Day 313: Follow Up

Since I've been here in Afghanistan our small base has been attacked 15 times to include a combination of rockets, mortars, and improvised explosive devices. Fortunately, 14 out of those 15 times no one was hurt and the mission continued on as usual. But, the one significant casualty occurred during our most recent rocket attack as my medical team and I were urgently summoned to the the Afghan Army clinic to assess a young soldier who caught shrapnel into his chest. What made this experience so interesting was that we weren't sure if the rockets had stopped coming so we had to dash up to the Afghan clinic with our "full battle rattle" on. Come to find out, this soldier was struggling to breathe as a result of the shrapnel still stuck in his left chest. From what I could tell, he was retaining air in his chest cavity through the hole in his chest (tension pneumothorax) which required urgent decompression with a large bore needle. I had my Afghan medic pull out a long 14 gauge (very large bore) needle and walked him through the insertion of the needle over the patients 3rd rib and into the chest cavity to release the air that was building up...which, by the way, temporarily relieved his shortness of breath. At that point we quickly called for an air medevac and took him to the landing zone, and while standing there waiting to have the patient picked up I prayed so hard that no more rockets would be launched at us as we were hanging out in the open air without the safety of a bunker.


What happened to the patient? Lucky for me, I was already on a convoy mission to Forward Operating Base Salerno the very next day which was where our trauma hospital was located. So when I arrived on post, I swung by the hospital to pay him a visit, and low and behold there he was with a chest tube in place. Come to find out, that needle decompression bought him just enough time to get the definitive treatment that he needed. Talk about a follow up visit with a happy ending!