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By Martin Hill, BA, CHS-III; Mike Galarneau, MA; Gerry Pang, MA; & Paula Konoske, PhD
The Marine Corps Chemical Biological Incident Response Force (CBIRF) was established in 1996 in response to Presidential Decision Directive 39 to outline the nation’s plan for responding to terrorist acts at home and abroad. CBIRF’s mission subsequently expanded from biochemical response to the full scope of chemical, biological, radiological, nuclear, and explosive responses. The objective of this study was to determine the medical supply requirements for CBIRF’s expanded mission.
In November 2003, preliminary research on injury types and medical interventions seen at previous terrorist incidents was presented by the Naval Health Research Center (NHRC) to a subject-matter-expert (SME) panel consisting of military medical and logistical experts. The SME panel identified the clinical tasks that CBIRF needed the capability to perform. NHRC’s method of modeling supply requirements was then applied to those tasks, establishing the clinical requirements for CBIRF’s Authorized Medical Allowance Lists (AMAL). This study was able to identify weaknesses in the existing CBIRF AMALs and strengthen the unit’s field medical capabilities with the addition of new technologies and modularization that allows greater flexibility in responding to terrorist disasters.
Results
Trauma Supplies. NHRC’s method of modeling medical supply requirements, developed to establish and review AMALs for various levels of care in the Navy and the Marine Corps, was used to determine the type and amount of trauma supplies and equipment CBIRF needed to accomplish its mission. The NHRC modeling method ensures military clinicians get the proper type and amount of medical equipment and supplies they need to successfully complete their field missions. The method involves a four-step process that usually begins with the identification of the patient types that are likely to be encountered, including those with combat wounds, nonbattle injuries, and illnesses. These are identified from the Defense Medical Standardization Board (DMSB) patient treatment briefs, which establish the military treatment protocols for more than 400 injuries and illnesses, called patient conditions (PC), which the DMSB has identified as the most likely to be seen on military operations. The treatment briefs identify the treatment to be given for each PC at all levels of care in the military medical system—from the combat medic through the field hospital—and are commonly used by the armed forces for training and modeling manpower requirements.
NHRC’s usual process involves producing a patient stream using a casualty generation program such as the Marine Corps CASEST program, or the NHRC FORECAS program. Both of these programs use historical combat casualty statistics applied to the DMSB patient conditions to predict casualties in a variety of battle scenarios using both conventional and non-conventional weapons. The selected patient conditions are matched with appropriate clinical tasks, and those tasks are then mapped to the necessary supplies. This process produces an audit trail identifying those necessary supplies and avoids stocking AMALs with needless items.
Figure 1 provides an abbreviated illustration of the NHRC modeling process as applied to a combat medical scenario. Shown is a sample task profile for providing emergent care to a patient with a trauma brain injury (PC 005) in the triage section of a Level 2 surgical field hospital. Not shown, but also used in the calculation of materiel, are the number of patients with that type of injury (or patient condition code), their average length of stay, the number of times a clinical task is expected to be performed on each patient in a 24-hour period, and the quantity of each supply needed for performing each task.
At the time of this study, NHRC research found no reliable means of projecting a casualty stream for terrorist-related events or studies identifying and quantifying likely terrorist-related injury patterns. Attempts to produce a terrorism-related trauma casualty stream using the combat-oriented CASEST and FORECAS patient generators proved unsatisfactory. However, CBIRF’s intense training efforts had shown that the unit was capable of treating up to 100 serious, nonambulatory trauma victims over a 1- to 2-day period (Temerlin, 2003). Therefore, the SME panel agreed that a casualty stream of 100 patients would be appropriate for calculating trauma supplies.
Since a reliable stream of patient types could not be developed, the SME panel reviewed a list of clinical tasks produced by NHRC and identified those that would be necessary capabilities for the CBIRF medical section. These tasks were culled from task descriptions developed by DMSB and NHRC for medical modeling purposes. The tasks selected by the SME panel are listed in Table 2.
What does the CFN program do for me?
