At Walter Reed National Military Medical Center, the largest joint service medical center in the U.S., located in Bethesda, Maryland, American Red Cross interns receive a unique hands-on learning experience where they are taught how to carefully mold prosthetic devices that help wounded and injured service members on the road to recovery.
At Walter Reed, each state of the art prosthetic device that touches a patient is designed, milled and produced onsite. Each model is individually cast from each patient. Prosthetists then work closely with the physical and occupational therapists in the adjacent Military Advanced Training Center to adjust fit as needed to ensure the best possible utilization of the prosthetic device.
The Prosthetic Orthotic Service within the Department of Rehabilitation at Walter Reed, is just one of the many clinics that utilizes Red Cross volunteers and interns to help ease military hospital staff workload so they can focus on the needs of their patients.
“They are a force multiplier, by doing technical work they enable the staff to do other tasks,” said David Laufer, chief of Orthotics and Prosthetics Services at Walter Reed.
Laufer personally interviews prospective Red Cross prosthetic interns to ensure they are the best fit for the lab. Only interns work in the lab, while Red Cross volunteers work in other administrative areas of the service. When selecting interns, Laufer looks at educational background, willingness/ability to work with their hands, and motivation to work with the patient population, in this case, mostly wounded and injured service men and women. Laufer has had little difficulty in teaching his interns despite the shock value that can be difficult for some individuals.
During the internship, Red Cross interns receive hands-on training to do the specific technical processes required to build a prosthesis.
“We begin with the most basic, mixing plaster and progress through to positive model rectification depending on the intern and the length of time they spend with us,” said Laufer.
To create a prosthetic device, first a patient is assessed at a multi-disciplinary clinic by a physiatrist, prosthetist, or physical therapist. From that assessment, a detailed prescription is developed to meet the outcome goals of the patient. Then, the prosthetist makes a negative model of the patient's residuum, making note of specific marks such as bony prominences, suture lines, etc. The prosthetist prepares and pours the negative model by filling it with plaster and peeling the shell.
Next, the prosthetist rectifies the positive model using his or her knowledge of the patient's prescription and specific marks to enable the fabrication of a socket. Then, the socket is either thermoformed or laminated over the positive model, trimmed to size, bench aligned and assembled for fitting. Finally, the prosthesis is custom fit and aligned to the patient.
Morgan Oxenrider, a Red Cross intern this past summer who is enrolled at George Washington University in Washington, D.C., said learning how to do the modifications (sanding down the cast to fit the patient) is the hardest part of creating the prosthetic.
But working with the patients, the service men and women, is the best part, Oxenrider commented.
This is just one of the many examples of the work the Red Cross does to support wounded warriors, their families and veterans at military hospitals around the world. Find out more about the Red Cross Service to the Armed Forces today.