Navy-Marine Corps Medical News (December 2010)

a joint venture by Naval Facilities Engi-neering Command Southwest and is alla part of the base’s project to improvequality of life for its Marines and Sailors.

“As you drive around the base youcan still see buildings from the WorldWar II era,” said Marano in his openingremarks at the groundbreakingceremony. “Thankfully there are fewerand fewer every day, as they are beingreplaced with more efficient, state ofthe art structures, with quality of life inmind. The hospital plays a huge role inthat improvement for our Marinesand Sailors.”

The services provided by the newhospital will include inpatient medicalfacilities, ancillary departments, emer-gency care, primary care, specialty careclinics, support spaces and facilities for

A Public Affairs Publication of the Bureau of Medicine and Surgery

December 2010New Naval Hospital on Cutting Edgeof Technology for Next 50 Years

See HOSPITAL, Page 3

MEDNEWS Items of Interest:

December marks “Navy Medicine’sAdvancements in Medical Technol-ogy” - During this month, NavyMedicine highlights military medicaltechnological advancements that havea direct impact on the quality, accessi-bility, and sustainability of care NavyMedicine provides to Sailors, Marines,and their families.

MHS Conference will be held Jan.24-27 at the National Gaylord Hotel,National Harbor, Md.

BUMED Sailor of the Year - HM1Tyrone Hodges was selected asBUMED SOY. Hodges will competein the VCNO SOY competitionnext year.

Holiday message from the troops -Defense Media Activity created aholiday message from over 40 com-mands to share the holiday spirit. Seethe video: http://go.usa.gov/1ua.

Find us on Facebook. U.S. NavyBureau of Medicine andSurgery, and follow us onTwitter @ Navy Medicine

Did You Know…Telepharmacy Robotic Medica-tion Dispensing Unit (TRMDU)is a two-way communicationsoftware that enables a health-care professional to remotelymanage prescriptions storedand released by the patient-operated delivery unit. Itmaintains one electronicmedication administrationrecord in real time.

MARINE CORPS BASE CAMPPENDLETON, Calif. — Marine andNavy leaders broke ground on the 70-acre construction site for the new CampPendleton Naval Hospital, Dec. 2.

The four-level, 500,000 square foothospital will be located near the maingate and will have an expected staff ofmore than 1,100.

“The new Naval Hospital is keepingon the cutting edge of technology for atleast 50 years to come,” said Col. Nicho-las F. Marano, commanding officer,Marine Corps Base Camp Pendleton.

The new hospital is funded under theEconomic Recovery Act, created byPresident Obama. The $394 millioncontract is awarded to Clark/McCarthy,

MARINE CORPS BASE CAMP PENDLETON, Calif. — Military and civilian personnel involvedwith the Naval Hospital Camp Pendleton replacement hospital construction project break groundto officially begin construction on the facility, Dec 2. The new 500,000-square foot, multi-levelfacility will replace the current 37-year old hospital. (U.S. Navy photo by Mass CommunicationSpecialist 1st Class Michael R. McCormick/Released)

By Lance Cpl. John Robbart III, Marine CorpsBase Camp Pendleton

Wherever I go people often ask mewhy I’m so focused and committed toresearch and development when wehave an ongoing two front war andcountless other priorities. It is becausethe medical technology breakthroughsthat advance the quality of care weprovide our Sailors and Marines andtheir families originate from the re-search development labs and schools.We must continue to support innovativemedical technology-focused researchso we keep pace or stay ahead of thetechnology curve. Science and technol-ogy, research, and development are thebases from which most of our innova-tions come. We anticipate further tech-nological advancements in all areas ofmedicine in the coming years.

This month I’d like to highlight someof those military medicine technologicaladvancements that are having a directimpact on the quality, accessibilityand sustainability of care we provideour beneficiaries.

The first is advancements in elec-tronic health records (EHR) which willleverage care and also the mobility of themilitary health system. A more ad-vanced EHR that uses cutting edgeinformation technology and security

Navy Medicine’s Advancements in Medical Technology

December 2010 Page 2

will help as men and women move inand out of combat zones or relocate sothat a complete EHR will follow themregardless of location. The EHR willinclude immunizations, past medicalhistory, current medications, andallergies to those medications to createa more efficient system in how wehandle medical care, and the accuracyand quality of that care.

