Photos from Stuart! His second mission to Germany.
Mmmmm, beer!
Loading a patient on the bus for transfer
Patients on the right side of plane
Working in the dark, as per usual
Heres an excerpt from the journal he is keeping:
Friday I awoke to a barrage of text messages and
emails stating that my team was going to have a mission that evening/early the
next morning. This was quite a nice surprise as we thought that Germany team
was going to take the mission as previously done. This debate of who should
actually be flying the patients back to Germany from Bagram causes quite some
consternation with all of the teams down range. In our minds, patient safety is
placed at risk as the teams that fly from Germany have to fly for 8 hours,
package the patient and learn all of their nuances within an hour. After that
they turn around, get on the plane and fly with the patients for another 8
hours plus another 30 minutes to an hour transport to the hospital. This makes
for a long day for all of these individuals and places patient safety at risk
during these times. Of other concern from the teams downrange are the benefits
that are provided to the Germany team for their short time in theater. If they
only fly in for that single hour then they receive tax free benefits for the
entire month and potentially hazardous duty pay on top of that. Its not that we
don't want them to receive those benefits but for those of us that sit down
range for the better part of the month it becomes frustrating for them to get
those benefits and take our missions which Bagram used to fly all the time. Now
I understand that these are the decision of many people high above us and have
been going on for months before this but I wish they had the foresight to see
the problems that will arise before they happen.
Anyways, after a short rant I will refocus back to our mission
which we were so blessed with. We worked out for an hour, ate dinner and then
headed to the hospital shortly after that to get to know our patients. After
about 2-3 hours at the hospital, talking with all of the doctors, looking at
films and labs and placing orders for the flight we felt ready to go. The two
young guys we were flying were injured in a dismounted IED (improvised
explosive device) blast. They had apparently gotten out of their MRAP (mine
resistant armored protection?) vehicle when the device exploded. There was a
third individual who unfortunately did not make it. Our first patient was a 25
year old guy who was the driver of the vehicle. His injuries included a
traumatic brain injury from a depressed skull fracture with no elevation in his
intracranial pressures yet. A cricothyroidotomy was performed in the field and
that was formalized in the OR at Bagram the day before we flew. He was responsive
when off sedation and would start to follow commands but was only able to move
his left side and had little if no movement on the right side. For the most
part he was otherwise stable and didn't have any heart issues, kidney issues,
or GI issues. He did would potentially be any elevation in his ICPs from his
brain injury as we were approaching the time of maximal swelling. The next
patient was a 29 year old male who was the passenger of the vehicle. He
suffered many physical derangements that lead to an extensive resuscitation at
the forward operating base and Kandahar before being transported to Bagram.
Those physical injuries included a right above the knee amputation, right arm
thru the elbow amputation, left knee wound, left 4th and 5th digit fractures, a
couple of rib fractures, transverse process fractures of the lumbar spine,
multiple facial fractures, a right eye injury with a corneal abrasion and
limited vision. He also had a cricothyroidotomy in the field with formalization
of the trach at Bagram. With all of the traumatic amputation I assume he had
extensive arterial bleeding that wasn't controlled with a tourniquet and he
received a super massive transfusion at Kandahar. This included over 40 units
of red blood cells, 40 units of fresh frozen plasma, platelets and
cryoprecipitate. He continued to receive some blood at Bagram in the OR but was
fairly stable by the time we needed to transport him. He was weaned from a
ventilator already though which is extremely surprising and was actually
communicating and moving the extremities that he had left. Fortunately for him,
he had a cousin that was redeploying and was able to divert and come spend time
with him as well as travel back from Bagram to Germany with us. have some
wounds that included both of his knees needing washouts in the OR as well as a
scrotal injury with shrapnel that needed to be removed. He still required
mechanical ventilation for his brain injury but his vent settings were minimal.
The biggest issues for us in flight
After
looking at these guys in the hospital we had some down time before the mission
actually left and we tried to get some sleep and relax a little before the long
flight. We went to the hospital around 2 in the morning local time and left on
the plane shortly after 4 am. Thankfully, this flight was fairly uneventful and
we didn't have any significant problems. The soldier with the brain injury was
stable the entire time and did excellent the entire flight. He was rock solid
stable and didn't increase his ICPs at all during that time. The other
individual was great as well but we needed to place him on a little support
from a ventilator during the flight because of the physiologic changes with
ascending to altitude. Other than that he was still communicating and doing
well all the way to the hospital. We were able to land safely and get them
dropped off at the hospital. From there we checked in to the hotel and grabbed
a quick bite to eat before taking a well needed nap.
And on the home front:
Just a little cuddle time
Trying to feed herself
J playing with Jacob and Justin
She's found the fireplace...oh no.
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