Vascular surgeon Col. Chatt Johnson, MD, instructs DRC participants on treatment of disaster-related vascular injury.


Published 9/1/2012

Volunteers Need More than a Big Heart

Disaster Response Course helps build special skill set

In their regular practice, orthopaedic surgeons don’t usually see vascular injuries, compartment syndrome, and burns, but these are precisely the kinds of injuries frequently sustained during disasters. They’re also among the conditions addressed during the Disaster Response Course (DRC), developed by the Society of Military Orthopaedic Surgeons (SOMOS) and cosponsored by the AAOS, the Orthopaedic Trauma Association (OTA), and the Pediatric Orthopaedic Society of North America (POSNA).

“We are thrilled to have POSNA as a cosponsor of the 2013 DRC,” said Col. Tad Gerlinger, MD, course director. “Pediatric considerations are critical in any kind of disaster situation, and the insight that our partners at POSNA bring to these special issues is critical.”

DRC faculty members Scott C. Nelson, MD, and Lt. Col. Kevin L. Kirk, DO, discuss surgical technique.

“This course is an excellent first step,” continued Dr. Cass. “It outlines what conditions we might face and what tools we might have on hand. It imparts much practical advice on ensuring that our good-hearted efforts are both well received and effective.”

Clinical skills, personal preparation
The DRC is presented by a diverse group of faculty with a wealth of expertise in austere environments. The course begins with a full day of didactic lectures on clinical topics relevant to disaster situations, including the following:

  • extremity soft-tissue injuries
  • amputations
  • fractures
  • axial skeleton injuries
  • vascular injuries
  • crush injuries
  • compartment syndrome
  • fasciotomy
  • blast and burn injuries
  • pediatric injuries

In addition, faculty address issues surrounding personal preparation for working in a disaster environment. These aspects include topics such as working with the military and nongovernmental organizations (NGOs) and cultural and ethical considerations.

Course participants also spend a half day in a cadaveric lab, where training focuses on surgical skills specific to treating patients in resource-limited environments. The lab session includes managing periarticular fractures, external fixation of both upper and lower extremities, practicing fasciotomy and escharotomy techniques, and soft-tissue coverage. A vascular surgeon demonstrates shunts, and participants have the opportunity to work with Fogarty catheters.

Vascular surgeon Col. Chatt Johnson, MD, instructs DRC participants on treatment of disaster-related vascular injury.
“One of the lessons we learned from the earthquake in Haiti is that disaster response efforts require more than a big heart on the part of volunteers,” said Joseph Cass, MD, who was among the first to take the DRC when it was offered in 2011. “Working in an austere environment requires a special skill set that many of us have not used.

New components
The 2012–2013 DRC agenda includes a new discussion devoted exclusively to U.S. domestic disasters. A carryover from previous DRC, the highly rated “MacGyver Symposium: Improvised Orthopaedic Techniques,” now includes an interactive component. Small breakout sessions give course participants and faculty the opportunity to discuss improvisations they have employed while working in resource-poor, austere environments. Finally, the expanded bioskills lab also includes an amputation demonstration.

The DRC will be offered in Naples, Florida, Dec. 14–15, 2012, and at the Orthopaedic Learning Center in Rosemont, Ill., March 18–19, 2013.The DRC is open only to AAOS fellows and international affiliate members. For more information and to register, visit

Inaugural DRC a Success
Course participants rated the first disaster response courses, held in San Diego in December 2011 and in San Francisco in February 2012, very highly. Both courses sold out, resulting in 115 trained AAOS members.

“The San Francisco DRC was superbly well run and was taught by true experts in the field,” said course participant David Rovinsky, MD. “I particularly enjoyed the cadaver labs with the opportunity to practice surgical techniques necessary for disaster relief work that we do not encounter in everyday orthopaedic surgery in the United States, such as inserting external fixator pins without power, applying local flaps, and performing vascular procedures. It was awesome to meet and work with ‘real deal’ orthopaedic surgeons who have ‘been there and done that.’”

“The great energy brought by course participants and faculty contributed to the success of the inaugural DRCs,” said Dr. Gerlinger. “This was especially clear in the lab, where there was tremendous opportunity for exchange between faculty and participants and among participants themselves. I look forward to these interactions again in future courses.”

Become a Registered Responder
The 2010 Haiti earthquake and subsequent response by AAOS members prompted the creation of a formal disaster preparedness plan. The AAOS, OTA, and SOMOS worked together to develop a comprehensive disaster preparedness plan to enable an effective and efficient volunteer response.

As part of this plan, a disaster responder database was established and three types of responders were recognized: trauma-trained surge responders, acute phase responders, and sustaining phase responders. Anyone interested in signing up as an AAOS-Registered Disaster Responder must complete the DRC as a prerequisite.

For more information, visit or email