Reservist

ISS3 2012

Reservist Magazine is the award-winning official publication of the United States Coast Guard Reserve. Quarterly issues include news and feature articles about the men and women who comprise America's premier national maritime safety and security

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Shipmates in Focus Reservist Brings Expertise to Traumatic Brain Injury Treatment By Caroline Acton, CG-1313 Intern contributions as a Coast Guard Reservist with the Department of Defense's (DoD) Automated Neuropsychological Assessment Metrics (ANAM) program and most notable for his work as a government contractor in the development of Military Acute Concussion Evaluation (MACE) Training Programs, which were developed to ensure a uniform procedure for conducting traumatic brain injury (TBI) assessments in a deployed combat environment. Prior to the implementation of the Training Program, deployed O MACE DoD medical personnel did not have standardized evaluation and documentation protocols for screening, identifying and documenting TBIs. According to Lt. Doria, "This lack of standardization may have exposed sailors, soldiers and Marines to negative compounding effects of TBIs because they were not being uniformly evaluated after experiencing a TBI event (e.g. explosions)." The MACE Training Program, under the stewardship of Lt. Doria, has succeeded in educating providers on the standard processes for evaluating and documenting TBIs. The training program equips medical personnel to identify TBIs and will ultimately protect the health and wellness of many sailors, soldiers and Marines. Capt. Jeffrey Salvon-Harman, MD, Chief of Operational Medicine and Medical Readiness for the Coast Guard, elaborated, "Broader implications exist beyond TBI itself. Suffering from a TBI unknowingly may result in depression or substance abuse, and can even lead to premature separation from service." Lt. Doria was employed by the Henry M. Jackson Foundation for the Advancement of Military Medicine through the Center for Deployment Psychology, Uniformed Services University, which was contracted by the U.S. Navy Bureau of Medicine (BUMED). There he was the principal facilitator in the development of four new training courses over the span of about one and a half years forming the foundation of the MACE Training Program. The courses support the Navy and Marine Corps' TBI Program in assessing brain trauma within the Navy, Marine Corps, and Coast Guard. 30 RESERVIST ᕇ *TTVF t n une 1ͺǡ ʹ01ʹǡ ieutenant ichael Ǥ oriaǡ Ph.D. was presented with the U. S. Coast Guard Meritorious Public Service Award from the Director of Health, Safety, and Work-Life for his The purpose of the MACE Training Program is to properly train medical personnel in providing a brief standardized battleϐield evaluation that combines the documentation of the subject's injuries and symptoms, and a cognitive screening procedure for a TBI incident (e.g., concussion) and facilitates the rapid decision-making process for identifying the requirement for an increased level of medical care on the battleϐield ȋiǤeǤ MedEvac). When an Improvised Explosive Device (IED) detonates, all personnel within a 50 meter radius of the blast require MACE screening and receive a minimum 24-hour recovery period to recuperate. Personnel are then rescreened again using MACE after the mandated time period, and medical treatment determinations are made affecting the personnel's deployment status, orders, and subsequent medical treatment. The courses Doria developed include: a standardized MACE Program; a MACE Train-the-Trainer Program; a MACE Line Leader Training Program and a Lead MACE Trainer Program designed for each of the three branches. Training is tailored to different levels of instruction of those deployed personnel. The MACE Program itself is a peer- taught, four-hour continuing education course that consists of several components with a edical fϐicer ȋ Ȍ and a corpsman coǦ teaching the material. The MO teaches about brain function and the policy pertaining to TBI/ concussion, which is "a traumatically induced structural injury or physiological disruption of brain function as a result of external force to the head," states Doria. Signs of mild TBI/concussion include: loss or alteration of consciousness, impaired memory, confusion or disorientationǡ neurological deϐicits or intracranial lesions detected with imaging. IEDs are currently the number one cause of brain injuries. The corpsman provides instruction on how to administer the MACE training. In addition, participants practice with exercises, partake in case studies, and watch instructional videos. The model designed by Lt. Doria provides quality control and centralized headquarters management of curriculum design and development, instructional delivery, testing,

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