The Certified Forensic Nurse (CFN) title can demonstrate to your colleagues, patients, clients, employers, and the healthcare community that you have extensive knowledge and education, personal experience, and that you are committed to furthering your education in the forensic nursing profession. CFN also helps to contribute to the weight and relevance of your testimony and how applicable the evidence is that you must present to a court of law.
Forensic nursing is an exciting and rapidly growing specialty field that offers great opportunities and rewarding career options for nursing professionals. However, it can be challenging to set yourself apart from your peers to get the recognition and respect you deserve, both in the medical community and the legal arena.
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Want to know more about the American College of Forensic Examiners? Read the definitive history of the world's foremost association for foresnic experts, mental health professionals, and homeland security experts. If you want to understand the rise of ACFEI, this is the only book you'll ever need.
You can access United for Truth here.
Aside from our many strategic alliances and accreditations, here are some more things to keep in mind before choosing a credentialing program, and why the American College of Forensic Examiners Institute and its sister associations are a good choice to make:
For more information about credentials, the associations, or our journals, please visit us:
The American College of Forensic Examiners Institute: www.acfei.com
The American Psychotherapy Association: www.americanpsychotherapy.com
The American Association of Integrative Medicine: www.aaimedicine.com
The American Board for Certification in Homeland Security: www.abchs.com
Membership. Some of The American College of Forensic Examiners’ well-known members and Board members include; Dr. Henry Lee, Dr. Greg Vecchi, Dr. Zhaoming Chen, Dr. Marc Rabinoff, Congressmen Billy Long and Steven King, and Governor Tom Ridge. These individuals, as well as many other not listed here, have helped mold and guide ACFEI to be the prestigious, online, interactive, multimedia publisher that it is today. They have contributed their knowledge and expertise to ACFEI’s online credentialing programs such as the Certified Forensic Physician®, CFP program; the Registered Investigator®, RI®, program; and the Certified Forensic Consultant, CFC® program; to name a few.
ACFEI and all of its associations are continually seeking further validations, alliances, and accreditations in order to offer maximum continuing education benefits to its thousands of members. Sometimes it is our very members who foster these relationships; we encourage you to get involved and share your ideas for future alliances! This is a group of associations that recognize themselves as yours. We invite you to add your expertise to the pool and make it even greater.
Call (800) 423-9737 for more information, or visit acfei.com.
ACFEI is also an approved provider of training by the following professional organizations:
The outside bodies listed above, as well as the many other attest to the fact that the ACFEI has met or exceeded their regulations and standards to be approved providers of training. Organizations that represent medical doctors, accountants, psychologists, attorneys, law enforcement officers, dentists, military personnel, and numerous other professions and specialties would never approve an lesser, unregulated institution to provide training to these important persons.
Please contact either the American College of Forensic Examiners International, The American Board for Certifcation in Homeland Security, The American Association of Integrative Medicine, or the American Psychotherapy Association for more information about their respective programs, accrediting organizations, and educational opportunities:
www.acfei.com; (800) 423-9737
www.abchs.com; (877) 219-2519
www.aaimedicine.com; (877) 718-3053
www.americanpsycotherapy.com; (800) 205-9165
As the editor in chief of The Forensic Examiner, Annals of the American Psychotherapy Association, and Inside Homeland Security (all peer-reviewed and available on newsstands); and for the associations themselves (The American College of Forensic Examiners International, The American Board for Certification in Homeland Security, the American Psychotherapy Association, and the American Association of Integrative Medicine), I have the privilege of working not only with individuals with remarkable talent, credentials, experience, and professionalism here at the ACFEI Headquarters, but also with the thousands of members who renew their memberships year after year to learn, network, and even teach one another.
I am proud to work with the courses and articles conceived and written by dedicated professionals who have made it their living to help heal, defend, serve, protect, and save their fellow citizens from terrorism, criminals, mental illness, disease, and so many other world problems and pandemics. I have reviewed dozens of resumes and curriculum vitae for my peer reviewers and course authors. Their degrees, credentials, and experience speak for themselves of the excellence embraced and exuded by the associations.
