COL(R) Laura R. Brosch, PhD, RN: Ethical Challenges and Advancements in Combat Casualty Care Research

WarDocs - The Military Medicine Podcast

Explore the fascinating world of Military Medicine research and ethics with our special guest, retired Army Nurse Corps Colonel Dr. Laura Brosch. As the Assistant Vice President of Research Initiatives and Compliance at the Uniformed Services University of the Health Sciences, Dr. Brosch shares her journey into Military Medicine and experiences developing ethical protocols for conducting research in combat theaters. From the development of Theater Clinical Practice Guidelines to the introduction of novel treatment modalities for combat casualty care, you'll gain incredible insight into the challenges and advancements in Military Medicine.

Discover how the Special Medical Augmentation Response Team (SMART) and the military's use of Investigational New Drugs (INDs) are crucial in modern Military Medicine. Dr. Brosch discusses the importance of regulatory compliance when administering these drugs and highlights the advancements in surgical products like combat gauze, Chitosan powder, and much more. Learn how these products were safely fielded in high OP TEMPO environments and understand the unique challenges faced when setting up a research capability in theater.

Join us as we delve into the Joint Trauma System and the Theater Clinical Practice Guidelines developed under Colonel Paul Cordts’ guidance. Dr. Brosch shares the ethical considerations taken into account when deciding which protocols to implement, such as DVT prophylaxis, tourniquet use, hypothermia prevention, and concussion awareness. Hear about the challenges of collecting data in the chaos of combat and the processes used to obtain DOD-required waivers and approvals for hospital trauma research. This conversation offers a unique perspective on the complex ethical considerations of conducting medical research in the military. Don't miss this enlightening discussion!

Chapters:

(0:00:00) - Military Medicine Research and Ethics

(0:10:11) - Medical Research in Theater

(0:26:40) - Trauma Research Guidelines and Waivers

(0:41:14) - Military Medical Research and Ethics

Chapter Summaries:

(0:00:00) - Military Medicine Research and Ethics (10 Minutes)

We speak with Dr. Laura Brosch, a retired Army Nurse Corps Colonel and Assistant Vice President of Research Initiatives and Compliance at the Uniformed Services University of the Health Sciences. We discuss her pathway into Military Medicine and how she became the nursing research consultant to the Surgeon General. She shares how the Medical Research And Material Command played an early role in OAF and OEF, and how a plan was developed to ethically conduct research in combat theaters. Laura also explains how Theater Clinical Practice Guidelines were developed and how they've evolved over the past 20 years, and how the military brings novel treatment modalities for combat casualty care to the battlefield.

(0:10:11) - Medical Research in Theater (16 Minutes)

Dr Laura Brosch and I discussed the Special Medical Augmentation Response Team (SMART) and the military's use of Investigational New Drugs (INDs). We explored the responsibility of SMART and the importance of regulatory compliance when administering these drugs. We also examined the advancements made in surgical products like combat gauze, Chitosan powder, and other products, and how they were safely fielded in a high OP TEMPO environment. Lastly, we talked about the need to set up a research capability in theater and the unique challenges this presented.

(0:26:40) - Trauma Research Guidelines and Waivers (15 Minutes)

We discuss the Joint Trauma System and the Theater Clinical Practice Guidelines they developed, Colonel Paul Cordts’ involvement in bringing these guidelines to life, and the ethical considerations taken into account when deciding which protocols to implement. Specific protocols such as DVT prophylaxis, tourniquet use, hypothermia prevention, and concussion awareness are discussed. The challenges of collecting data in the chaos of combat and the processes used to obtain DOD-required waivers and approvals for hospital trauma research are also discussed.

(0:41:14) - Military Medical Research and Ethics (7 Minutes)

We talk with Dr Laura Brosch about the complex ethical considerations of conducting medical research. We explore the protocol she developed to allow the use of investigational products in the event of combat casualties. We discuss the regulation changes and how our research community has become more sophisticated. We also discuss the special rules for military service regarding research protections, and Laura shares her experiences as Assistant Vice President of Research Initiatives and Compliance at the Uniformed Services University of the Health Sciences. Finally, we reflect on her contributions to Military Medicine and the importance of ethical conduct in research.

Episode Keywords:

Military Medicine, Research Ethics, Army Nurse Corps, Uniformed Services University, SMART, Investigational New Drugs, Combat Gauze, Chitosan Powder, Joint Trauma System, Theater Clinical Practice Guidelines, DVT Prophylaxis, Tourniquet Use, Hypothermia Prevention, Concussion Awareness, Regulatory Compliance, Research Capability, DOD Waivers, Research Protections

Hashtags:

#wardocs #military #medicine #podcast #MilitaryMedicine #CombatCasualtyCare #ResearchEthics #SMARTteam #InvestigationalNewDrugs #SurgicalAdvancements #JointTraumaSystem #CombatMedicine #Research

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