Trauma, Military Partnerships, and Unique Training Drills Put Cooper Trauma Center on the Map

In Camden, New Jersey's Cooper University Health Care Trauma Center, a beacon of emergency medical innovation and expertise brightly shines. EMS World had the privilege of speaking with four team members of the health system’s Section of Military, Diplomatic, and Field Surgical Affairs: John Chovanes, D.O. FACS, COL, USAR, Chief Surgeon; Jaime Kuklinski, Administrative Coordinator; Richard Heffernan, Jr., Field Logistic Operations Coordinator; and Timothy Galvin, Administrator.  Their insights offer a profound look into the workings of this unique trauma program and how it has been leveraged to provide training opportunities for the military, first responders, and more.

Cooper Trauma Center: A Unique Medical Facility

Located in the heart of Camden, New Jersey—a city transitioning from its industrial roots to a renewed focus on business, Education, and medicine —Cooper University Health Care stands out. Despite the challenges over the past several decades with crime and poverty, Camden has been on an upward trajectory with incremental improvements, with Cooper being not only a hallmark of medical excellence and expertise but also catalyzing urban change.

Cooper University Hospital, a leading academic medical center in Camden, is a powerhouse in trauma, and emergency care, offering care in more than 75 specialties and subspecialties. With more than 10,000 team members, Cooper responds to approximately 5,000 trauma alerts annually, accepts 83,000 Emergency Department visits, almost 55,000 urgent care visits, 31,000 hospital admissions, and more than two million outpatient and ambulatory visits annually. The Center handles an impressive 28,000+ surgical cases annually.  The hospital boasts a helipad for immediate interventions and serves as a vital educational resource, with 300 residents and fellows across more than 40 specialties, in conjunction with its affiliate medical school, Cooper Medical School at Rowan University.

A Culture of Supporting Military and Veterans

Cooper has an ongoing commitment to active military and veterans. Through a variety of educational opportunities, human resources programming, community outreach activities, and programs and awards designed for team members, Cooper demonstrates its support to those who serve in a myriad of ways. Heffernan highlighted the hospital's unique culture, where every staff member who is on active duty, reservist, or veteran proudly wears a special badge on their ID tag. In this way, Cooper recognizes the service of each person who served. "They are veteran and military proud at Cooper University Health Care... and it’s nice to see," he says, emphasizing the strong military ethos within the hospital. He notes that patients who are veterans often feel more at ease and less anxious when they see the ‘Military’ tag, fostering a deeper connection and comfort.

Special Programs and Partnerships

The hallmark of Cooper’s support to the military is shown through the development and rapid expansion of its Section of Military, Diplomatic & Field Surgical Affairs over the years.

Cooper serves as the only Level I Trauma Center for all of southern New Jersey and is one of the busiest trauma centers in the region. Due to its high-volume trauma center and expertise in surgery and critical care, Cooper is the only hospital in the United States that has trained elite medical providers from every military branch; multiple local, state, and federal government agencies including Homeland Security; and international partners.

The program was established in 2013 starting with the Air Force’s Pararescue Jumpers (commonly known as “PJs”), is a crucible of expertise and collaboration and has rapidly expanded over the past several years.

“As a Level I Trauma Center and leading academic health system, Cooper is uniquely qualified to provide the hands-on training members of military medical teams need to gain the experience and skills to save lives on battlefields around the world,” said John Chovanes, DO,  the founding medical director and chief surgeon of Cooper’s Section of Military, Diplomatic and Field Affairs, and a colonel in the Army Reserve Medical Corps, who has seen a great deal of trauma firsthand.

The Cooper Trauma Center's training programs, which include collaborations with military personnel and special forces, are foundational to their operations. "We have many special programs...people are surprised by our program’s reach," Galvin added, underscoring the depth and diversity of their initiatives.

In 2019, Cooper became the first hospital in the nation to partner with the U.S. Army to establish the Army Medical Department Military-Civilian Trauma Team Training (AMCT3) program and later that year became one of only three hospitals nation to provide specialized medical training to active duty and reserve personnel from all branches of the U.S. military as part of the SMART (Strategic Medical Asset Readiness Training) initiative. Under the AMCT3 program, military medical personnel including trauma surgeons, neurosurgeons, emergency medicine physicians, specialized trauma and emergency room nurses, surgical physician assistants, nurse anesthetists, and paramedics are assigned and embedded at Cooper for multi-years of service to learn, train, and provide care alongside Cooper’s staff.    

Cooper also hosts the Special Operations Combat Medics (SOCM) program, rotating military medics through hospital and field environments. This program not only trains special operations medics from all military branches but also brings the finesse of surgical skills into the rigor of field readiness.

The Strategic Medical Asset Readiness Training Program is designed as a two-week hands-on opportunity for Army soldiers who are currently working in their home environments as O.R. Scrub Techs, LPNs, EMTs, and Paramedics.  During their rotation, they work alongside their civilian counterparts at Cooper to hone their medical readiness skills and better proficiency in their abilities.  