In partnership with the DoD’sTelemedicine and Advanced Technol-ogy Research Center, we are studyingthe potential benefits of a TelepharmacyRobotic Medication Dispensing Unit(TRMDU) for our returning servicemembers who suffer from TBI or otherpost-traumatic stress. The medication

delivery unit has two-way communica-tion software that enables a health careprofessional to remotely manage pre-scriptions stored and released by thepatient-operated delivery unit. Not onlywould this unit leverage and extend theclinical pharmacy capacity, it wouldmaintain one electronic medicationadministration record in real time.

With care increasing at transitionalhousing, outpatient, and in-homesettings, the TRMDU system isexpected to give medical providers theability to remotely deliver, adjust, andmonitor a patient’s drug therapy fromthe battlefield, to a combat supporthospital, to an outpatient center, andultimately to a home setting.

Another cutting edge technologycoming to fruition includes advance-ments in hand, extremity, and even facetransplantation and also new break-

SURGEON GENERAL’S CORNER

Navy Bureau of Medicine and Surgery

Vice Adm. Adam M. Robinson, Jr.U.S. Navy Surgeon General

Capt. Cappy SurettePublic Affairs Officer

Valerie A. KremerMEDNEWS Managing Editor

Public Affairs OfficePhone: 202-762-3160

Fax: 202-762-1705

Bureau of Medicine and Surgery

2300 E Street NW

Washington, DC 20372-5300

Vice Adm. Adam M. Robinson, Jr.,

U.S. Navy Surgeon General

“We must continueto support innovativemedical technology-focused researchso we keep pace orstay ahead of thetechnology curve.”

throughs in retinal and visual rehabilita-tion. There have also been electricaland physiologic advancements inhelping to restore vision. For TBI care,we are using the virtual environmentto challenge the brain through special-ized video games and other computer-based programs that provide visual,spatial, language and coordination tasks.

Lastly, we are in the lead in develop-ing a more agile next generationDNA vaccine technology against deadlydiseases like malaria, dengue fever,and scrub typhus as well bio-engineeredweapons. This new generation ofvaccines is expected to be safer, cheaper,more stable, easier to administer, withfewer side effects, and more effectiveagainst a wider variety of diseases.

All of these advancements in carestarted with an idea and translated intoprograms and initiatives to help betterserve our wounded warriors, ourdeployed Sailors and Marines, and theirfamilies. You can be confident we willcontinue to focus on using technologyto our advantage to maintain the highestquality across the continuum of care.It is my honor to represent you as yourSurgeon General. Thank you for every-thing you do, but most of all thank youfor your service.


non-ambulatory patients with stays in excess of 24 hours. It willalso include a central utilities plant, a multi-level parking struc-ture and surface parking. Site enhancements such as walkingpaths are also included in the construction project.

The guest speaker at the groundbreaking event was ViceAdm. Adam. M. Robinson, Jr., surgeon general of the Navyand Chief of the Navy’s Bureau of Medicine and Surgery.

“Navy Medicine is Marine medicine,” said Robinson.“Wherever Marines go, there will be Navy."

Robinson explained to the guests how the new hospitalwould be centered more on patient care.

“Focusing on our warriors that come to our hospitals is thefundamental strength by which Navy Medicine is conducted,”said Robinson.

The hospital is scheduled to be completed January 2014, andwill be ready for use later that year.

HOSPITALFrom Page 1

MARINE CORPS BASE CAMP PENDLETON, Calif.— Artists renderingof the new Naval Hospital Camp Pendleton replacement hospital. Thenew 500,000-square foot, multi-level facility will replace the current37-year old hospital. The new hospital is scheduled to be completed Jan.2014 and will be ready for use later that year. (Courtesy photo)

Naval Hospital Bremerton Opens New Simulation Center

By Douglas H Stutz, Naval Hospital BremertonPublic Affairs

BREMERTON, Wash.— A ribboncutting ceremony marked the officialgrand opening of Naval Hospital Brem-erton's Simulation Center, Nov. 18.

As part of the ceremony, and withsuch advanced tools as high-fidelitypatient mannequins and a MobileObstetric Emergency Simulator, theassembled Navy doctors, nurses, hospi-tal Corpsmen, and support staff wereintroduced to high-tech replicationsoffering all-too-real training opportuni-ties at their own command.

"We are training for tomorrow'smission today," said Cmdr. Sally Butler,NHB quality management head. "I'mreally excited and proud that we cannow train for the unexpected andunpredictable as well as the routine,and also for our operational readinesscomponent heading down-range."

According to Butler, learning how toprovide medical support to critical careadult patients provides the core struc-ture of the simulation lab, but there is agradual emphasis being placed on train-ing to handle pediatric casualties andchild trauma cases. The SimulationCenter will enable staff members to

practice techniques to ensure patientsafety, clinical competence and opera-tional readiness.

