wrinkled, cerebrum, which caps the entire brain. The cerebrum is the largest and most advanced part of the brain. This part of the brain controls certain skills like planning, problem-solving, judgement, sensory and movement. It is divided into two hemispheres- the left, and the right(7). Both the left and right hemispheres of the brain control the skills previously mentioned. So, what I just explained helps to understand why people who suffer from a TBI have all the problems that they do.
So, you're having these problems with everything imaginable, and its very difficult for you to do everyday tasks, you wonder why. Simple things never seemed like a challenge to you before; taking care of yourself never seemed to be so hard. Well, since you've had a TBI, its hard for you to remember. Most likely, you will have to relearn everything all over again. You will pass this phase eventually, but, learning takes time. You will have to re-train yourself, and your brain does this by connecting again through repetition.
School, becomes a huge challenge in your everyday life, it seems that you have difficulties with attention, forgetfulness, and understanding. You never had that problem before so intensely, what's wrong with you? The answer is nothing, you are still healing. Just remember to be positive and try to find out if you can qualify for some kind of special program at school to help you. Because of your impaired memory, tests are very difficult for you, and you need extra time, and perhaps you need to go into a separate room. Talk to your instructor and inform them of your condition, this will help them to help you.
If you are working, you need to let your co-workers be aware of your special needs. It may be hard for you to remember how to do certain things, or it may be difficult to do your job. These problems will go away eventually, just try to find another way to work around your problems successfully. Try not to work so hard, because your recovery will take time, your body and brain are still recuperating.

You find that you're not only having problems in everyday tasks, school, and work, but also your relationships seem difficult. You feel very emotional, and you may have anger issues, and sadness, try to cope with the issue(s) positively. Something that someone might say will make you angry, and you might start crying, or be violent to that person. This is normal for a person with a TBI, you are still healing and it's hard to relearn how relationships work.
Your love life isn't going well either, your significant other doesn't understand what you're going though. They say you've changed into a different person and are impatient with you. This is hard on you emotionally, you don't understand why you are having these problems, before your TBI, things weren't like this. So, you should try communicate and express yourself to solve the problem. It's difficult to go through so many emotions in your life. You have changed, everything that you have been through has changed you, accepting this fact is very difficult to deal with, especially for your partner. If things don't work out in a relationship, you may have to take a break so you can focus on recovering.
Your partner may have issues with coping with the many changes within you. But, you yourself are also coping with the many problems you're having in your life. You are having many difficulties in all aspects of your life right now, and you will need to cope with all of the emotions and physical recovery that you will deal with. This is very difficult to do, it is the hardest part to handle with a TBI.
Within the recovery process, there will be many obstacles that you will go through. Emotions are some of the obstacles that you will have face throughout recuperation. Typically, people with TBIs go through various emotional stages. They are: confusion and agitation, denial, anger and depression, the testing phase, and lastly, uneasy acceptance.

First, there is the confusion and agitation phase where you get frustrated because you can't understand what's occurring in life. Next you have denial, where you think there is nothing wrong with you. Some people cope with things differently, you might get angry at people when they say that you cant do something. There are two types of denial that people deal with; the first type is emotional denial, where you avoid the problem completely, and don't address what has happened to you at all. And secondly, the other type of denial comes from changes to the brain, the brain refuses to process certain information. Denial is very common for the situation, it is a form of non-acceptance.
The anger and depression phase comes next. This phase is where things finally settle mentally and reality kicks in. You get angry with yourself, or others around you, this causes unhappiness. This is a form of coping in a emotional way. You think to yourself, if only…or what if…, thinking like this will not help solve the problem. You are dwelling on the past situation, move forward and focus on the now.
After that phase, you can move on and test your capabilities. During this phase, you will challenge yourself to see where your limits are. This can be a very difficult phase to go through, you find through testing yourself that you are no longer at the level you used to be at. This is a very frustrating stage to be at; you find that you are no longer capable of doing things you used to do. This phase will pass with the uneasy acceptance phase.
Uneasy acceptance is understanding where you stand, and being able to tolerate it. Your limits are no longer where they used to be; uneasy acceptance is acknowledging that fact and being all right with the current situation. Uneasy acceptance is the last phase that you will go through, and this phase will occur on and off.
Essentially, everyone who goes through a brain trauma will go through dramatic personality and cognitive changes. After a brain injury, you may get confused, angry, paranoid, and violent, perhaps even suicidal(Abrahamson xi). A traumatic brain injury is very devastating, but, “The modern miracles of emergency medical services, medivac helicopters and surgical breakthroughs have enabled us to save the lives of those with serious brain injuries that were fatal very recently”(xiii).