Cooper’s MILDAF comprehensive training programs include the National Guard, which includes medics, physician assistants, and physicians, thereby ensuring a broad impact. The Advanced Surgical Skills for Exposure in Trauma (ASSET) Course is another example of their commitment to top-tier training. Their collaborations also extend to training advanced capability paramedics and physician assistants within Federal Law Enforcement Agencies. Cooper’s Field Medical Surgical Unit (FMSU) also had a role in caring for Afghan refugees housed in southern New Jersey from August 2021 to December 2021 further demonstrating their adaptability and commitment to humanitarian efforts.

Cooper’s Telemedicine program, offered to multiple Federal agencies is another significant facet of their work, providing essential consultative services to medical personnel providing services in detached high-threat environments. These Federal Medical Specialists often attend skill refresher courses at Cooper, ensuring they remain at the forefront of medical practice.

2022 MASSE Exercise - Salem County Sheriff Dept. and Cooper Trauma Center

In September 2022, Cooper Trauma Center collaborated with the Salem County Sheriff's Department, New Jersey State Police T.E.A.M.S. unit, along with other Federal, State, and Local Law Enforcement Personnel (LEPs) for a training exercise, called the Mid Atlantic Severe Situation Exercise (MASSE). Held at the Salem County Sportsman Club, this exercise focused on “Point Of Injury” training for non-medical LEPs, Tactical Paramedics, and EMTs using cadavers to provide real-world experience. The training included a variety of critical skills such as tourniquet application, wound packing, and advanced procedures like cricothyrotomy. Kuklinski shared that there was a request for an on-site amputation station. They simulated a tree fall where a leg was trapped and the team ended up having to “amputate” the leg. The primary goal however was to improve LEP participants' capability, confidence, readiness, and survivability in the line of duty, while also fostering interoperability between law enforcement and medical professionals. A live fire drill was conducted in significant collaboration with Salem County Emergency Management, involving scenarios like on-site cadaver amputation. Heffernan shared, “We worked on adjusting the mindset of the law enforcement who was there during the live fire.  They had to shift gears and start treating the people that they shot, which they were not previously used to. Participants walked away incredibly grateful for the unique training opportunity.”

“Feedback from training exercises has been overwhelmingly positive, with stories of lives saved afterward and improved responses from participants,” according to Kuklinski. The focus remains on enhancing law enforcement mentalities and situational awareness.

Expansion of the Program in 2024

This year, Cooper plans to expand its exercises, introducing new scenarios for Fire, Rescue, and Law Enforcement response. The Mid-Atlantic Severe Situation Exercise (MASSE) is now scheduled for April 29th through May 3, 2024. Heffernan is the lead planner. “Our goal is to train 160 law enforcement, 64 EMTs / paramedics, and 40 firefighters from over nine counties.”  The integration of cadaver training in indoor settings aims to enhance EMTs' and paramedics' skills.

2024’s exercise will encompass five days including multiple patient care scenarios.  They will include a barricaded subject with a hostage, victims entangled in either farming, equipment, or a car, more field amputations, and continue with the use of cadavers.  “We will also expand the number of buildings and tents that we are using,” shared Heffernan.

 "This program will integrate some amazing life-like skills under simulated scenarios for the responders who participate,” said Galvin.

Final Thoughts

The Cooper Trauma Center stands as a unique institution in trauma care and military and first responder training. With anticipation for future developments and exercises, the Center continues to play a pivotal role in the landscape of trauma medicine and the training of first responders on the local, state, regional, and Federal levels.

“Ultimately, we would like to help replicate this and teach other hospitals in the county how to do this, because I think that this is a model that could be emulated throughout the continental United States at the right hospital,” said Dr. Chovanes.

“Our armed personnel from the military are intimately involved in caring for the sickest and the most injured in all of New Jersey — we do that in a very collaborative manner. We are very proud of these programs, and we will continue to grow them and refine them.”

This interview was conducted with:

John Chovanes, D.O., FACS, COL, USAR, Chief Surgeon for the Section of Military, Diplomatic and Field Surgical Affairs at Cooper University Health Care

Timothy P. Galvin MSN, RN, CCRN-K, Maj, DANG(ret.), Administrator for the Section of Military, Diplomatic, and Field Surgical Affairs at Cooper University Health Care

Richard J. Heffernan Jr., BS, Field Logistic Operations Coordinator for the Section of Military, Diplomatic, and Field Surgical Affairs at Cooper University Health Care

Ms. Jaime Kuklinski, BA, Administrative Coordinator for the Section of Military, Diplomatic, and Field Surgical Affairs, at Cooper University Health Care

Barry Bachenheimer, Ed.D, NREMT/FF is a frequent contributor to EMS World and is an active educator and field provider.