"The training here will lead toimmediate life-saving efforts in thefield," she said.

A sizable show of hands was raisedby staff members at the grand openingwhen asked who had experiencedpediatric injuries/child trauma whiledeployed as an Individual Augmentee.

"Pediatrics is the new frontier intrauma training for us," said Butler.

Butler said several Navy nurses whohave already deployed to Iraq andAfghanistan as IAs, are currently receiv-ing specialty training in a simulationcenter to then help facilitate and sharethe learned lessons once back at NHB.

"Because we (Navy Medicine) werethere and when the local populationknew we were there, they would bringtheir children needing care and we neverturned anyone away," said Lt. Cmdr.Kevin Gue, NHB intensive care unitcritical care nurse.

"Whether it's dealing with traumahere or trauma down range in Afghani-stan, this simulation center gives us thetool and means to get as close as we can

BREMERTON, Wash.— Lt. Cmdr. KevinGue, a critical care nurse for the intensivecare unit at Naval Hospital Bremerton, prac-tices rendering emergency aid to a pediatriccasualty during the grand opening of theNaval Hospital Bremerton Simulation Cen-ter, Nov. 18. The center will allow Navydoctors, nurses, hospital Corpsmen andsupport staff to prepare for a wide range ofmedical emergencies. (U.S. Navy photo byDouglas H. Stutz/Released)

See BREMERTON, Page 4


Navy Surgeon General Addresses Global HIV/AIDS Challenge

BREMERTONFrom Page 3

simulation dummies and mannequins are the next best thing tolive tissue. We've really come a long ways from how it used tobe. This gear is great."

The Simulation Training Center is available for adultresuscitation; child/infant resuscitation; labor and deliverymanagement; advance airway management for adults; nuclear,biological, or chemical incident training; multidisciplinary teamtraining events for medical and surgical wards, intensive careunit and Emergency department; operationally focused traumareenactment to support the now-mandatory pre-deploymentTCCC for hospital corpsmen.

"We also plan on sharing the center, such as with the USSJohn C. Stennis (CVN 74) medical department," said Capt.Mark Turner, NHB executive officer. "It will be very helpful forthem in any number of training evolutions in preparing forcarrier strike group operations."

get with necessary training to be prepared," said Capt. Mark E.Brouker, NHB commanding officer. "No training can providereal-life trauma instruction, but our new center will help us drilland gain skills very close to real-life."

"My goal is to pass on my acquired experience from the fieldand help others to build up their muscle memory skill whenhandling casualties to be successful in a combat zone," saidHospital Corpsman 2nd Class Andrew Chase of Eugene, Ore.,Simulation Center leading petty officer.

Chase is also a Tactical Combat Casualty Care Courseinstructor, having spent approximately 14 months in Iraq, fromthe desert of Al Anbar province to Baghdad, to the southerncoastal region of the Al Faw peninsula.

"No one can fail in this simulation center," said Chase. "These

From Bureau of Medicine and Surgery PublicAffairs

SAN ANTONIO - The U.S. Navysurgeon general addressed the impor-tance of controlling HIV/AIDS in globalmilitary and peacekeeping organizationsto an international audience Dec. 6,during the 10th annual HIV/AIDSPlanning and Policy Seminar held at theCrowne Plaza, Dec 3.-10.

Vice Adm. Adam M. Robinson, Jr.discussed the healthcare challengesassociated with the spread of HIV/AIDSand provided some recommendations tosenior Ministry of Defense and Ministryof Health medical officers from morethan 40 countries including sub-SaharanAfrican nations, Southeast Asia, EasternEurope, and South America.

"HIV/AIDS is not a problem for justsome countries, but for all militariesaround the world," said Robinson. "Thisis a significant public health issue andnot one that can be ignored."

The seminar is designed to assist par-ticipants in the development of strate-gies and policies to execute sustainable,effective programs for HIV preventionand consequence management.

Robinson highlighted success storiesin countries like Botswana, Chile, thePhilippines, Thailand, and Zambia, andrecommended that all nations working

together should look at what they weredoing right and replicate their bestpractices across the board. Accordingto Robinson, these countries haveimproved or expanded their preventioneducation, including training theirmilitary medical and nursing staffs.

Robinson also emphasized theimportance of 100 percent comprehen-sive testing for all military members,regardless of nation, on an annual basisat a minimum.

