AM, Mayne Professor of Critical Care, University of Queensland, Australia
Professor Reade is an intensive care physician, anaesthetist and clinician scientist, appointed to the University of Queensland in 2011 by Joint Health Command of the Australian Defence Force as the first Professor of Military Medicine and Surgery. He holds a DPhil in applied molecular biology from the University of Oxford, and his postdoctoral research fellowship at the University of Pittsburgh focussed on clinical trials and the analysis of observational datasets. In 2021 he was appointed Head of the Mayne Academy of Critical Care at UQ, with oversight of teaching and research in anaesthetics, intensive care and emergency medicine. He continues to lead the expanding ADF trauma research program based at UQ, encompassing trauma systems design, blood and fluid resuscitation in trauma, and traumatic brain injury. His frozen platelet trial program, conducted with Australian Red Cross Lifeblood, aims to improve worldwide access to this vital component of trauma resuscitation. As an officer in the Australian Army, Brigadier Reade has deployed nine times, including twice to Afghanistan and three times to Iraq. From 2015-2019 he was the Director of the Regular Army’s only deployable hospital, and 2019-2022 he was Director General Health Reserve, with oversight of specialist clinical personnel and capability development.
Similarities and Differences between Military and Civilian Trauma Systems
Military and civilian trauma systems both aim to reduce mortality by focussing on injury prevention and reducing severity of injury, and for injured patients, by providing advanced prehospital interventions as rapidly as possible before transport to the most appropriate hospital in a distributed trauma system. However, while military clinicians are almost exclusively trained in civilian hospitals, the challenges faced by deployed military trauma networks have necessitated several system-level innovations that might be useful elsewhere. For example:
- Military hospitals must deal with frequent rotations of staff, often from several international partners, and so have developed formal mechanisms to integrate new clinicians into functioning teams.
- Military hospitals often deploy into areas that have previously had little or no clinical capability. Resources are allocated based on data and predicted need, rather than the legacy of earlier decisions.
- Military trauma systems have proved open to between-nation quantitative comparisons of clinical results, with systems associated with suboptimal mortality rates rapidly adopting identified best-practices in training, staffing and protocols.
- Military hospitals must work in a contested and logistically challenging environment in which clinical considerations are often subordinate to tactical imperatives. Consequently, clinical leadership has been separated from military command, with hospitals having both a Commanding Officer and Director of Clinical Services, each with clearly defined leadership roles.