Critical care at Landstuhl Regional Medical Center

Area of Science:

• Military Medicine
• Trauma Care
• Critical Care

Background:

• Landstuhl Regional Medical Center (LRMC) is the largest U.S. military hospital globally, providing care outside combat zones.
• LRMC has treated over 45,000 patients from Operations Enduring Freedom and Iraqi Freedom since November 2007.
• The facility serves a diverse patient population across three continents, facing varied diagnoses including battle and non-battle injuries.

Purpose of the Study:

• To describe the evolution and current state of the trauma/critical care service at LRMC.
• To highlight the unique challenges and adaptations in managing casualties from ongoing conflicts.
• To underscore the role of LRMC as a critical care hub for U.S. military personnel.

Main Methods:

• Multidisciplinary, intensivist-directed care approach.
• Management of a wide spectrum of clinical diagnoses.
• Utilizing robust critical care air transport capabilities.

Main Results:

• Average daily intensive care unit census has tripled compared to 2001.
• Patient acuity level has doubled.
• Combat casualties constitute 85% of service admissions.

Conclusions:

• LRMC's clinical practice has evolved due to wartime damage control, air transport, and patient flow.
• The focus is on optimizing patients for safe evacuation and definitive care in the U.S.
• Achieving American College of Surgeons level II trauma center verification in 2007 demonstrates commitment to high-quality military medical care.