"Testing should be an integral part ofevery military's HIV/AIDS strategy thatgoes hand in hand with counseling andprevention programs,” said Robinson.

The U.S. Military has been active inworking with other federal agencies,non-governmental organizations(NGOs), and global partners in combat-ing HIV/AIDS. The DoD HIV/AIDSPrevention Program (DHAPP), basedat the Naval Health Research Center(NHRC) in San Diego, Calif., is theDoD executive agent for the technicalassistance, management, and adminis-trative support of the global HIV/AIDSprevention, care, and treatment for

foreign militaries.In addition to administering funding,

conducting training and providingtechnical assistance to focus and otherbilateral countries, DHAPP overseesthe contributions to the U.S. President'sEmergency Plan for AIDS Relief(PEPFAR). PEPFAR is the largesthealth program ever initiated by onecountry to address a single disease. A2009 study found PEPFAR reduced theAIDS death rate in the countries in-volved by 10 percent.

Robinson told the audience that theNavy has an important role to play inthe fight against HIV/AIDS which is inkeeping with the maritime strategy.

"Our military men and women of allservices are ambassadors to our nationwherever they are deployed," saidRobinson. "Our military-to-militarymedical partnerships are a key elementin the fight against HIV/AIDS. Thesepartnerships are a part of our largerSMART Power efforts to engage withother countries not only diplomaticallybut through aid, training, education,and research."


Simulated Med Technology Advances Learning in Navy MedicineBy Valerie A. Kremer, Bureau of Medicine and Surgery Public Affairs

WASHINGTON - Navy Medicine is capitalizing onsimulation, modeling, and training technologies throughoutthe country to strengthen critical skills for Navy medicalpersonnel.

“Mannequins, virtual worlds, and gaming involving train-ing are some of the advancements in modeling and trainingfor Navy medical personnel,” said Cmdr. Cindy Ambach,Navy Medicine director for Clinical Modeling and Simulation.“These tools allow the student to increase performance andbetter evaluate and project future scenarios.”

The tools also assist in tackling the increased demands ofa high operational tempo and diverse deployment environ-ments and missions. Through the use of these superior man-nequins, improvements in the application of mock injuries,and virtual reality systems like the Wide Area Virtual Envi-ronment (WAVE), the Navy is reinforcing its commitmentto providing world-class care to its Sailors and Marines.

Although the Navy still uses low and medium fidelitymannequins, or patient simulators, to provide basic clinicallearning experiences, truly realistic training is achievedthrough high fidelity mannequins.

“High fidelity mannequins react like a human,” saidAmbach. “They have pupils that dilate, they breathe, bleed,have IV access for practicing medication administration, andmake lung and bowel sounds. There is even a high fidelity

mannequin that gives birth so students can practice the child-birthing process.”

The use of high fidelity mannequins has had a significantimpact in the training process for Navy medical personnel. Themannequins react just like humans ensuring proper technique is

SILVER SPRING, Md.— The Wide Area Virtual Environment (WAVE),located at the National Capital Area Medical Simulation Center, is a largescale simulator designed to train medical teams in battlefield and natural-disaster scenarios. It has three-dimensional images displayed on threevertical screens to immerse viewers in a virtual setting. (Courtesy photo)

See TECHNOLOGY, Page 7

Drug Take Back Program Creates Large Turnout at Camp Lejeune

NAVAL HOSPITAL CAMP LEJEUNE, N.C. — Naval HospitalCamp Lejeune joined forces with the long arm of the law,Marine Corps Base Provost Marshal’s office, Saturday, Dec. 4,for a Drug Take Back program.

The program allowed Marines, Sailors, retirees,and family members to turn in old or expiredprescription drugs without hassle. The event washighly successful and participants from throughoutthe base and local community turned in a colorfulassortment of 20,000 pills of various shapes andsizes. A number of inhalers, creams, and pre-filledmedical syringes were also turned in.

The Drug Take Back program is designed to helpthe community help itself by safely turning in medications,which will help the environment, aid in the prevention ofmedications falling into the hands of children, and also helpprevent accidental overdose or misuse.

“Many parents appreciate the initiative,” said HospitalCorpsman 2nd Class Timothy Ashburn, a certified pharmacytechnician and volunteer at the Drug Take Back Program.“Parents were dropping off their medications to be sure theywere protecting their children and children’s friends. Many

attested to how their own medicine cabinet was a dangerousplace.”

