Firearm wounds have become today's urban trauma. Because of the current situation, the Emergency departments of the civil hospitals of Mexico's various federal bodies are frequently attended by patients who have been wounded by high-powered firearms and by high speed projectiles. These wounds were once only seen in situations of war. This is why it is now a priority to train medical care groups in handling these injuries.
Part of the mission of both the Academia Mexicana de Cirugía and la Universidad Nacional Autónoma de México is to promote education and research in all branches of surgery through their experience and active participation, thus contributing to the health of the Mexican people. To that end, they set about the task of developing the First Bilateral Workshop on the Handing of Fire Weapon Wounds, in conjunction with the Benemérita Cruz Roja Mexicana, the Secretaría de la Defensa Naciona, and the Secretaría de Marina Armada de México They were also able to call on the broad experience and collaboration of the United States Northern Command, USNORTHCOM.
The mission of the United States Northern Command is to support the civil population and includes relief operations in the event of national disasters such as fires, hurricanes, floods and earthquakes. Their support also includes operations against drug trafficking, and managing the consequences of acts of terrorism by the use of weapons of mass destruction. Most of the members of the Northern Command have been trained by staff who have participated in armed conflict, such as the Afghanistan War (2001 to the present date) and the Gulf Wars (1990–1991 and 2003–2011), and therefore have broad experience in handling firearm injuries.
The above prompted the Academic Dr. Alejandro Reyes Fuentes, Chairman of the Academia Mexicana de Cirugía 2013–2014, to arrange this bilateral workshop on the handling of firearm wounds in collaboration with the United States Northern command, through Lieutenant Commander Alfredo R. Sancho, and the Hospital Central Militar, as had taken place in the facilities of the Hospital Central Militar of the Secretaría de la Defensa Nacional on 22 and 23 September 2014.
The senior academics in charge of the course were the Academic Doctor Alfredo R. Sancho on the part of the United States Northern Command, the Academic General of the Medical Brigade Surgeon Angel Porfirio Cervantes Pérez, Former Chairman of the Academia Mexicana de Cirugía and the Academic Medical Colonel Surgeon Héctor Faustino Noyola Villalobos, Chief of Surgery at the Hospital Central Militar. The Secretaría de la Defensa Nacional via the Hospital Central Militar provided the facilities to give this course, with the participation of nine international professors on behalf of the United States Northern Command and 17 national professors of various health institutions, all of whom widely experienced in handling patients with firearm wounds.
The course consisted of four modules, which covered subjects from the general principles of ballistics, trauma kinematics, stabilisation and transport, and the organisation of trauma teams, to the specific management of major wounds such as burns and spinal injuries. Essential areas of the course related to the management of post-traumatic stress and the comprehensive rehabilitation of the injured patient, and their reintegration into their family once the specific firearm injury had been resolved, and these were covered by the staff of the United States Northern Command who shared their large experience in the comprehensive rehabilitation of these types of patients.
This course was attended by 200 participants from various civil and military institutions. They had the opportunity to learn about the experience of these types of injury in Mexico and that of experts who have taken part in war conflict. At the end of the course they were awarded a diploma with the academic endorsement of the Universidad Nacional Autónoma de México.
The readiness expressed by the Northern Command of the United States to work in conjunction with Mexico's academic and medical care institutions is evidence of their great interest in sharing experiences. In this case reinforcing what we do well in our institutions, showing us what we need to improve and, very importantly, what new needs to be done, such as the management of post-traumatic stress once the specific injuries have been handled.
This course shows us that in Mexico, due to the progressive increase in complex wounds from firearm injury, the civil and military health institutions have been “obliged” to become updated on the comprehensive management of patients who have received these types of injury. Previously this situation fell to the competence of the military hospitals or civil trauma centres, but unfortunately now these patients can receive treatment in any healthcare institution, which makes it necessary for the academic institutions to educate the medical community in the management of these types of injury.
The creation of this course is evidence once again that the Academia Mexicana de Cirugía, the Universidad Nacional Autónoma de México, the Secretaria de Marina Armada de México and the Secretaría de la Defensa Nacional through the Hospital Central Militar, are all working towards a common goal, “Serving Mexico”.