“Surgical Strike” Tactics To Be Adopted For Clinical Use

December 10, 2003

IOWA CITY, IA—At the University of Iowa, the Department of Surgery has initiated a pilot program inspired by military tactics used by the United States in Iraq and Afghanistan. Its new Surgical Strike Teams, or SSTs, are units of surgery residents, attendings and medical students that can be rapidly deployed to the ER or OR to perform procedures.

Dr. James Waggerty

Dr. James Waggerty, Ret. U.S. Air Force Commander and Assistant Chief of Surgery at the University of Iowa, expressed optimism regarding the program.

“We're looking at moving in and operating on consults that we get from the ER even before there's any data back. It's just more efficient to do the procedure rather than having to waste time deciding if it's necessary,” he says.

“Sometimes we know what room the patient is in, but we don't know their name or which bed, so we just operate on both patients. It just saves time.”

Waggerty described a recent mission carried out by SSTs in the hospital's emergency department last week.

“In that campaign, code-named Operation Stone Road, we had high-level reconnaissance indicating a patient with right lower quadrant abdominal pain present in the triage area. Satellite photos from the ceiling of the ER confirmed our suspicions, and a coalition of medical students was dispatched on the ground to move the patient onto an empty gurney.”

“Next, we had a team of six surgical residents and one attending rolled in on task chairs, while trained SST nurses obtained consent, established IV access, and prepped the patient. A Special Op anesthesiologist then injected Versed, intubated, and administered isoflurane.”

“After the initial incision was made, we commenced Phase II, in which a second wave of physicians consisting of twelve surgical residents and two attendings came in to explore the region identified by coalition intelligence as McBurney's Point. At the same time, the attending and residents from Phase I infiltrated the remainder of the ER, performing laparotomies on any other patient with abdominal pain.”

“Simultaneously, medical students were crawling the ground on six hospital floors, moving patients and visitors onto empty gurneys to prepare for Phases III and IV of the campaign.”

Despite the apparent failure of Operation Stone Road to produce a surgical cause of abdominal pain in the index patient (who had already had an appendectomy, and whose pain was eventually determined to be due to constipation), Waggerty describes the mission as “on the whole, an overwhelming success.”

“We had reliable evidence demonstrating the likelihood of appendicitis in this patient; of course, that evidence is classified, so you’ll just have to trust us. But make no mistake: we acted accordingly, and the fact that we didn’t find anything ... well, at least our billing’ll help the hospital turn a nice little profit, won’t it? Case closed. God Bless America!”

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