This was the first time that the nationwide program wasco-hosted by Naval Hospital and Military Police at Camp Lejeune.The event was spearheaded by Lt. Sonja Diaz-Sevilla, NHCL

pharmacist. Several members of the hospital JuniorEnlisted Association helped with the collection of themedications. The hospital staff hopes the eventcontinues on a quarterly basis.

The Camp Lejeune Base Provost Marshal’s officewas in charge of ensuring that the medications wereturned into a designated Environmental ProtectionAgency approved facility responsible for the safedisposal of all of the medications that were turned in.

The Naval Hospital public affairs office andmarketing department collaborated with Marine Corps Basemarketing division to lead a vigorous marketing campaign inadvance of the event.

The event drew praise from beneficiaries as they walked up toturn in their medications. Several of the beneficiaries compli-mented and thanked the staff for hosting the event..

Capt. Daniel Zinder, commanding officer, NHCL, had com-mented previously that the Naval Hospital was proud to partici-pate in the community event and that the hospital look forward toparticipating in other community events in the future.

By Raymond Applewhite, Naval Hospital Camp Lejeune Public Affairs


TRICARE Assistance Program Supports You During the Holidays

Especially during this time of theyear, it is critical that TRICARE benefi-ciaries reach out to family members andfriends if they are experiencing anyholiday blues. Sometimes frequentcommunication with a loved one canget a beneficiary back on track. TRI-CARE Assistance Program (TRIAP) ishere to assist.

To access information on TRIAP,go to www.tricare.mil/triap or go toyour regional health care contractor’swebsite.

TRIAP is web-based videoconferenc-ing that provides short-term, solution-focused, non-medical counseling forsituations resulting from commonlyoccurring life circumstances such asdeployment stress, relationships,personal loss, and parent-child commu-nications. All TRIAP services, available24 hours a day, seven days a week, and

365 days a year, are provided on aone-to-one basis, in the context of aconfidential relationship, with alicensed professional.

"Through the coordinated effortsof leaders, medical professionals,chaplains, families, and militarypersonnel, TRIAP services can providepositive care for those who seek help,"said Col. Chris Philbrick, deputydirector, Army Health Promotion,Risk Reduction Task Force.

TRIAP services are available to:active duty service members, activeduty family members (children mustbe age 18 or older), beneficiariesusing TRICARE Reserve Select, andbeneficiaries covered under theTransition Assistance ManagementProgram. Beneficiaries do not need areferral or prior authorization to useTRIAP services.

From Bureau of Medicine and Surgery Public Affairs

TWENTY-NINE PALMS, Calif.— The U.S. Navy surgeongeneral visited the Robert E. Bush Naval Hospital, Dec. 3.,during his tour of Navy medical facilities that support theMarine Corps in southern California.

Vice Adm. Adam M. Robinson, Jr. toured the hospital,participated in a retirement ceremony, and spoke withcommand leadership where he discussed the history and impor-tance of Navy Medicine's partnership with the Marine Corps.

"The bond that Navy Medicine shares with our Marines islike none other - it's sacred and unique," said Robinson. "Whenour Marines deploy, they know they will be well-cared for, fromthe battlefield to when they return home. We will follow theMarines into heaven or to the gates of hell."

The Robert E. Bush Naval Hospital, located in the HighDesert region of the Mojave Desert, is a tenant command onthe Marine Corps Air Ground Combat Center in the city ofTwenty-nine Palms.

The Marine Air Ground Task Force Training Commandconducts relevant live-fire combined arms training, urbanoperations, and joint/coalition level integration training thatpromotes operational forces readiness. The hospital is astate-of-the-art, 160,000 sq. ft. facility containing 22 beds, anEmergency Medical Department, four operating rooms, a new

seven-bed Desert Beginnings Labor Delivery Recovery andPostpartum (LDRP) Unit, and a 15 bed multi-service ward(MSW) for inpatient care. A modern full-service pharmacy,laboratory, radiology departments, and a physical therapy clinicare also available to beneficiaries.

Capt. Ann Bobeck, Naval Hospital Twenty-nine Palmscommanding officer, said it is an honor to support the Marines’mission.

"I am very proud of our staff here at the Robert E. BushNaval Hospital," said Bobeck. "They work hard every day todeliver the best possible care to the Marines and their familieshere at Twenty-nine Palms, not to mention the many militaryretirees who live in the area."

During his visit, Robinson also highlighted his commitmentto supporting force readiness and the importance of providingquality patient and family centered care.

"When our Sailors and Marines deploy, it is critical that theyknow their families will be well cared for in their absence," saidRobinson. "This commitment by Navy Medicine not only bringspeace of mind, but it supports force readiness as our war fighterscan better focus on the job at hand."

