Developing a polytrauma rehabilitation center: a pioneer experience in building, staffing, and training

The military operations in Iraq and Afghanistan have resulted in patterns of injury not commonly seen in previous conflicts. Improvised explosive devices are the primary weapon, and exposure to blast is the most common mechanism of injury. Blasts can result in polytrauma injury, in which multiple body systems, including the head and brain, are injured. Nursing and rehabilitation care can be further challenged by other blast sequelae such as pain, amputation, blindness or low vision, hearing impairment, and aphasia. This article describes the process by which one Veterans Affairs Medical Center developed its inpatient rehabilitation service into a polytrauma rehabilitation center to meet the medical and rehabilitation needs of these patients. Special attention is given to the education and training program developed to solidify the membership of the center's nursing staff in the interdisciplinary treatment team.