All in a weeks work

Operating Room at Camp Bastion - 4 Room Open Bay

(We are not supposed to take pictures in there - so don't tell)

    Life around this deployment is set around the hospital.  I usually spent about 12-15 hours there a day.  The day begins with rounds starting at 7:45 with a team of surgeons - General, Plastics, Ortho, Anesthesia, and Nursing in the ICU (called ITU in the UK).  90% of the inpatients are local nationals (many of them kids), ANA/ANP - with UK/US/Etc making up only a small portion - if they are injured they usually fly (medevac) home immediately.  At 8:45 the Ortho surgeons on call go to morning board rounds with about 40 people from every department.  We attempt to make a plan for all the patients.  Unfortunately the plan sometimes includes sending them to the local Afghanistan hospitals when we are finished with their initial care.  They have a medical establishment that is about 100 years behind us and so, sadly, this sometimes can be a death sentence for those that still have significant medical needs (more on this in a later post).  After the board rounds, the OR starts - anywhere from 2-8 'elective' cases a day.  I have been averaging about 2 cases a day for myself - some of which take 30 minutes and others that take 2-3 hours.  At any point in the day -  and usually often - we have medevac calls where every team reports to the ER and awaits the arrival of new Trauma patients.  At that time the elective schedule comes to a halt and we take care of the newly injured - these cases take quite some time.  After the schedule for the day is done we have another set of meetings at 7:45 and then rounds after that.  I usually have time to grab a quick bite to eat at some point, but otherwise go back to my room and relax for a couple of hours.  Not much else to do at old Camp Bastion.

    The OR is one giant room - all open bay - 4 rooms total and no dividers so we can see the other teams operating at the same time.  I have even gone straight from one case to another table and started helping without rescrubbing.  It's really quite a trip and sterile technique is more of a suggestion than a rule here.  

     We get a report every week outlining what we did as a team.  Last week the Ortho team cases were:

2 Triple Amputations

7 Double Amputations

6 Single Amputations

50 Irrigation/Debridements/Wound Vacuum/DPC's (Cleaning and closing wounds)

4 Arterial Reconstructions (Two popliteal, One Femoral, one Brachial - 3 legs and an arm)

2 Femoral External fixators (Applying a device with pins and bars to hold broken bones in place)

3 Tibial External fixators

1 Pelvic External fixator

4 Fasciotomies - 1 arm and 3 legs (releasing tight tissue to allow blood flow to damaged extremities)

5 Skin grafts

I also did 3 chest tubes (for blood or air in lungs) and a tracheostomy (making a hole in the neck to breath out of) - and, no, I am not really qualified to do this.

     Hell of a week for any department - much less one in the middle of a desert in a mobile hospital.  

Three out of 4 OR's at once - One Thoracotomy, One Laparotomy,

and another with a double amputation

As a final note, my good friend and former partner in Naples started his deployment this week and also has started a blog.  I invite you to follow him as well and keep him and his beautiful family (April and Jackson) in your thoughts.  Zook in Kandahar.

All for now!