Dr. Waxman is an associate clinical professor of emergency medicine at the David Geffen School of Medicine at UCLA and an attending physician in emergency medicine at Olive View-UCLA Medical Center.
Dr. Matthew Waxman has extensive experience teaching emergency medicine abroad and providing critical care globally for patients in numerous African, Asian, European, and Latin American countries. Most recently, Dr. Waxman spent July of 2017 working with the World Health Organization and disaster relief organization NYCMedics at a trauma stabilization point (TSP) in Mosul, Iraq.
In 2014, Mosul (Iraq’s second largest city) was seized by the Islamic State of Iraq and Syria (ISIS). In November 2016, the Iraqi Army, with support from an international coalition, began an offensive to retake the city. Anticipating a humanitarian crisis, the World Health Organization partnered with various nongovernmental organizations to establish trauma stabilization points in the region. TSPs are a novel concept and provide first hour trauma care similar to the standard of care in a U.S. emergency department. By July 2017, constant bombardment from airstrikes and combat destroyed the city’s infrastructure, displacing hundreds of thousands of civilians.
While in Iraq, Dr. Waxman worked on a team with two other physicians and 10 other healthcare providers. Because TSPs had been targeted early in the conflict, security was of utmost priority and the healthcare team was co-located with an Iraqi Special Forces Platoon. TSP locations moved between abandoned houses as the front lines of the conflict changed and were set up within 2km of the front lines to provide immediate care and receive casualties.
Typical patient presentations at the TSPs included high velocity gunshot wounds, blast injuries, as well as burns from airstrikes and improvised explosive devices. Later in the conflict, Dr. Waxman and the healthcare unit also began seeing civilians who were suffering from the psychological effects of the war and presenting common complaints. The TSPs followed humanitarian principles and provided unbiased care for Iraqi soldiers, ISIS, and civilians.
Care in the TSPs was highly organized to follow evidenced based protocols and transfer critical patients to the next level of care as soon as possible. Patients arrived at the TSPs from the front lines, transported by Iraqi army military vehicles. Patients were stabilized and interventions such as tranexamic acid, fluid resuscitation, and chest tubes were performed. Once stabilized, Islamic Red Crescent ambulances transported patients to the next level of care. Civilian casualties were transferred to several receiving hospitals with surgical capabilities. These hospitals were run by organizations such as MSF (Medicins Sans Frontiers) and the Qatari Red Cross. Military casualties were sent to an operating room-equipped casualty collection point (CCP) that was run by the U.S. Special Forces.
In addition to providing clinical care, Dr. Waxman spent time in Erbil, Kurdistan writing protocols, organizing supplies, and helping with logistics. Dr. Waxman will continue his work with NYCMedics, returning to Iraq during the upcoming battle in Tal Afar in October 2017.
More information is available at www,nycmedics.org.