Some articles have been coming out about us since we have left.
Here is a nice article in Reader's Digest
And here is one that I am almost positive is of the dog I had pictured in an earlier post in a CNN article. Here is the Blog for Cpl Lee, Lex's Fallen Handler.
I arrived home this last Thursday evening, and it is hard to express how wonderful it is to be here. The incoming baby was able to wait for me (probable arrival is by next weekend).
It is at this time that I'm going to retire this blog, at least until my next trip 'over there'. Thank you for all the interest that you have shown, I have met many people through this venue that made a tough time a little more bearable.
Again, Thank You.
We arrived yesterday to North Carolina, hard to say how nice it is to see green stuff. Couple days here, and I'll be on my way home. 110 degrees when we left, 60 when we arrived.
We did some tourist type things our last couple days. One of them was to walk a mile or two down the road to where some abandoned 1950's era bombers are laid to rest. They are pretty beat up, apparently weren't even worth bombing in one of our initial ventures into this country.
The last photo is of the American and Iraqi flags flying near where we worked this last half-year.
And no one is complaining. It is amazing what we will happily put up with, as long as we are on our way home.
We returned to the lunar landscape that is Kuwait. (ALMOST HOME!!). A couple days here as we wait for our flight, and we'll be on our way to North Carolina.
LT Vince Johnson and myself at the goodbye meeting with the General and TQ Surgical Officers.
The new group has been here for almost a week, and they have completed their last major hurdle. We staged a mock mass casualty drill for them to demonstrate what they are capable of, and we will soon have our official Replacement in Place - Transfer of Authority (RIP-TOA) ceremony, after which they will officially own the building, and our official job until our plane arrives is to play volleyball. It will still be a couple weeks until I am home, but we are closer than ever.
Very, very busy day yesterday. Started with 2 soldiers in full arrest on arrival, one was able to be revived. He was my flight, and this was by far my most critical patient to date. I'm proud to say he was in as good a condition, if not better, at the end of the flight compared to the beginning. Our staff invested a lot of themselves into this patient, and all were relieved to know he made it to the next level.
Several other groups of patients came in throughout the day. All turned out ok, but made for a constantly busy day, from beginning to end.
(Picture thanks to LT Harrison at TQ Surgical, picture is from my 19th flight)
We are coming close to the end of our time out here, but it has been a busy week anyway. A couple of notes regarding what we have been seeing (not all-inclusive by any means)
See the link (CLICK ME) for an article on our pinning ceremony in the Marine Corps News...
A couple weeks ago, we were visted by a journalist for several days named Leslie Sabbagh. She writes for a couple magazines, including Popular Mechanics and The Christian Science Monitor. Here are some links and notes about some of her online posts...
This is her blog (CLICK ME) for Popular Mechanics...
This is the entry for TQ Surgical she wrote(CLICK ME), it is worth noting that the two Corpsmen she quotes are both staff from Great Lakes, HM3 Ramirez is on his 3rd deployment to Iraq, and HM3 Smith is my cohort with teaching the EMT class here.
This is a link (CLICK ME) to an excellent article she wrote about the Army medics that we fly with. It is about their flying to point of injury missions, not the interfacility flights they do with us.
Here is her homepage (CLICK ME)
With me is LT Patrick Harrison, we were together in the same Marine Battalion (1/6) a good 12-13 years ago, and were promoted to Petty Officer 3rd Class (E-4) at the same time during our Med float (6 months of floating around the Mediterranean with 2000 other Marines).
The FMF pin I have been talking about is above our left chest pocket, it is now a permanent part of our uniform, whichever one we happen to be wearing.
Left to Right - Back Row - SGT Champagne, HM2 Dunkley, HN Russell, HN Rivers, HM2 Hallenbeck - Front Row - Myself, HM3 Smith (co-coordinator)
The other major project I have been working (aside from the completed FMF qualification) is in the process of wrapping up in the next week or two. Around the beginning of May, HM3 Smith and myself decided to see if teaching a traditional EMT-Basic course out here was feasible. Class started the end of May, and has been going strong ever since. There has definitely been some logistical issues to work through (books, tests, equipment, class space), and fitting 120+ hours of class and clinical time into an operational schedule has been a challenge. While they missed out on the traditional ambulance time they would have gotten in a stateside class, I think they more than made up for it with the intensive trauma patients they cared for while here.
The National Registry of EMTs has acknowledged that this is the 1st EMT class taught in Iraq they are aware of.
5 students will be completing the course (4 Corpsmen and 1 Marine), and they have all shown a dedication to this class to be admired. They did all the requirements for this course on top of their normal duties.
Location, Location, Location.
