Day 228: Practice

As the "doc" I'm tasked with finding creative ways to train our troops in the art of combat medicine and first aid. Funny thing is...I'm no expert myself! Lucky for me, I have a team of medics, all with different experiences, to help me put the training evolution together. We brainstormed the course outline, and our goals for the students (16 total). Because we only had 1-2 hours available per day, we had to spread the course out over 4 days. Here was the break down of our class.

Day #1 - Combat Lifesaver Bag - What's in It?, Principles of Managing an Airway, Triage, Catastrophic Bleeding - Tourniquets

Day #2 - Chest Trauma - Managing a Tension Pneumothorax, Primary/Secondary Assessments, How to Call a MEDEVAC


Day #3 - IV Training and Litter Training - A change of pace from the death-by-powerpoint portion of our training workshop. Primarily a hands-on day. (see the poking above!)

Day #4 - What we call the "Capstone" event of our training workshop. The medics and I planned a "real" mass casualty scenario to familiarize our students with what a multi-trauma emergency can feel like on Camp Clark...here's the scenario...

We have a convoy which just left Camp Clark when an IED exploded just as they left the gate. 1 vehicle was directly hit, and the driver was still able to turn the truck around and come back to base. Apparently, everyone in the vehicle is severely wounded. The truck is now arriving...


The team is on standby as the truck roles in. We have 3 victims - the driver, gunner, and front passenger, all severely injured. The picture above is one of our "victims" with a severe neck wound. One of the students as well as my interpreter, Latif are assessing his "injuries" and transferring him over to a litter (what we in the civilian world would call a stretcher). The primary treatment area is the Troop Medical Clinic (TMC)...


...we pulled the 3 victims from the vehicle, and they have been carried over to the TMC by litter. We have one with a severe neck wound, another with a chest wound, and the other with severe wounds to his R arm/leg. Tourniquets were placed prior to arriving at the TMC.

While in the TMC, the "victims" are being assessed. All were given large bore IVs, chest wounds were treated, airway maneuvers were performed, and a Medevac was called over the radio. The bird is going to land in less than 15 minutes, we need to hurry and get the patients loaded for transport.


As you can see, we could only fit 2 of the 3 victims in our ambulance so the team was able to improvise in order to get the third patient transported successfully (see pic below).


There's our third "victim", strapped onto a litter and placed right on top of the hood. I thought that was an excellent method for transport.


The team did an excellent job from start to finish, from getting the patients out of the vehicles all the way to transporting the patients by ambulance to the helicopter landing zone. A job well done! If anything happens to us on Camp Clark...we'll be ready. Class dismissed!!

Day 160: Newbies

One of the expressions used in the Army is the phrase, "down range", which simply means being out there in the trenches where the fighting is happening, what some may refer to as the "front lines". Compared to many other bases in Afghanistan, our base is considered one that is "down range". Well, there are pluses and minuses with that. The plus side is the fact that the base is usually small (150-200 people) and the general personality of the populace is one that is laid back. The big minus is that troops intended for our base often get snatched up by units that are, for lack of a better phrase, "up range", therefore leaving us stretched for manpower . The administrative battle to ensure that the 3 medics that are leaving me are replaced with not 1, not 2, but 3 living, breathing, competent medics was a battle that I was not intending to lose.

To make a long story short and after many phone calls and e-mails to higher headquarters later. The rumors and the talk of the possibility of getting replacement medics turned into the real thing.

Go Team!

Well, here is a picture of my new team of young, eager medics. Together we will be covering the medical care of the US troops as well as the medical mentoring of the Afghan National Army troops. The medics bring a lot of skill sets with them as some have a wealth of experience in ambulance/inpatient care, pediatrics, tactical medicine, nursing, computer science, teaching, and even funeral directing (that probably covers most of our bases!). I think we have a pretty strong, well-rounded medical team. It will be fun to treat them like my young medical students...actually, although many of them don't have a college degree, their clinical medical knowledge and experiences far outweigh the experiences of a typical 1st or even 2nd year medical student.

Sgt Hodgett and SSgt Farris treating a "casualty"

To break them in, I went ahead and set up some training scenarios for my new medics. Surgical lubricant and Raspberry Crystal Light can really bring some of these scenarios to life! It was fun to review some of the basics in being a combat lifesaver. In the picture above is Sgt Hodgett and SSgt Farris working on a patient with an amputated left arm. Sorry it's a little graphic but that makes the training fun!