Under the umbrella of the American College of Forensic Examiners International, I have reviewed and edited articles that discuss cutting-edge research written with government agents I interviewed in person at Quantico; I have met forensic legends Dr. Cyril Wecht and Dr. Henry Lee (both long-time ACFEI members); and I get to see to completion the modules and coursework that are born of the passion of many prominent individuals from an array of important fields. I know for a fact that the continuing education curricula individuals like these and others help create are forged from impeccable research, training, and consultation. These people are far too intelligent, prestigious, and philanthropic to waste their time with lesser organizations; Dr. Robert O’Block’s ACFEI stands only for legitimacy and professionalism.
What is it that draws so many—nurses, physicians, soldiers, investigators, government employees, psychologists, psychiatrists, social workers, and a sheer multitude of other honorable professions—into the American College of Forensic Examiners Institute fold? Decide for yourself, as thousands wisely did before you:
www.acfei.com
www.abchs.com
www.americanpsychotherapy.com
www.aaimedicine.com
The American College of Forensic Examiners Institute began in 1992; it is still here. Most membership associations rise and fall in less than a decade, but the passion of ACFEI’s founder, Dr. Robert O’Block, and the thousands of reputable people his associations help each year, has fueled continued growth since ACFEI’s inception nearly two decades ago.
As we continually improve our continuing education coursework, Web presence, and printed publications, that growth is bound to continue. The fields in which our members work, study, and fight—homeland security, all areas of forensics, integrative medicine, and psychotherapy—are not going anywhere anytime soon, and are dynamic and ever evolving. When you join the American Board for Certification in Homeland Security, the American Association for Integrative Medicine, the American Psychotherapy Association, or the tried-and-true American College of Forensic Examiners Institute, you will see that we rise above the competition in offering continuing education excellence. Dr. Robert O’Block has created a unique opportunity for you to meet like-minded professionals to network, learn, and teach one another and the world at large.
To learn more about each of these associations, please come see us:
The American College of Forensic Examiners: www.acfei.com
The American Board for Certification in Homeland Security: www.abchs.com
The American Association of Integrative Medicine: www.aaim.com
The American Psychotherapy Association: www.americanpsychotherapy.com
The American College of Forensic Examiners International began in 1992; it is still here. Most membership associations rise and fall in less than a decade, but the passion of ACFEI’s founder, Dr. Robert O’Block, and the thousands of reputable people his associations help each year, has fueled continued growth since ACFEI’s inception nearly two decades ago.
As we continually improve our continuing education coursework, Web presence, and printed publications, that growth is bound to continue. The fields in which our members work, study, and fight are not going anywhere anytime soon, and are dynamic and ever evolving. When you join the American Board for Certification in Homeland Security, the American Association for Integrative Medicine, the American Psychotherapy Association, or the tried-and-true American College of Forensic Examiners Institute, you will see that we rise above the competition in offering continuing education excellence. Dr. Robert O’Block has created a unique opportunity for you to meet like-minded professionals to network, learn, and teach one another and the world at large.
To learn more, please visit www.acfei.com.
What is it that draws so many—nurses, physicians, soldiers, investigators, government employees, psychologists, psychiatrists, social workers, forensic examiners, and a sheer multitude of other honorable professions—into the American College of Forensic Examiners Institute fold? Let me share with you just a few of the numerous reasons so you can better decide for yourself, as thousands wisely did before you:
Accreditation. The American College of Forensic Examiners Institute is an approved provider of continuing education by the following:
Continuing education alignments. In addition to the several accreditations above, we are also proud to inform you that:
To learn more, visit www.acfei.com
By Leann Long, BS
A Tragedy Unfolds
On the morning of February 2, 2002, the parents of Danielle van Dam were forced to face their worst nightmare when they discovered the empty bed of their 7-year-old daughter. Danielle was last seen the night before when Damon van Dam put his beautiful blue-eyed daughter to bed. The distraught parents immediately reported Danielle as missing, and an extensive search involving hundreds of volunteers began. Authorities assumed that the innocent young child was abducted from her bed while she slept on the night of February 1, 2002.
Copyright ©2009
ABFE,
ACFEI,
and ABCHS. All rights reserved. Dr. Robert O'Block, Founder, CEO, and Publisher.
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