Friday, October 29, 2010


From Helicopter to the Shakeout Shed
We usually have quite a bit of time to prepare for incoming casualties.  Everyone prepares his equipment, dons gloves, and waits.  It is quite calm, actually.  Most patients arrive by Blackhawk helicopters.  As soon as they arrive, the patients are whisked quickly into the "shakeout shed."  Here, their clothes are cut off, and any unexploded ordinance or weapons are removed.  A rapid triage is done.  The order of treatment is Urgent, Priority, and Routine.  A fourth category, Expectant, is for those who cannot be saved by further intervention.  They receive comfort measures, only.

SSG Hemmerle, SSG Duffy, SPC DeLeon, and CPT Abordo
In a matter of minutes, the wounded are wheeled into the ATLS section of the FST.  Teams rotate daily to care for the most urgent, second, third, etc. The ATLS staff is composed of CPT Abordo, an RN, who is the OIC (officer in charge), SSG Duffy, a paramedic, the NCOIC (non-commissioned officer in charge), SSG Hemmerle, and SPC DeLeon.  The last two are "68 Whiskeys", which means that they are graduates of the 68W school, a 6 month program including training in IV insertion, airway management, control of bleeding, chest needle decompression, etc.  The 68W is now called a "Patient Care Specialist."  This MOS has replaced the 91B designation called the "Combat Medic."  A 68W possesses the skills to be an EMT-Basic in civilian life.

ATLS Section in Action
In the ATLS, the nurse anesthetist is responsible for airway assessment, Glasgow Coma Score, respiratory care, pain control, and assessment the patient from the chest up.  The ATLS staff starts peripheral IVs and controls bleeding.  They have also become quite proficient at the FAST exam (Focused Assessment Sonography for Trauma).  This quick portable ultrasound can detect pericardial effusions as well as intra-abdominal bleeding.

The secondary assessment is done by turning the patient  from side to side to examine for further injuries.  Xrays are taken, and, if necessary, the patient is taken to the OR.

The 909th staff has performed this routine so many times, that it is poetry in motion to watch.  They are incredibly calm, effective and efficient at their duties.  There is no wasted movement.  I wish I could show you a film of them in action.  Suffice it to say, our soldiers couldn't receive any better treatment anywhere else!

The views expressed in this blog are those of the author only, and not necessarily of the US Army or the US Government.  None of the information given is classified in nature.

1 comment:

  1. God Bless and come home safe-- all of you!

    Thanks for everything,

    Lisa Haas, CRNA
    Northern California