During his tour of select Navy medial facilities in the area,Robinson also participated in the ground breaking ceremoniesof the replacement Naval Hospital at Camp Pendleton, Dec 2.

Got News? If you’d like to submit an article or have an idea for one,contact MEDNEWS at 202-762-3160, fax 202-762-1705 or [email protected].

By Sharon Foster, TRICARE ManagementActivity

The holidays are a great opportunityto bond with family members andreconnect with old friends, but thistime of year can also present significantstress, particularly if a loved one isdeployed for the holidays. An emptyseat at the dinner table, holiday shop-ping, minus one or unwrapped giftsunder the Christmas tree can causethe holiday blues. Joyous remindersof the holiday season can also bringpain and loneliness.

In a four-minute video, “Getting theHelp You Need, When You Need It,” atwww.tricare.mil/mentalhealth, Adm.Mike Mullen, chairman of the JointChiefs of Staff, encourages servicemembers and family members to reachout for help if they are struggling withfeelings of stress, anxiety, or depression.

Navy’s Top Doc Thanks Personnel for Care Provided to Marines


learned and administered.”If a student is not pressing hard enough for chest compres-

sion, the mannequin will react to that,” said Ambach.Advancements in moulaging, or the application of applying

mock injuries, have also advanced the training of medical person-nel. Moulaging allows the student to see what limbs look likeonce amputated with visible bones, and see what shrapnel wouldlook like in the body.

“Students are able to get in there and create many scenarios,”said Ms. Sheila Hill, supervisory education and training policyspecialist, Navy Bureau of Medicine and Surgery. “The manne-quins can endure more than a human. It allows the students tocreate scenarios to anticipate a crisis.”

Through the combined use of mannequins, simulation, and

TECHNOLOGYFrom Page 5

virtual worlds, Navy Medicine has even taken training onestep further. WAVE, located at the National Capital AreaMedical Simulation Center, is a large-scale simulator designedto train medical teams in battlefield and natural-disaster scenar-ios. It has three-dimensional images displayed on three verticalscreens to immerse viewers in a virtual setting.

“Imagine having your mannequin physically with you,getting fired at,” said Ambach. ”You have to move your manne-quin to a safe place to perform resuscitative care. The WAVEeven simulates environmental conditions like heat.”

The 8,000-square-foot virtual space allows team membersto interact with each other and real equipment, and gives in-structors the opportunity to teach and assess teamwork skills.3D images are displayed on the screens with paired videoprojectors while users wear lightweight 3D to view the screen.

“In the future, it will be total immersion into the learningenvironment,” said Ambach. “It will be amazing to see whatsimulation will look like ten years from now.”

NAMRU-3 Conducts Training, Studies Neurologic Disease in GeorgiaBy Darnell P. Gardner, Jr., Public Affairs Officer, NAMRU-3

CAIRO — A five-person team from U.S. Naval Medical ResearchUnit No. 3 (NAMRU-3) traveled to Tbilisi, Georgia, to conductlaboratory and epidemiologic training and initiate a new proto-col entitled, “Hospital-based Surveillance on the Etiologies ofAcute Meningitis and Encephalitis in the Republic of Georgia.”

Ms. Margaret Farrell, lead epidemiologist, explained, “Thisprotocol is the first phase of an overarching plan to establishsurveillance for acute infectious neurologic disease in theRepublic of Georgia. In Jan. 2011, we will initiate a complemen-tary surveillance system for acute flaccid paralysis (AFP) atfour predetermined hospital sites.”

Dr. Jolanta Jacobs, Mr. Mohamed Abdel Maksoud, and Ms.Engy Emil conducted laboratory training at the National Centersfor Disease Control (NCDC) and the Infectious Diseases Hospi-tal. The training included lectures on safety, sample collectionand processing, and real-time polymerase chain reaction (PCR).

The knowledge and skills gained from this training will beapplied toward the laboratory testing associated with threeDepartment of Defense Global Emerging Infections Surveillanceand Response System (DoD-GEIS) funded protocols:“Characterization of the infectious causes of acute febrile illnessin the Republic of Georgia,” “Hospital-based Surveillance on theEtiologies of Acute Meningitis and Encephalitis in the Republicof Georgia,” and “The Epidemiology and Etiology of FlaccidParalysis of Infectious Origin in the Republic of Georgia.”

“I was very impressed by the cheerful professionalism andeagerness to learn and apply the knowledge for their institutions,shown by all of the Georgian staff in all of the laboratoriesvisited,” said Jacobs.

