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UF Health Traumatic Brain Injury Expertise Used on Frontlines in Ukraine

A group of Ukrainian soldiers
A group of Ukrainian soldiers. (Getty image)

Bang.

It was just one gunshot among the countless being fired nearly 6,000 miles away, but the impact of the resulting wound would soon reverberate all the way back at University of Florida Health in Gainesville.

That bullet struck the head of a Ukrainian soldier fighting in a fiercely contested area of eastern Ukraine. The soldier fell in the trenches near Ocheretyne, a village that was a key Russian strategic target in the Donetsk region.

A wound like this one would normally be fatal on the Ukrainian battlefield, the combatant left to die for lack of adequate medical know-how.

However, on April 28, some surprising news traveled from the war’s frontlines to the inbox of Chris Robinson, DO. The UF Health neurocritical care specialist had given a webinar focused on penetrating traumatic brain injury, or pTBI, just two days earlier to roughly 150 medical personnel in Ukraine, many of them medics.

“One of the combat medics in the field, in a trench, sent a picture of a soldier who got shot in the head that basically said based on what you just told me (in the webinar), I utilized it and actually saved the guy’s life, and normally we just let them go,” Dr. Robinson said. “It was amazing.”

Dr. Robinson had worked on that webinar presentation for a month and a half. He spent time getting it translated into Ukrainian, but first, he needed to at least have some glimpses of what those in his webinar were witnessing every day. He studied harrowing images of suffering soldiers to familiarize himself with the type of pTBIs he’d be lecturing about.

The goal was to provide guidance that could be used to quickly identify and treat these wounds, most caused by bullets or shrapnel while taking into consideration the medics’ limited resources.

The challenge would be to design a webinar for a diverse range of medical personnel, and Dr. Robinson was prepared for that. What he didn’t quite expect was that he’d be sharing that information with people squarely in the midst of what resembles World War I-style warfare.

“I mean literally a guy was on his phone wearing camo and came out of a trench. I said, ‘Oh, my God,’” Dr. Robinson recalled. “From combat medics to doctors in the field hospitals, and then the neurosurgeons in the hospitals where those patients would go. I was like, ‘All right. I’m actually talking to people who really want to hear what I have to say.’”

If that weren’t true, the wounded soldier in the photo, halfway around the world and barely hanging on, would have run out of lifelines. He wouldn’t have been stabilized and delivered alive to the appropriate care unit by a combat medic who took precious time during a violent war to attend his webinar.

The standard treatment plan called for simply packing the wound. The approach in Dr. Robinson’s presentation covered six additional measures. They included recommendations on when to give blood transfusions; performing an emergency tracheostomy to ensure adequate oxygenation; administering a diuretic to lower intracranial pressure; and elevating a patient’s head 30 degrees when they’re being transported.

Chris Robinson, DO
Chris Robinson, DO

One of the combat medics in the field, in a trench, sent a picture of a soldier who got shot in the head that basically said based on what you just told me (in the webinar), I utilized it and actually saved the guy’s life, and normally we just let them go. It was amazing.

— Chris Robinson, DO

Dr. Robinson’s presentation was arranged by United Help Ukraine, a nonprofit established in the U.S. in 2014, the year of Russia’s annexation of Crimea. Over the last two years, the organization has deployed $65 million to provide medical, humanitarian and psychological assistance to those in Ukraine affected by the war.

The group reached out to UF Health because of its nationally recognized expertise in TBIs, building on a collaboration that began last October.

“We had two very successful webinars prior to that one,” said Anna Yabluchanskaya, MD, MPH, the medical aid program director for United Help Ukraine. “There was one for pain management for amputees, and the second one was for PTSD, so this is the third one, and this one was very, very impactful. We didn't expect such huge results so quickly.”

Dr. Yabluchanskaya received the text from the combat medic, emailing Dr. Robinson to pass along the medic’s gratitude. She pointed out how the survival of the soldier defending Ocheretyne is only part of the ripple effect his webinar is having.

“As we see here, we already got an impact, but I’m already sure that its impact is much higher,” Dr. Yabluchanskaya said. “We had a lot of neurosurgeons who asked a lot of specific questions to Dr. Robinson, and I’m definitely sure they will use these ideas and expertise in their daily work, so we cannot even estimate the impact from this point of view.”

Dr. Robinson spent 30 minutes after the webinar answering questions, some simple, others complex. They asked how to detect signs of TBI without the ability to take a CT scan, and how to treat a TBI in combination with other wounds.

In the end, Dr. Robinson said “everything from A to Z” was covered to arm the attendees with information more important than any weapon. Maryna Baydyuk, PhD, United Help Ukraine’s president and executive director, said webinars like Dr. Robinson’s are part of a more sustainable effort to equip Ukraine’s military with knowledge to increase its capacity to treat the wounded.

“Unfortunately, Ukraine will probably be a leading country in terms of the number of those types of traumatic brain injuries,” Dr. Baydyuk said. “Because people didn't have that prior knowledge to deal with such a huge number of patients with TBI, equipping them with this knowledge is absolutely crucial. It’s so much more valuable than anything else.”

While this wasn’t the first time Dr. Robinson has impacted someone’s life, the photo that was sent to him represented more than that. He saved someone’s life whose duty was to risk that very same life for his country. He was also reminded of what he described as “the privilege we have in the United States from an educational perspective” and just how many other gruesome situations around the globe stand to benefit from expert guidance.

“Seeing the picture gave me a sense of purpose of why we do what we do,” Dr. Robinson said. “That we, in our little bubble here in the United States, are minuscule compared to the rest of the world. That there’s a lot more we could be doing to, on a very simple basis, to help these people. I felt like, ‘This is why I went into medicine.’ I haven't had that feeling in a long time.”

About the author

Talal Elmasry
Marketing Content Writer

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Peyton Wesner
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pwesner@ufl.edu (352) 273-9620