Saturday, February 27, 2010

Training at the Role 3 in Kandahar

After arriving in Afghanistan we were given the first day off (Sunday) to catch up on sleep and boy did we need it. Although, we had a scheduled flight from Kuwait to Kandahar it was not a "hard" time and we waited forever to get on the plane - a C-17. Oh yeah, and we had to fly in our body armor, so we were cramped like sardines. Seriously, the only body part I could move was turning my neck - for 4 hours. It was as uncomfortable as I've ever been. Even more than when my mother tells the story about me running away from home at age 5, only to return after 15 minutes because I "pooped my pants". It was terrible!!

We had an orientation brief Monday morning where we met the Role 3 Hospital Commanding Officer (CO) and Executive Officer (XO) – the CEO and COO for you nonmilitary types. For those unaware of what “role” means, combat medical care is divided into roles based on the type of care they can provide. Role 1 is battlefield medicine provided by corpsmen and medics. This includes initial life-saving measures like applying a tourniquets to control bleeding (mostly for amputations), starting an IV to provide fluids for blood loss, placing a needle into the chest cavity for collapsed lung, etc… From Role 1 the patient is transported to a Role 2, which is near the front line, that provides urgent/emergent stabilization of combat injuries and life/limb saving surgical interventions. Typically, patients sent to a Role 2 facility require surgery within anywhere from 60 minutes to 4 hours. Our Forward Surgical Team is a Role 2. The Role 3 facility provides more definitive care and surgical procedures for patients who are more stable and/or who are transferred from the Role 2. Kandahar Hospital is the Role 3 for Kandahar province.

After our initial briefs, our team went to our respective units at the hospital – ER nurse (me) and corpsmen went to the ED, ICU to the ICU and surgeons and surgical techs went to the OR for orientation. It was not long after we arrived in the hospital that they started receiving casualties. Talk about jumping in head-first. In the 4 days we were at the hospital they received about 30 casualties, most of them NATO forces (only one group of 4 were US Army). The others were from Britain, Canada and Romania. After seeing the first couple of patients it was easy to get back into my role as an ER nurse – its kinda like riding a bike. They emphasized in our initial briefings that there is no training you can go through in the US that can prepare you for the types of injuries you will see in “ theater”. Boy are they right. In the short time I was at the Role 3 I was awed by the quality of care these patients receive. As one of the surgeons put it, if some of these injuries occurred in Wyoming or Montana in the US they may not survive, but here they not only survive, but do quite well. Its really amazing and I’m very anxious and excited to be a part of it. I was really tentative about this deployment since I haven't been in a clinical role for so long, but after seeing the care NATO medicine provides I can't wait to get started.

The Role 3 is also staffed my multiple NATO countries. I think I saw staff from Denmark, Britain, Canada and the US. Even at 40 years I old I chuckled under my breath when the Canadians said about (aboot) or out (oot).

I also had my first experience with treating a local national. If you were not aware, the military hospitals here do treat local Afghan's if they are injured as a result of combat or if they are at risk of losing life, limb or eyesight. There was a 5 year old Afghani boy brought to the hospital after sustaining a camel bite to the head. Yep, a camel bite. It fractured his skull in two places. Very sad.

For security reasons I can’t tell you when we will be leaving here and arriving at our final destination, but I’ll post after we arrive.

I was able to get a cell phone, so I have been able to call Judi. Its really nice to hear her voice, even if its just voice mail. I also bought a camera and have a lot of pictures, but I have to wait to get Internet access on my laptop (non government) so i can upload them.

Take care,


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