Training from the front lines

A dozen medical students watch intently as William Kinkle manipulates a laryngoscope down the throat of an eerily lifelike medical dummy.

"Follow the tongue down the midline, find the epiglottis, then kind of jiggle the tongue out of the way," says Kinkle, a registered nurse and paramedic who teaches airway-management courses.

Kinkle was one of four instructors at yesterday's Trauma Skills and Simulation Workshop at the University of Pennsylvania's Clinical Simulation Center at 18th and Lombard Streets, a day-long, elective session that introduced some of the basic techniques used by trauma-care specialists.

"Trauma care is not part of regular med school training. We learn . . . life support [techniques], but trauma is its own specialty," said Doug Stoddard, a fourth-year Penn medical student who organized the event.

"When a patient comes to the trauma bay in the ER, it's up to the trauma surgeon to [decide] whether we need to open this person's body. It's one of the more cerebral surgical specialties, because you have minutes to make your call, but you have to think about how your patient will be doing weeks out."

The first of its kind in Philadelphia, the program drew 46 students from four medical schools: Penn, Temple University School of Medicine, Thomas Jefferson University, and the Philadelphia College of Osteopathic Medicine.

It was conceived in 2007 by Stoddard and his mentor, John P. Pryor, who was trauma program director for the Hospital of the University of Pennsylvania and a decorated major in the Army Reserve when he was killed on Christmas during his second tour of duty in Iraq.

"He was very, very passionate about trauma care and about helping people who were in their most desperate position in their lives," said Stoddard, 28, an Army Reserve second lieutenant who plans to do his residency in trauma surgery with the Army.

"He already had done one tour [of Iraq] . . . and he believed every doctor should be exposed to trauma training. It was this philosophy which attracted me to him as a mentor."

Stoddard, who at 6-foot-5 towered above most of his fellow medical students, said Pryor had written him an e-mail in November asking that they postpone the class because he was about to mobilize.

"He said, 'I apologize for my weakness,' " Stoddard said. "It was so typical of Dr. Pryor. Here he was preparing to go back to the war and he was apologizing to me!"

Patrick Kim, interim trauma program director, who supervised Stoddard's curriculum, was on hand to teach Focused Assessment With Sonography for Trauma, which uses specialized ultrasound to detect internal bleeding.

Why would already overworked med students take a course that wouldn't earn them any credits?

Hawaii native Grant Garbo, who is beginning his fourth year at Temple, said he hoped the workshop would give him a leg up when he began his residency.

"I wanted to start getting some experience so that when I see a real procedure I'll have a better idea of what they're doing and why they're doing it," he said.

University of Scranton graduate Bridget McGovern, a second-year student at the Philadelphia College of Osteopathic Medicine, said the program was perfect for someone in the military.

"I'll eventually be in a trauma setting" as a military surgeon, said McGovern, who was commissioned in the Air Force Reserve in July, "so I thought it was a good idea go get into it as early as possible."

"I love my country, and it's my role since they've given me a lot," she said of the Air Force, which is paying for her training. "And my family has a long history of military service."

Partly based on the American College of Surgeons' Trauma Evaluation and Management curriculum, yesterday's workshop included lectures on basic trauma care, hands-on skills workshops, and trauma simulations using SimMan modules - dummies that can simulate medical conditions including heart attacks, internal bleeding, and childbirth.

"The Sims give them a chance to work in a comfortable environment away from actual patients," Kim said.

Given Pryor's service, it wasn't surprising that there was a military presence. Maj. Leon Hooten of the Army Medical Recruiting Office in Cherry Hill was available for students interested in the military.

Army Reserve Maj. Forrest Fernandez, director of the Trauma Center at Reading Hospital, gave a lecture on military trauma.

"The techniques we use are a bit different since the gunshot wounds we treat are high impact. An AK-47 round will travel three times faster than a handgun," said Fernandez, who has served in Iraq.

Stoddard said you didn't have to be in Iraq to put trauma training to good use. "Gunshot wounds are such a problem here, we've been at war in Philly for years," he said.