Holds true even in Iraq, as in it is probably not good to live near a police station in Iraq. An Iraqi family of 3 (dad, mom, ~12 year old daughter) were at home, perhaps sitting around in the living room, when a mortar round fired by the bad guys errantly landed in their house. All 3 came to us, the first flight nurse flew with the daughter (intubated due to altered level of consciousness from a head injury) and the father (chest injury and general shrapnel), and after a lengthy surgery to repair a serious abdominal bleed and a very damaged lower leg (without a doubt the surgeons saved her leg - or at least gave her a fighting chance to keep it), I accompanied the mother to one of the level 3 facilities.
We found out yesterday that as of yesterday we would no longer be receiving any mail while we are out here, in preparation for our departure next month. Boxes and letters will no longer make it here, and any that were enroute to here are being turned back. I am not sure where these letters will be sent to, maybe they will be waiting for us in Camp Lejeune.
Thank you to everyone who has sent packages and letters, they have brought a little bit of home to this alien landscape (remember... I am from Wisconsin).
We had a few Iraqi Police come in during the day after a firefight with some bad guys. Most had extremity injuries, but one was significantly worse off with a bad pelvis injury and internal bleeding. After he was treated in the OR, I flew with him, and one of the extremity injuries to Al-Asad in a Blackhawk, my first day flight with the army (they used to do only night flights.)
We seem to be stuck on Groundhog's day, every day the same as the one before. We are planning for our relief to arrive soon, and it is nice to be thinking about home (as in 'I'm going home'). we do have a little while yet until that happens, but just planning for it is a nice feeling.
A couple days ago we had several Marines arrive after their vehicle was hit by an IED, most were ok, a couple went to the OR, and one required a nurse to fly with him after the surgery. Many of our staff didn't get any sleep that night. We have been getting injured into our facility much more often than what I mention here, keep in mind that there are several nurses that are in the flight rotation, so for every flight that I go on, there have been several other nurse flights in between.
I am amazed at the night time skies out here. There is hardly ever a cloud in the sky, and it makes for an incredible night time view of the stars. Even in the farmlands of Wisconsin, I do not think I have ever seen such a clear view of the stars.
Here's a first, I've been interviewed on a blog. Feel free to check it out (CLICK ME), and I encourage you to spend some time looking around the site (CLICK ME), and vote on some of the charities for injured service members.
Please read what VAjoe has to say in his own words:
"I don't know if you've had a chance to look around my site, but VAJoe will be donating $2,000 to military charities. It's called Charity for Charities (http://www.vajoe.com/charity/).
In Charity for Charities, people come to VAJoe and vote for their favorite military charities. They can nominate charities, also. The charities with the most votes and one randomly selected charity share the $2,000. I'm trying to raise awareness of military charities and the work they do in a way that is fun for people."
FMF Pin
Fleet Marine Force Qualified Officer
OPNAV INSTRUCTION 1414.6
"Attainment of the FMFQO designation for a Navy officer signifies an achieved level of excellence and proficiency in Marine Corps operations and indicates a fundamental understanding of a Marine Air Ground Task Force (MAGTF) and its components. The FMFQO insignia signifies additional general knowledge that enhances their understanding of war fighting, mission effectiveness, and command survivability. Officers who wear the FMFQO insignia stand out as significant contributors to the Naval services' ground warfare mission. The FMFQO qualification may only be obtained through the formal qualification program set forth in this instruction."
5 Months of classes and studying, and I completed my oral board last night. Almost all of the officers here have completed the requirements, or will shortly, and we will all put our pins on our uniforms in a ceremony later this month. Pictures to come after that.
This was one of my 2 major projects I've been working on outside of normal duties, more to come on the other project soon.
Had my 17th flight on Monday. Took a Marine to Balad after he was hit by an IED, shrapnel injuries and a belly injury. Flight was very busy, but his condition actually improved over the course of the flight. The trip to Balad, or Al-Asad, isn't nearly as scenic as going to Baghdad, but we prefer the less scenic route if it means less chance being shot at.
I have seen this building a couple times during the flights to Baghdad, the way it is built out on the water is pretty impressive.
15th and 16th flights on Monday.
The first flight was a Marine that was shot in the face, but amazingly arrived fully alert and talking. He was intubated to protect his airway and I flew with him to Baghdad, no problems.
The second flight was with 2 Marines, both intubated. They were hit by an IED, one with major damage to one of his legs, the other with a neck injury. I flew with both of them to Al-Asad, no problems. VERY HOT up in the air, no matter how much water you drink, you just can't seem to keep up with all the sweating.
The picture is from the 1st flight, I am in the back of a CH-46. The grey/green strap around my chest is the gunner's belt, it is attached to a length of strap that is secured to the deck. That way I can get up and work with the patient without fear of falling out the back.