A traumatic brain injury is a journey where one goes through frustrations as well as victories. So, there is hope for one who experiences a TBI. With the help of others, and self-help, you will overcome all the difficulties and struggles of the aftermath of a TBI.
You need to remember while going through this difficult time that you need to: “Be kind to yourself and use your energy wisely-but don't be afraid to live life. Mourn the loss of the “old you” and take a few risks, find humor in everyday things, and reconnect with friends and family at your own pace and on your own level”(Alber 268).
Remember that “No one can predict your eventual outcome. Your symptoms may be permanent, come and go unpredictably, or fade altogether. The one factor can determine your outcome in the way that really counts is you-how you see and accept yourself”(265).
Conclusively, we can say that a TBI is a very common, serious health issue that many people are unaware about. I was discharged from the hospital in less than 3 months; being a survivor of a TBI, I know that I am very fortunate and lucky to have recovered as well and speedy as I did. Traumatic Brain Injuries are very intense, I almost died from one, and many people actually do. The best advice that I can give to people who are suffering from a TBI is to keep your expectations of yourself higher than the expectations of others, and you will be able to survive through it all.
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works cited
Abrahamson, Patt. Brain Injury:a family tragedy. Houston, TX: HDI Publishers, 1997.
Alcamo, Edward I. Anatomy coloring workbook. New York, NY: Random House Inc., 1997.
Brain Injury. [United States]: New Mexico Head Injury System, 1990.
Hill, Barbara Albers, and Diane Roberts Stoler. Coping with mild traumatic brain injury. New
York, NY: Avery, 1998.
United States. Centre for Neuroskills. 1995-2002.

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Medivac Features

March 30th, 2010 | Author: wlomvy

The Following Blog Post is from Associated Content and brought to you by Air Ambulance Service

The course starts in Hopkinton, MA, follows Rte 135 through Ashland, Framingham, Natick and Wellesley and then veers onto Rte 16 through Newton, to eventually arrive in Copley Square, in that part of Boston known as Back Bay. Hours before the event starts, long stretches of the route are completely closed down to vehicle traffic and stay that way for hours after the main body of runners pass.

As a cab driver in Framingham, I dreaded Patriots' Day, because the running of the Boston Marathon literally cut off south Framingham from the rest of the world. Depending on where you happen to be when the Marathon route is shut down for the race, you can spend your time either ferrying fans and spectators all over creation, or simply stand next to your cab, watching people watch the race. There has been enough prior planning to locate MEDIVAC helicopters at key points to transport accident victims or mothers in labor, but just about everything else comes to a screeching halt.

My closest experience with involvement in the Boston Marathon was to transport a fare from Framingham Union Hospital to the medical tent… in Copley Square… while the race was in progress. As part of the entry agreement, The Boston Athletic Association agrees to see that every runner who enters makes it to the finish line, even if he/she needs to be transported. They pay on delivery to the medical tent. All I had to do was figure out how to do that.

He was still in his running outfit and carried a scrunched up little banner with his assigned number. He was, I believe, from Kentucky and had about $5,000 of his own money tied up in the race- entry fees, transportation, hotels, meals… In short, he was a serious runner- Not some clown attending a cookout in Hopkinton, who had a few too many beers and decided to stumble alongside the race for a photo op, or to impress his friends.

He'd had the flu back in February of that year, but thought he was over it. Being the dedicated athlete he was, he'd taken off with the other runners at the start of the race, made it a couple miles to the Ashland town line… and took a nasty header straight into the pavement, completely dehydrated and his electrolytes all out of whack. They'd transported him by ambulance along back roads, to the hospital, to stabilize and rehydrate him. Getting him to the finish line was my problem.

Under normal circumstances, the straightest shot was the Mass 'Pike, to the Prudential/ Copley Square exit- about seventeen miles and maybe twenty minutes, one way. That, of course, wasn't going to happen. State Police cruisers blocked the exit ramp. The best I could do was make the South Station exit and then roll back along crowded side streets to Copley- a frustrating hour and one half trip.

Once we made the medical tent, I was also treated to the unique experience of trying to find someone in authority to sign off on the charge slip. During that forty-five minute exercise, I got to watch as busses, ambulances and other cabs pulled up and discharged- or assisted- their fares into the tent.

It was like something out of a war or disaster movie. People hobbled in or were carried on litters; People lay moaning on combat stretchers, while attentive volunteers and medical staff flitted here and there, checking vitals and treating for exhaustion- all in all, a pretty grim, sad scene… And then it hit me. These people weren't accident victims or innocents caught up in some disaster. They were wannabe athletes, strung out on their own endorphins, who either didn't train properly, or who had over-extended themselves because their friends were watching.

I finally got my charge slip signed, shook my head and left. I have no sympathy for self-inflicted injury.

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