Farrell and Ms. Suzanne Restrepo-Martinez, along with Dr.Tamuna Akhvlediani, the in-country study coordinator,conducted protocol initiation training with the surveillancestaff, which included clinical personnel from the four hospital

study sites and data management staff from NCDC.This training covered an overview and background of the

surveillance protocol, standard clinical procedures, staff roles,and responsibilities, informed consent, data and samplecollection, study documentation, database management,and monitoring and evaluation.

“We are looking forward to the next Tbilisi visit,” saidFerrell. “The training will include laboratory training related tomicroscopic agglutination testing (MAT); the introduction ofelectronic data collection via personal digital assistant (PDAs);a neurologic/neurophysiologic consultation by CDC neuroepi-demiologist, Dr. James Sejvar; and the establishment ofsurveillance for AFP.”

TBILISI, Georgia - Ms. Engy Habashy, team member from NAMRU-3instructs National Center for Disease Control technicians on poly-merase chain reaction (PCR) techniques during lab training in theRepublic of Georgia. (Photos courtesy of NAMRU-3 Public Af-fairs/Released).


Happy Holidays from the Navy Surgeon General

patients and their families in body, mind, and spirit.As you celebrate with your families this season, think about

the lives you impacted through your sacrifice and service and beproud of your accomplishments. Keep yourhearts and minds on our Sailors, Marines,

Soldiers, Airmen, and Coast Guardsmen whoare deployed far from home, some of whom are inharm's way and remember those we have lost thisyear. May their ultimate sacrifice on behalf of ournation remind us of those who have gone beforeand what we are fighting for.

I remind you all to please celebrate responsi-bly. Whether you are deep frying a turkey ordriving home from a holiday party, keep thesafety of you and your loved ones on your mindand remember that others on the roads may not

be driving responsibly, so exercise caution at all times.Happy Holidays Shipmates! Thank you for everything you do

every day to care for our Sailors and Marines around the world. Ialso want to thank your families for their support which wecount on throughout the year. As I begin my last year as yourSurgeon General, I could not be more proud.

Thank you for your service and may all the blessings of thislife be with you and your families this holiday season and in thecoming year.

By Vice Adm. Adam M. Robinson, Jr., U.S. Navy Surgeon General

To the 63,000 thousand personnel that make up the NavyMedicine community, please accept my warmest wishes toyou and your families this holiday season. This isa time to celebrate our faith in our churches,synagogues and other places of worship. It isalso a time to reflect on the sacrifices of ourCorpsmen, Nurses, Doctors, Dentists, AlliedHealth Professionals and Health Care Adminis-trators who are deployed with Sailors andMarines worldwide-providing critical missionsupport aboard ship, in the air, under the seaand on the battlefield.

This past year we have saved lives in Haiti,conducted humanitarian missions in the Pacific,Southeast Asia, Africa, and South America, andprovided care for family members and retirees at militarytreatment facilities around the globe. For those of you on callaround the world please know that your service and sacrificedoes not go unnoticed. The work you do every day is savingand impacting lives in a very positive way. It is always chal-lenging to be away from friends and family during the holi-days, but remember this time because I can think of no moreimportant work than preserving life and limb, and healing our

Navy Med TRICARE Outpatient Clinic Pharmacy Goes High-Tech

By Mass Communication Specialist 1st Class(SW) Todd Hack, Naval Medical Center SanDiego Public Affairs

SANTEE, Calif. — Naval MedicalCenter San Diego's (NMCSD) TRI-CARE Outpatient Clinic (TOC) EastCounty Pharmacy in Santee, Calif.modernized pharmaceutical care inSeptember 2010 with the installation ofa new robotic system.

The ScriptPro® robotic filling andcomputerized workflow system helpsto reduce prescription errors achievingsafety in every step of the prescriptiondispensing process. Different robots(SP100, SP50, SP200) were installedat each NMCSD clinic depending onits size.

"We were the only Naval MedicalCenter San Diego Health Clinic phar-macy to have a robotic system in 2007,"said Bill Nguyen, TOC East Countypharmacist. "The new system is saferthan the old system and includestelepharmacy workstations."

The new robotic systems werepurchased by Naval Medical LogisticsCommand in Fort Detrick, Md., forNavy Military Treatment Facilitiesaround the world. The cost for installa-tion of the new systems to NMCSDclinics and TOCs was approximately$4 million.

