Doctors to be taught battlefield surgery in inner-city hospitals as gun crime rises

Doctors are to be trained in battlefield surgery to cope with the rising number of stabbing and gunshot victims in inner-city hospitals.

Medical staff at two London hospitals will be taught the emergency techniques on an intensive course that until now has been used to prepare military surgeons for frontline treatment of troops in the Balkans and Afghanistan. The three-day course at the Royal College of Surgeons in London has helped army medics to treat soldiers wounded by bombs, land mines and gunfire.

Doctors from the Royal London Hospital in Whitechapel and the Homerton University Hospital in Hackney intend to attend the course later this year in an important step towards adopting "trauma" techniques common to inner-city hospitals in the United States and South Africa.

The Homerton plans intensive training in vascular, chest and heart surgery as part of the course, run by Professor Jim Ryan, senior lecturer in trauma at University College London and a former professor of military surgery at the Royal Army Medical College.

Professor Ryan, who worked as a surgeon in the Falklands conflict, said the course would equip health service doctors with a range of trauma skills used by army doctors. He said: "In the developed world there has been an increase in the number of penetrative injuries and surgeons are less well trained for a more complex problem." Course tutors have been recruited from the military and the NHS to teach standards set by the International Association for the Surgery of Trauma and Intensive Care.

Donal Shanahan, a senior consultant surgeon at the Homerton, which deals with more gunshot victims than any other casualty department in Britain, proposed specialist training after returning two weeks ago from a trip to Baragwanath Hospital in Soweto, the crime-ridden township outside Johannesburg. Mr Shanahan spent six weeks in the hospital in response to concerns that junior doctors at London hospitals needed a broader range of skills to deal with the victims of stabbings and gun crime.

Unlike their British counterparts, trauma surgeons at Baragwanath's casualty ward, which deals with about 170 gunshot victims a month, can deal with any part of the body before transferring patients to intensive care.

If plans are approved by the heads of casualty at Homerton and the Royal London at a meeting next week, the hospitals will become the first in this country to adopt compulsory trauma training for new recruits. Experts in trauma surgery believe compulsory training will soon be adopted by other inner-city hospitals.

The Homerton, which handles a relatively high number of penetrative injuries because of a drug-related turf war, also wants to send surgeons to hospitals in America and South Africa on study leave to practise dealing with chest and abdominal wounds. The casualty department at the Homerton deals on average with five gunshot victims and 50 stabbings a month. A third of trauma cases are gun or knife-related – a 40 per cent rise on 1996.

Since his return from South Africa, Mr Shanahan, who is one of the hospital's most senior surgeons, has sought to calm local fears aroused by claims that Hackney was as dangerous as Soweto.

Mr Shanahan said the situation was far worse in Soweto. "I was shocked at what I saw at the Baragwanath," he said.