Donald Jenkins, M.D., honored for innovations in care

Photo showing Donald Jenkins, M.D. Distinguished Service Medal recipient Donald Jenkins, M.D.

Donald Jenkins, M.D., addresses the American Legion National Convention, August 2014

Donald Jenkins, M.D., director of the Level I Trauma Center at Mayo Clinic's campus in Rochester, Minnesota, was awarded the Distinguished Service Medal, the American Legion's highest honor, at the Legion's 96th National Convention in August. Previous recipients of the award include Gen. Colin Powell; Presidents George H.W. Bush, Lyndon B. Johnson and John F. Kennedy; Secretary of State Henry Kissinger; Cardinal Francis Spellman; and Drs. Charles W. Mayo and Jonas Salk.

Dr. Jenkins, a former U.S. Air Force trauma surgeon and immediate past chair of the National Trauma Institute, was recognized for his decades of extraordinary service in both military and civilian medicine. His innovations in trauma care and pioneering efforts to promote the exchange of ideas and expertise between military and civilian trauma specialists are among his greatest accomplishments.

Taking civilian lessons to the battlefield

When Dr. Jenkins first arrived in Iraq in 2004, injured combatants were usually taken to the closest facility, often a small outpost, instead of to the facility best equipped to treat them. "Everything was undertriaged, and casualties were dying," he says.

So he implemented a trauma system based on the San Antonio model — one of the best in the United States — and helped create combat support hospitals that rivaled or surpassed American Level I trauma centers. During the Fallujah offensive in November 2004, one of the deadliest months of the Iraq war, Dr. Jenkins and colleagues serving at the Air Force Theater Hospital north of Baghdad performed nearly 300 surgeries in 10 days. Not one patient died.

Iraq and Afghanistan are noted in general for high survival rates, thanks to advances in battlefield medicine, such as body armor, hemostatic gauze, rapid evacuation of the injured and planes transformed into flying critical care units. Many of those advances were pioneered by Dr. Jenkins and his colleagues.

He championed the use of tourniquets — long discouraged in both military and pre-hospital settings, even though uncontrolled bleeding from extremity wounds was the leading cause of preventable death among American casualties in Vietnam and accounted for 7.8 percent of preventable deaths in the first years of the conflicts in Iraq and Afghanistan.

Thanks in large part to Dr. Jenkins, lifesaving devices such as Combat Application Tourniquets (C-A-Ts) are now standard military issue and all soldiers are trained to use them. C-A-Ts have also made the transition to civilian emergency care. Police and fire departments routinely use them in the field, and they were crucial for emergency departments treating Boston Marathon bombing victims.

In Iraq, Dr. Jenkins experimented with wound vacuum machines to prevent infection before skin grafting and promoted the use of Nomex uniforms, which dramatically reduced the incidence of burn injuries. Perhaps most important, he advocated a return to the long-abandoned practice of using whole blood for patients requiring massive transfusions, which has been shown to save lives and is now increasingly used in U.S. civilian hospitals.

"In the Iraq conflict, the weapons were bigger and better and the injuries were worse. But the mortality was not worse because we had learned and implemented certain lessons," Dr. Jenkins says. "Now that these conflicts are winding down, the future lies in research and in ongoing military-civilian cooperation."

That is the heart of Dr. Jenkins' achievement: bringing civilian models to the battlefield, incorporating military lessons into civilian care and saving more lives on both fronts.

For more information

Jenkins D. Two Fronts, One Battle: Trauma Surgery Innovations. Medical Professional Video Center. Mayo Clinic. 2014.