Evolution Of Trauma Nursing

The concepts of Homeland Security and Homeland Defense, although have similar missions, tasks, responsibilities and operations, are very different. This paper will take a look at Following the both Homeland Security and Homeland Defense separately and well as how they work together to secure the United States

Imagine the following scenario: A 43 year old male and his 41 year old wife have just finished celebrating their twentieth wedding anniversary at a local restaurant. The husband had a cocktail at the bar while waiting for the table, and then had a couple of glasses of wine with dinner. After dinner, the happy couple drive their vehicle home on a snow covered highway. The car begins to swerve on the ice and enters oncoming traffic and hits a semi cab head-on. After an extended extraction of the driver by paramedics, the driver is found to be unconscious, has multiple head lacerations, chest contusions from the steering wheel, and his left leg is bleeding profusely from a compound femur fracture. The female is conscious, in shock, and states that she is 36 weeks pregnant and has pain in her abdomen. Both victims are flown via helicopter to the nearest level 2 trauma center where 2 teams of emergency room doctors, trauma surgeons, respiratory therapists, x-ray technologists, phlebotomists, chaplains, social workers, and of course, trauma nurses, are waiting to assess the patients and provide life-saving care. This scenario is not the exception in a level 2 trauma care center of the emergency-room, it is the average situation that a trauma nurse will find his or herself in every day. Because of the fast paced situations that require split-second critical decisions, the advanced life support training that is required, and the often unrewarded care, a career in trauma

I am going to concentrate on definitions “b” and “c” above because although the trauma patient is at the hospital because of “a”, there is nothing we as chaplains can do about that. That part of the trauma is the concern of the medical staff.

Burnham, G. (2010, November 19). Introduction to National Security Action Memorandum Number 273. Retrieved October 11, 2014.

There is a raging debate on where exactly the homeland security should be placed in the US structure, and whether it should be under the Department of Defense, the criminal justice, or it should be a joint effort of every American citizen. To answer this question, it is important to consider the scope of the activities carried out under homeland security.

Continuing on the issue of communication and perception, in a published article, (AACN BOLD VOICES), 2012 Jan; 4(1): 17, “ Red Cross Removes Practice Barriers to Nurse’s Role During Disaster. A change in American Red Cross policy allows nurses the practice flexibility they need to use all their skills and training when treating patients in disaster situations. They said within the chaos that can occur during a disaster, no amount of written material can address every health situation that may arise, Red Cross chief nurse Sharon Stanley says in the article. The nurse-led disaster health services community response model allows the Red Cross health team to provide the best in care while partnering with community health care systems on the ground to better address disaster client needs, she adds. Giving nurses flexibility in such situations better enables them to work with people

Our country is currently served by the American military that is comprised of a set of armed forces, whose sole purpose is the protection of our people and our freedom. Within these systems soldiers are taught to work together as a team trusting one another with their lives, while being guided by the core values that are inevitably embed within each service member creating a sense of moral and ethics that distinguishes each member as a true guardian of our country. Although this is so, unfortunately within these governmental systems this sense of comradery is tarnished when individuals that serve face the potential dangers of Military Sexual Trauma (MST). According to the Federal law Title 38 United States Code 1720D and the Department of Veteran Affairs military sexual trauma is defined as “Psychological trauma as a result from a physical assault of a sexual nature, battery of a sexual nature, or sexual harassment which occurred while the Veteran was serving on active duty or active duty for training” (Department of Veteran Affairs, 2014).

The missions held by homeland security and homeland defense are vital to the protection of the country against acts of terror. While relatively young programs, much has been achieved in the homeland security and homeland defense missions. To continue this success, the programs must evolve as the world evolves, and more specifically, the terrorists. To stay relevant, the Department of Homeland Security, its subordinate agencies, and the Department of Defense must evolve with the threats in a way that does not impede on civil liberties.

