Emergency care in Iraq continues around the clock (3/04)

Emergency care in Iraq continues around the clock

story and photos by Staff Sgt. Stacy L. Pearsall
1st Combat Camera Squadron

"All EMEDS personnel must report to work!” The message boomed three times over the giant voice system before being muffled by the sound of inbound helicopters.

Members of the 447th Expeditionary Medical Squadron stumbled into the late-night darkness from tent city in their pajamas with a sense of urgency only to find their work area in organized chaos.
“We have a traumatic amputee inbound,” yelled a voice over the background noise.

“When I heard there was a traumatic amputee coming in, all I could think was, that’s me,” Maj. (Dr.) Ky Kobayashi said in a confident voice, “I’m going to be doing surgery tonight.”

The squadron’s lead surgeon, he stood at the end of the empty bed, looking toward the tent entrance. Everyone waited, in position, for the critically wounded to arrive. Maj. Greg Cassidy, the squadron’s chief nurse, made final preparations just before hearing the beeps of the ambulance. The plywood double doors swung open, and several medical technicians, from the collocated 447th Contingency Aeromedical Staging Facility, rushed through, tightly gripping a litter. They laid the most critical patient on the first bed. The other two patients were taken to the back to be stabilized.

The patient’s body jolted in pain as Capt. Rob Smith, a nurse anesthetist, hastily moved to sedate him. Captain Smith checked the patient’s airways and inserted a tube to help him breathe.

“If you’re not breathing, you’re hosed,” he said. “It’s rewarding to be here, knowing I make a difference.”

Minutes later the patient fell asleep from the anesthesia. An X-ray team maneuvered a giant portable radiograph machine, and everyone stood back from the table. Several exposures later, the X-ray team scampered off to process the films. Major Kobayashi inspected the patient’s legs and prepared for surgery. Upon command, the staff tending the patient grabbed the litter and marched toward the operating room. The patient’s leg didn’t look good, and the surgeon had a tough decision to make.

Meanwhile medical technicians, nurses and staging facility nightshift staff were monitoring the other sick or wounded military people, American civilians and foreign coalition forces who had arrived earlier in the evening on an Australian C-130 cargo plane. They awaited a dawn departure to Ramstein Air Base, Germany, for further treatment.

Welcome to Camp Sather, Baghdad International Airport, Iraq.

The squadron and staging facility combined forces to make up the largest Air Force medical squadron in Iraq. Formally known as the Mobile Air Staging Facility, the unit can hold 100 mass casualty victims up to 12 hours. Routinely, it houses 50 beds with surge, which means it can handle well over 50 patients at a time should a crisis occur. Doctors, surgeons, nurse anesthetists, nurses and medical technicians work like a well-oiled machine, 24 hours a day, seven days a week.

Patients arriving at the staging facility undergo a thorough checkup and chart review. Paper gowns from forward medical facilities give way to uniforms donated by fellow service members.

After the hustle and bustle of in-processing dwindled, the medical technicians and nurses began their rounds and getting to know the patients.

“I make sure that I talk to my patients and touch them. It’s important they know we care,” said Lt. Col. (Dr.) Liz Clark, a flight surgeon with the squadron. “I make it a point to tell my residents to do the same. There isn’t anything more comforting than the human touch.”

Time seemed to fly as the medical staff carried on its nightly duties.
In another tent, Major Kobayashi was done with surgery.

“There has never been a patient who we didn’t think was going to make it,” he said softly. “I was looking for every reason not to take his leg. But, there are three things I look for: nerve injury, soft tissue and bone damage, and no pulse. This kid had [all three]. Losing a limb is not ideal,” he paused for a moment with a somber look. “If I didn’t take it [his leg] and it got infected, he could die…” he stared at the floor, his voice trailing off.

“He saved his life,” Captain Smith interjected.

The surgeon looked up with a knowing grin, “Saving someone’s life is rewarding. I feel very fortunate to be here, to wear this uniform, and be where I feel I can contribute. We train for this, and your training pays off,” he continued.

“Besides, that’s what we are here for; the reason why we are in the military medical field is to take care of the troops,” Captain Smith added with a smile.

The door from the operating room creaked open, and the medical staff filed out. It was still dark and cold, but the sun would rise soon. People in pajamas made their way back to tent city to rest up for the next shift.