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Authors: Andy McNab
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Chinook to shut down,
which means the rotors are still turning and the engines are
still pushing out the super-heated exhaust fumes. Add to this
mixture the darkness and the adrenalin that's running high,
and it's easy for mistakes to happen: intravenous lines can be
pulled out, airway tubes become dislodged, even stretchers
dropped.
In most cases, the casualties are loaded into the ambulances
without too much delay. The ambulance crews are well
practised by now. On the first few occasions, when the crews
sometimes drove up too close to the Chinook, the hot exhaust
would melt the blue lights on top of the vehicles! I accompanied
the most seriously injured casualty in the back of the
ambulance with the ODP; the other members of the MERT
escorted the remaining casualties. Within a few seconds, we
were at the emergency department. The trauma teams were
awaiting our arrival. They had been waiting a while, and
were already aware of the number of casualties and their
injuries. The last link in the chain for the MERT is to hand
over the casualties to the awaiting trauma teams, one team
for each casualty. Clinical information is handed over quickly
and succinctly. We use a recognized system, which takes
thirty seconds, and as soon as it's complete, the trauma team
descends on the casualty simultaneously assessing and treating
the injuries. This is a well-practised drill.
The role of the MERT is now complete; it has provided
that link from the medic on the ground to the emergency
department in the field hospital. It has handed over live
casualties.
The trauma teams quickly confirmed the serious nature of
the casualty we had handed over. The head injury was the
most serious, and required emergency neurosurgery. At
this time, in 2006, there was no neurosurgery in Afghanistan.
This casualty needed to be evacuated to Oman. The transfer
was the responsibility of the embedded RAF critical-care
transfer team. These teams are constantly on standby at
Camp Bastion to transfer the critically injured from the
hospital to other locations around the globe, if required.
The transfer went according to plan and the casualty
arrived in Oman within three hours. He underwent neurosurgery
within six hours of wounding. Six hours may sound
like a long time, but even back in the UK this time line is often
not possible. The fact that this is achievable in Afghanistan, in
the middle of a war zone, is a testament to the medical system
and the people who run it. No one part is more important
than another: from the medic on the ground to the MERT, the
hospital at Bastion and finally the transfer team of the RAF,
it's a chain. And any chain is only as strong as its weakest
link.
In this instance, the casualty survived, despite very severe
injuries, and he is now back with his family. The two other
soldiers injured with him underwent immediate surgery at
Bastion and were evacuated back to the UK, where
eventually they made a full recovery.
July 2006
Colour Sergeant Richie Whitehead, Royal Marines
I had to take a last-minute visit to Garmsir, down south. They
needed a forward air controller – JTAC [joint terminal air
controller], as they call it. And there was none available
because 3 Para, in their wisdom, had taken everything and
everyone with them for their ops. I was in the Ops Room and
they were short [of an air controller]. I said: 'Everyone should
be able to do this. We've all had basic training of being able to
call in air if needed.'
And someone said: 'Can you do it?'
I said: 'Of course, I can.'
He said: 'You've got half an hour.'
I went and packed my kit. We drove down through Nad Ali
and via western desert in WMIKs [armed Land Rovers]. It
was a big patrol and it was with an OMLT [operational
mentor liaison team]. The chief of police [Afghan National
Police] from Garmsir had rung up the colonel, the head of the
provincial reconstruction team and said: 'Look, there are a
thousand Taliban down here about to attack us.' We knew
early on that
which means the rotors are still turning and the engines are
still pushing out the super-heated exhaust fumes. Add to this
mixture the darkness and the adrenalin that's running high,
and it's easy for mistakes to happen: intravenous lines can be
pulled out, airway tubes become dislodged, even stretchers
dropped.
In most cases, the casualties are loaded into the ambulances
without too much delay. The ambulance crews are well
practised by now. On the first few occasions, when the crews
sometimes drove up too close to the Chinook, the hot exhaust
would melt the blue lights on top of the vehicles! I accompanied
the most seriously injured casualty in the back of the
ambulance with the ODP; the other members of the MERT
escorted the remaining casualties. Within a few seconds, we
were at the emergency department. The trauma teams were
awaiting our arrival. They had been waiting a while, and
were already aware of the number of casualties and their
injuries. The last link in the chain for the MERT is to hand
over the casualties to the awaiting trauma teams, one team
for each casualty. Clinical information is handed over quickly
and succinctly. We use a recognized system, which takes
thirty seconds, and as soon as it's complete, the trauma team
descends on the casualty simultaneously assessing and treating
the injuries. This is a well-practised drill.
The role of the MERT is now complete; it has provided
that link from the medic on the ground to the emergency
department in the field hospital. It has handed over live
casualties.
The trauma teams quickly confirmed the serious nature of
the casualty we had handed over. The head injury was the
most serious, and required emergency neurosurgery. At
this time, in 2006, there was no neurosurgery in Afghanistan.
This casualty needed to be evacuated to Oman. The transfer
was the responsibility of the embedded RAF critical-care
transfer team. These teams are constantly on standby at
Camp Bastion to transfer the critically injured from the
hospital to other locations around the globe, if required.
The transfer went according to plan and the casualty
arrived in Oman within three hours. He underwent neurosurgery
within six hours of wounding. Six hours may sound
like a long time, but even back in the UK this time line is often
not possible. The fact that this is achievable in Afghanistan, in
the middle of a war zone, is a testament to the medical system
and the people who run it. No one part is more important
than another: from the medic on the ground to the MERT, the
hospital at Bastion and finally the transfer team of the RAF,
it's a chain. And any chain is only as strong as its weakest
link.
In this instance, the casualty survived, despite very severe
injuries, and he is now back with his family. The two other
soldiers injured with him underwent immediate surgery at
Bastion and were evacuated back to the UK, where
eventually they made a full recovery.
July 2006
Colour Sergeant Richie Whitehead, Royal Marines
I had to take a last-minute visit to Garmsir, down south. They
needed a forward air controller – JTAC [joint terminal air
controller], as they call it. And there was none available
because 3 Para, in their wisdom, had taken everything and
everyone with them for their ops. I was in the Ops Room and
they were short [of an air controller]. I said: 'Everyone should
be able to do this. We've all had basic training of being able to
call in air if needed.'
And someone said: 'Can you do it?'
I said: 'Of course, I can.'
He said: 'You've got half an hour.'
I went and packed my kit. We drove down through Nad Ali
and via western desert in WMIKs [armed Land Rovers]. It
was a big patrol and it was with an OMLT [operational
mentor liaison team]. The chief of police [Afghan National
Police] from Garmsir had rung up the colonel, the head of the
provincial reconstruction team and said: 'Look, there are a
thousand Taliban down here about to attack us.' We knew
early on that
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