The evolution of homeland security concept has been connected with several strategic documents. There are 2014 Quadrennial Homeland Security Review, 2010 National Security Strategy and the 2011 National Strategy for Counterterrorism. There are also strategic documents that provide specific guidance to DHS entities and include the 2010 Quadrennial Homeland Security Review, the Bottom-Up Review, and the 2012 Department of Homeland Security Strategic Plan. Prior to issuance of these documents, national and DHS homeland security strategic documents included the 2002 and 2007 National Strategies for Homeland Security and the 2008 Department of Homeland Security Strategic Plan. All of these documents have varying definitions for “homeland security” and varying missions derived from these

During a declared disaster, the State Medical Assistance Teams (SMAT) are coordinated by the SMRS. They are requested and activated as an ESF-8 resource. These teams may be requested by other states across the nation to respond to major events through a mutual aid system between states (Mississippi State Medical Assistance Team, 2008). The SMAT concept was again modeled after the North Carolina SMRS SMAT, allowing for enhanced interoperability between the two states. One SMAT is up to a fifty-bed mobile field hospital designed to support impacted healthcare systems in a disaster. Mississippi has three SMAT units that may be deployed separately or combined. These teams provide the state of Mississippi an effective, all-hazards solution to support various missions. These mission profiles include disaster field medical care, alternate care site, weapons of mass destruction response, hazardous material response, contingency management, pharmaceutical point of distribution, and/or event medical support (Mississippi MED-1, 2009). The SMAT staff are both non-clinical and clinical providers from around Mississippi that undergo advanced disaster training and orientation to the mobile field hospital setting. Each of the SMAT mobile field hospitals provides a full array of clinical services that include cardiac telemetry, digital x-ray, ultrasound, ventilators, and intravenous pumps. Combining the efforts of the advanced trained staff with the

Nightmares keep coming back. Sudden noises make you jump. You’re staying at home more and more.” If you have experienced severe trauma or a life-threatening event — whether during a time of war or in a noncombat situation —

Zatzick et al., (2008) found that more than 20% of injured trauma survivors across the US develop symptoms consistent with a PTSD diagnosis 12 months after acute care in-patient hospitalization. Consensus guidelines from the National Institute of Mental Health identified seriously injured trauma survivors as a group at high risk for development of PTSD and related comorbid conditions (National Institute of Mental Health, 2002). In addition to the potential of the actual injury to cause traumatic stress, trauma patients may already have other risk factors for PTSD including low socioeconomic status, presence of mental illness, history of combat exposure, childhood neglect or abuse, sexual assault, or previous trauma (Shalev et al., 1994; Brewin et al., 2000). The experience of post-injury hospitalization has also been identified as a potential risk factor for development of PTSD. Several studies found that acute care patients requiring intensive care unit (ICU) admission, intubation, and mechanical ventilation are at risk for development of PTSD (Shaw et al. 2004; Cuthbertson et al., 2004; Kapfhammer et al. 2004;

This was further expanded during the Afghanistan and Iraqi wars. “Stability operations are a core US military mission…given priority comparable to combat operations.” (DOD Directive 3000.05, 2005). In Afghanistan conflicts, 15% of admissions were to 250,000 patients have received medical care, 37,000 animals have received veterinary care and 170 engineering projects have been completed. Pediatricians comprise 25% of the medical staff. Forty percent of the medical interactions are within the pediatric age group. Training for humanitarian response is now incorporated into medical curriculum at the Uniformed Services University of the Health Sciences and provides a medical service model worthy of expansion to our osteopathic medical

3. The study provides new information of women’s experiences with military sexual trauma during deployment in which other studies lacks in data and numbers. It could help the military policymakers to take immediate action to MST by improving services and better transparency in the US military.

The distinction between homeland security and homeland defense is pivotal in gaining a better understanding of how these agencies work and how they correlate to our nations infrastructure. We must understand the designated missions set forth for both these agencies while learning how they meet the tasks appointed to them and resources utilized to accomplish the mission. Learning the fundamentals of our nations infrastructure information must be provided to showcase how these agencies utilize the appropriate resources to guarantee the security of these critical infrastructures. Offering an opinion in the definition of homeland security and how resources are being utilized to fix vulnerabilities is vital to showcase what is being distributed and learned on a researchers and readers level. Homeland security and homeland defense play a pivotal role in ensuring our borders are protected.