How the skills used to treat war heroes could save YOUR life
There’s only half a metre from Anthony Cooper’s bed to his wheelchair.
But this is a distance that cannot be measured by a ruler alone.
Anthony could barely move at all when he first came to Headley Court, the military rehabilitation centre in Surrey.
Just months after Corporal Daniel Whittingham, 26, had his left leg amputated, he was enrolling in 'Iron Man' competitions
‘Coops’ — as he is affectionately known at Headley Court — who is just 24, lost both legs, nearly half of his fingers, an eye and suffers from a degree of brain damage after stepping on a landmine while on patrol in Afghanistan in July 2010.
Although doctors don’t yet know how independent a life Coops will have, there is no doubt that — thanks to an intense programme of physiotherapy, occupational and speech therapy, counselling and exercise rehabilitation — he has made extraordinary progress in a relatively short amount of time.
‘My big goal is to walk again,’ he says, heaving himself into the wheelchair with a flash of his trademark cheeky grin.
Headley Court has become famous for helping Britain’s injured servicemen and women — and techniques developed there are being adopted by mainstream medicine on people affected by injuries such as burns, wounds and loss of limbs.
More than 17,000 amputations of legs, arms, fingers and toes were performed at hospitals in England alone in 2009-2010, 70 per cent of these for patients who’d developed circulatory problems as a result of diabetes or smoking.
Around 90 per cent of soldiers who have lost one or two limbs in recent years return to duty, though often in a different role
Meanwhile trauma — the medical term for a very serious or life-threatening injury — is the single biggest killer in Britain for those aged between one and 40.
‘In three to four months of residential rehabilitation here at Headley Court, we are achieving the same functional gains as someone in civilian life would expect to achieve in roughly two years in the NHS,’ explains Warrant Officer Russ Coppack, Headley Court’s lead adviser on exercise rehabilitation.
AMUCH overdue overhaul of Britain’s trauma services is under way, and the consultant in charge, Professor Keith Willett, is trying to adopt best military trauma practices in a new network of specialist trauma centres.
‘It’s very sad we have people suffering serious injuries as a result of war, but it’s important that the lessons that are learned are translated into civilian practice,’ says Professor Willett, Britain’s first national clinical director for trauma care.
Battle experience has taught doctors the importance of massive blood transfusions immediately after a devastating accident — a big change from ten years ago.
Surgeons have also adopted damage control surgery, which means they will intervene the minimum they can to preserve life in the hours immediately following a life-threatening injury.
They will act to stop haemorrhaging, for instance, but will refrain from extensive surgery if possible, as battlefield medics have found this reduces the physiological load on the patient — doing too much surgery too quickly can prove fatal.
Another development is the use of Celox, a powder developed to treat battle wounds.
It acts as a rapid clotting agent to halt bleeding and is now in regular use at the Queen Elizabeth Hospital in Birmingham and in ambulances nationwide.
Lieutenant Colonel Steve Jeffery, consultant burns surgeon at the Queen Elizabeth, also points to the use of a laser doplar imager — a machine first used to scan the burns of soldiers arriving at the hospital from Afghanistan.
‘Patients with burns are often treated with strong microbial creams,’ he says.
‘These stop infection spreading very well but make the whole area go white, which can make it difficult for surgeons to see how deep the burn is, and whether skin grafting might be needed, for instance.
‘It can take two weeks for the effects of the cream to wear off, but the laser scanner at the Queen Elizabeth can see below the white area, so we don’t have to wait.’
But it’s rehabilitation where Headley Court is really paving the way.
Crucially, its patients begin to receive rehabilitation treatment the minute they are fit enough to leave hospital.
Patrick Burns, a 25-year-old paratrooper, had his right leg amputated after treading on a landmine a year ago.
Even though his leg was still swollen from the amputation operation when we visited Headley Court, he’d already been measured for his first prosthetic limb — and, having arrived at the centre the day before, had embarked on an exercise regime.
Staff also set to work to improve movement and function in all parts of the body.
A patient needs to build up strength and mobility in their remaining limbs to cope with a prosthetic one.
For Coops, one problem was his shoulder muscles — very stiff after nearly two months in a hospital bed — so he was put on a course of exercises at Headley Court’s gym, supplemented by physiotherapy.
In the NHS, such facilities are very patchy.
Professor Willett says: ‘Every hour you spend at Headley Court you are being rehabilitated.
'An NHS patient may receive as much physiotherapy overall, but the time until the next appointment may well be wasted.’
Military statistics speak for themselves — around 90 per cent of soldiers who have lost one or two limbs in recent years return to duty, though often in a different role.
Many of them undertake significant sporting challenges — just months after Corporal Daniel Whittingham, 26, had his left leg amputated, he was enrolling in ‘Iron Man’ competitions.
Professor Willett says his ultimate goal is to introduce a dedicated rehabilitation service throughout the NHS.
‘Headley Court shows you the gold standard of what is possible with a fit, young, motivated person when they have access to the best treatment,’ he says.