The new SP 100 robotic systeminstalled at the TOC East CountyPharmacy is easily calibrated and allowsfor different medications in each of its100 cells. The system can convey all of aspecific patient's medications to onelocation after labeling each bottle.

"We dispense more than 250 medica-tions here for approximately 100 pa-tients per day," said Nguyen. "Most ofour patients bring in prescriptions fromphysicians outside of the [TOC EastCounty] clinic or the NMCSD system."

The process is simple, a technicianverifies the patient's prescription labelagainst the medication, compares themedication to a picture of what the

medicine at the work station, and thenverifies it with the patient information.

The new technology offers softwareand hardware solutions that allowpharmacies to conduct safe and efficienttelepharmacy operations to include liveaudio or video connections from clinic-to-clinic and from provider-to-patientto allow for real-time communication.

When a pharmacist is not present,a pharmacy technician can scan theproduct's barcode and the hardcopyprescription. Then the technician cap-tures an image of the medication, andprints the image of the prescriptionlabel. Once all the prescriptions for thepatient are ready and batched, thetechnician calls the off-site pharmacistfor prescription verification.

If a pharmacist is unavailable formedication patient counseling, thepharmacy technician can call an off-sitepharmacist and share the prescriptioninformation on-screen so all partieshave a visual of the order.


Caring for Casualties During the Holidays in Kandahar

VOICES FROM THE FIELD

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blood is drawn, scans are ordered, and blood is hung. Standingby are the surgeons and the operating room crews, prepared towhisk the most seriously injured away to begin the surgery thatwill save a life.

And as quickly as the pace ramps up, it ramps down. Cleaningcrews break out the mops to clean the space for our next patients.The trauma crews replenish the stocks of bandages and fluids.And once again I can hear the holiday music coming from thei-Pod and see the stockings on the walls as the crew savors theseason while waiting for the next helo to land.

Please remember that during this time of year that thereare brave men and women in uniform proudly standing thewatch far from home in support of our great nation. I’m proud ofmy people and the phenomenal work they are doing to help ourwounded warriors and international partners here. I hope you allare as well.

Capt. Mike McCarten is a U.S. Navy family physician andaerospace medicine specialist, currently serving as the command-ing officer of the NATO Role 3 Multinational Medical Unit,Kandahar, Afghanistan. The Kandahar region has been the focusof much of the battle activity against the Taliban in the summerand autumn of 2010, many of the casualties from which wereevacuated directly to the NATO Role 3.

By Capt Mike McCarten, Commanding Officer of the NATO Role 3 Multina-tional Medical Unit, Kandahar, Afghanistan

KANDAHAR, Afghanistan — U.S. Navy medical teams working at theRole 3 NATO Hospital operate on a military member wounded in south-ern Afghanistan in the hospital's trauma bay, Jan 13. (U.S. Navyphoto/Released.)

Being deployed during the Holiday Season has always beenthe stuff of vivid memories. That is certainly true in Kandahar,Afghanistan where I command the NATO trauma hospitalsouth of Kandahar City, the NATO Role 3 MultinationalMedical Unit.

Over the past few weeks, the holiday spirit has been onthe rise. Christmas trees have appeared in many clinics,stockings are hanging behind the nurses’stations and theholiday music can be heard from i-Pod stations throughoutthe hospital. And as has also always been my experience, oneSailor seems to be the primary source of the holiday cheer.

At the Role 3, it is Hospital Corpsman 1st Class (HM1)Christine Hanley from Dallas, Texas. Every time I turn aroundand see another set of decorations being assembled anddisplayed, Hanley is in the middle of the action. As the entirecrew awaits our command holiday party scheduled forDec. 23, it is Hanley who is in the middle of the planning.She is the one in a million kind of Sailor that makes deploy-ment tolerable.

And while each of us embraces the holiday spirit, ourcare for the casualties from the battlefields of southernAfghanistan continues. The helicopters continue to land.Flight crews and Hospital Corpsmen rush into the traumabays with wounded Soldiers and Marines and we do our verybest to care for them.

With the arrival of casualties, the rhythm in the hospitalis familiar. The trauma crews, the nurses, the radiologistsall know their roles all too well. There is the orderly ‘chaos’of assessment and resuscitation where limbs are examined,

KANDAHAR, Afghanistan — U.S. Navy medical teams working at the Role3 NATO Hospital are taking a moment from providing quality patient carefor wounded warriors in Afghanistan to celebrate the holidays with theirshipmates and patients, Jan. 13. (U.S. Navy photo/Released)

Documents

Navy-Marine Corps Medical News (December 2010)