If anything good at all has come out of more than a decade of war in Iraq and Afghanistan it might just be the important emergency medical lessons learned over there that are now being put to use over here.
It’s likely no one in Vero Beach knows more about “tactical combat casualty care” protocols or TC3, from Afghanistan and Iraq than one local periodontist and one local orthopedic and sports medicine physician.
According to the Trauma Center Association of America, every year about 35 million people in this country are treated for traumatic injuries including gunshot wounds and car accidents. In fact, traumatic injuries are the leading cause of death for all Americans under the age of 44 and the sad fact is that for decades those injuries weren’t being treated properly.
For example, the typical first step in emergency care used to be to clear the patient’s airway and make sure he or she was breathing properly. Only after that did first responders start dealing with blood loss. Then TC3 came along.
In an article in News Daily, Caleb Causey, former army combat medic and current owner of Lone Star Medics in Arlington, TX says, “What difference does it make if we’re oxygenating the patient if (his or her) blood is squirting out on the ground?”
The second anniversary of the Boston Marathon bombing recalls similarly gruesome images. When the pressure cooker bombs Dzhokhar Tsarnaev and his brother planted sent shrapnel and nails ripping through the arms, legs and feet of some 246 people, the scene was chaotic. Still, new tourniquets developed over the past 12 years of war called “combat application tourniquets” or CATs helped radically reduce the loss of blood and lives. In fact, every victim who made it to a hospital that day survived. Three died at the scene, but 243 did not.
The CATs are smaller, lighter and infinitely easier to apply that old-style tourniquets. They can even be applied using only one hand and have neoprene bladders that can be inflated to provide additional pressure to help stop bleeding.
“From two wars on two fronts over a dozen years, we’ve learned a lot about what’s worked and what’s not worked,” says Causey.
So why do Dr. Barry Garcia, the orthopedics and sports medicine physician, and Dr. James Bentancourt, the periodontist, know so much about tactical combat casualty care?
The answer is simple. They are both volunteer special weapons and tactics (SWAT) team medics. They’ve both been trained in the latest emergency techniques and they’re both almost always “on call.”
“We always have to have at least one SWAT medic on at all times,” Bentancourt explains, so he and Garcia must carefully match their schedules for any out of town trips and the like. Bentancourt says he has been a medic for eight years and on the SWAT team for four while his partner medic, Garcia, has 10 years of service.
Of course, if you walk into Bentancourt’s office at the Indian River Implant Center and see an honest-to-goodness assault rifle leaning up against a filing cabinet, it’s possible you might start re-thinking the relative importance of healthy teeth and gums. Or you might realize you’re in one of the “SWAT docs” offices.
The energetic Bentancourt comes by this double-duty service honestly. He may even have inherited it. “My dad,” he says proudly, “was a deputy in Miami-Dade and an obstetrics and gynecology (OB/GYN) physician. I think I’ve followed in his footsteps.”
Bentancourt’s enthusiasm builds as he shows off more new tools including a small, red power drill that looks like it would be more at home in a hardware store display case or on the wall of some woodworking enthusiast than tucked into a camouflage backpack. Appearances, however, can be deceiving.
This particular drill is another product of the Iraq and Afghanistan wars. It allows high-speed insertions of needles directly into bone marrow to give patients intravenous fluids or medications far faster than was ever possible before.
Then Bentancourt pulls out another surprisingly new product that also has its roots in the Afghan and Iraqi wars. Celox is the latest generation of bandage. Frankly, not much had changed about bandages since strips of petticoats were torn away in the “Gone with the Wind” era but this new generation bandage is a quantum leap forward. Each one is impregnated with blood-clotting agents to help stanch the flow of blood. It’s a simple idea but it can have a dramatic and life-saving effect.
As fully trained and sworn deputies of the Indian River County sheriff’s office, both Garcia and Bentancourt also carry something to work with them that few other doctors do. They are fully armed when called to duty. “It’s mostly for defensive reasons,” Bentancourt explains, “but yes, we’re armed.”
As SWAT medics, Garcia and Bentancourt always have a twin mission. Not only must they attend to any injured officers, they also treat suspects, bystanders and anyone else injured at any deployment. “It’s basically care under fire,” says Bentancourt.
Fortunately, it’s not all that commonplace. Then again, it’s probably more commonplace than many here in Vero think.
“I think we had a total of 52 calls last year,” Bentancourt explains, “or about one per week on average.” Still, considering they cover almost the entire county serving search warrants, arrest warrants and responding to calls for help, Betancourt and Garcia can be glad they’re not based in Prince George’s County, MD where, according to the Washington Post, SWAT teams are called out over 500 times a year.
Oh, and that assault rifle leaning up against the filing cabinet? It’s temporary. Bentancourt is taking it home to do some gunsmith work on it. After all, a guy with a successful periodontal practice who is also a SWAT team medic, certified public safety scuba diver, husband and father probably needs one more thing to fill up all his extra time, right?
Dr. James Bentancourt is at Indian River Implant Center, 70 Royal Palm Pointe. The phone is 772-567-5981.