SMART program keeps medical Airmen mission ready for future conflicts

by Senior Airman Thomas Spangler
99th Air Base Wing/Public Affairs

1/16/2015 - NELLIS AIR FORCE BASE, Nev.  -- After more than a decade of war in Afghanistan and Iraq, many troops, unfortunately, sustained traumatic injuries ranging from gunshot wounds to injuries from explosions.

Those who were injured in these wars had a 96 percent survival rate because of the hard-earned skills medical professionals learned on the battlefield. The new Sustained Medical and Readiness Training, or SMART, program piloted by the 99th Medical Group at Nellis Air Force Base is designed to ensure medics from across the service maintain those skills, and are ready for the next conflict, by partnering with the University Medical Center of Southern Nevada Level I trauma center.

"We have to be just as ready at the beginning of the next war as we have been at the end of this one," said Lt. Gen. Thomas Travis, U.S. Air Force surgeon general, during his visit Jan. 13 to UMC.

Maintaining a high survival rate is only accomplished because these health care providers were constantly improving and honing their skills treating battlefield trauma injuries.

"A lot of the advances that are occurring in medicine are because of the care that has been provided down range, we want to keep that edge, we don't want to lose it," said Maj. Gen. Dorothy Hogg, U.S. Air Force director of medical operations and research, referring to the end of the wars in Afghanistan and Iraq.

With the end of these wars, there will fortunately be fewer battlefield casualties. However, this means that those military physicians, nurses and technicians who strengthened their skills down range will no longer have the same opportunities to maintain that edge.

When the physicians, nurses and technicians are not deployed they are serving in military treatment facilities. The military bases that these MTFs serve do not usually have patients with gunshot wounds or other injuries similar to those sustained in battle.

"You see things in war that we don't always see in this country, certainly not on our bases and at our military treatment facilities," Travis said. "We have a population that, for the most part, is very healthy. We don't have a lot of trauma, certainly not a lot of gunshots or knife wounds."

Health care providers, just like any other job in the Air Force, needs to constantly refine and maintain their abilities so they are ready for use in future real-world conflicts.

With the lack of traumatic injuries at MTFs for Air Force health care providers to treat and maintain their edge, the question becomes: with no battlefield injuries to treat, how do they maintain that edge?

"The MTF commander is responsible for making sure that the individuals in his or her facility are current and ready to go to war," Hogg said, who is also the Air Force chief of the nurses corps.

If an MTF is unable to provide the environment necessary for its physicians, nurses and technicians to stay current on their qualifications, and a local civilian hospital is unable or unwilling to provide that environment, then its healthcare providers would be temporarily assigned to attend the SMART program at Nellis AFB.

The SMART program has allowed Air Force physicians, nurses and technicians stationed at Nellis AFB, and now from across the Air Force, to temporarily work and train at UMC of Southern Nevada to ensure they stay current and maintain the high level of treatment they attained while deployed.

They are able to maintain their edge because they are treating injuries at a Level I trauma center where they will encounter injuries similar to those found on the battlefield, like knife and gunshot wounds. They would not likely encounter such traumatic injuries at the Nellis AFB medical center.

"Some trauma centers by virtue of their location and the population they serve see more penetrating trauma, they see a knife wound, a gunshot wound, something you don't wish on anybody," Travis said. "But for wartime readiness training, it's actually very good for our skills to be involved in the care of those types of patients, because you do see some of that down range."

This partnership will allow physicians, nurses and technicians from the across the Air Force, not just Nellis AFB, the opportunity to come to UMC of Southern Nevada and maintain their edge and be ready for the next conflict -- with the same level of skills or better than they were at the end of the last conflict.

"[The partnership between the 99th Medical Group and UMC of Southern Nevada] is an opportunity to use the expertise available in our civilian partners downtown, to use what the Air Force Medical Service has given us and continue to seek ways to hone our skills and currency," said Col. Guillermo Tellez, 99th MDG commander. "Programs such as SMART will ensure we are prepared for the next contingency if the Department of Defense calls -- we must remain ready at a moment's notice.

"By partnering with the UMC of Southern Nevada, the Air Force is able to better prepare its physicians, nurses and technicians for future conflicts and help ensure future wounded service members come home alive." Tellez said.