Please follow the link (CLICK ME) to read about a detachment of 8 of our staff to set up and staff a Mobile Forward Resuscitative Surgical System (FRSS) with one of the Marine units sent out here as part of the surge. Our thoughts and prayers are with them as they forgo the few creature comforts we have here at TQ (warm chow, better berthing, some sort of recreational activities) as they share a tent and eat MREs 3 meals a day.
(Aside from the obvious family and friends... In no particular order, and not all-inclusive)
She is working 90+ hour, 9 day workweeks.
She single handily saves 50 lives a day.
She has all the collaterals possible, and sits on a minimum of 32 meetings a week (4 separate clipboards required).
(she in no way twisted my arm to write this so that her co-workers at her parent command know that she is actually doing a whole lot of nothing here)
Around 11pm we all received a call for 8 incoming Marines, wounds from a VBIED (vehicle borne IED - big). Turns out the bad guys attempted to drive a very large truck filled with explosives into their position, but the Marines were able to hold him off at a distance, where he detonated himself once he realized he couldn't get any closer. Even at a distance, the blast still took out the front of the building the Marines were in, and several of the Marines were thrown around (one said he was thrown 30 feet back). No serious injuries (relatively speaking), mainly shrapnel and ruling out concussions. No nurse flights needed for these guys.
Earlier that day, an 18 month old boy was brought in after a 10 foot fall. Baby was fine overall, but we needed to have a CT scan done to verify that there was no head injury. When I was sent out here, it didn't really occur to me that I would be doing full spinal immobilization on an 18 month old, using blankets, tape, and a CPR board. It worked out remarkably well, he was sent to a higher level facility where the CT scan could be done. I found it remarkable that while we were waiting for the helicopter, the father was very interested in verifying that we were sending him to a military hospital, and not a civilian hospital (he was going to one of our military level 3's). He said (through a translator) that if we sent him to a civilian hospital in the wrong area of the country, "they will kill me and chop the head off my son". He is referring to the Sunni - Shiite issues out here. How accurate he was I can not attest to, but I can tell you that he believed it.
Usually after dropping a patient off at a level 3 hospital, we will stop for gas prior to returning. This is a picture of 3 different helos, all getting gas. (Enlarge photo for better view). From left to right, An Army Kiowa, Marine Corps Super Cobra (our escort), and an Army Blackhawk. Not pictured - the CH-46 that I was on for this flight.
The 7 year old from last Friday made a return trip through our facility on his way home. Despite a rather impressive head injury initially, he has recovered amazingly. To the point he is likely home already. He was very emotionally fragile, I'd also be a little upset if at one point I'm walking around my home neighborhood, than the next I know I'm surrounded by people speaking a different language. He was able to give his name and other info, so it should not have been to hard for him to get home home with the help of the Marine unit that brought him in.
These pictures are a fairly common site while flying over the countryside. I'm guessing that there is a water source in the middle of the circle, and it is easier to water the plants this way. Doesn't stop it from being humorous seeing crop circles everywhere...
Had my 14th flight yesterday. An Iraqi 7 year old boy, with a single, small, hole in his head from a bad guy mortar round (all injury information is from what I could cobble together, I cannot attest to the veracity of what happened prior to his arrival to our facility). According to the person that brought him in, one of the mortar rounds that were directed at the local Marines hit an apartment complex instead. This boy, name unknown, was delivered to those Marines that were targeted, and then brought to us. No name, no family, no history other than guesswork. His age is a guess, which something as simple as guessing the age of these children has proven to be a problem for us, as the children here are smaller than American children of the same age we are used to seeing. A 5 year old child here will often be identified by many of us as a 3 year old, a 9 year old as a 6 year old, etc. I'd imagine that nutrition has a lot to do with this.
The doctors and staff here attempted to stabilize the boy, but there is only so much we can do for these severe head injuries at this facility, he needed specialty care. I flew with him to one of our Level 3 hospitals, and this was one of my busiest flights yet. Didn't even have a chance to look out a window. Vital signs reflected the increasing pressure inside this kids head (not good), and I learned some things about head injuries that I had not heard about previously. The child was intubated, and I ensured he remained unconscious and paralyzed with medications. I'd like to say I delivered him to the facility in the same shape he left TQ in, but I honestly am not sure. His vitals were similar, but time under pressure is more damage to these brains, pressure that can not be relieved until specialty care.
Your prayers are appreciated for this boy.
My postings have been coming a little slower recently, I have really been busy as of late. I will continue to post when something interesting happens, and will also tell you all what has been happening recently that has been filling my time. It is not all patient care related, before I post, I'm looking for the right pictures to go with them.
Had my 13th flight yesterday (Sunday), took a Marine injured in a firefight to Al Asad. Smooth flight, no problems. Flew in a CH-46 (see photo), and it was a day flight. Kind of a windy day, and there were these mini-tornados (I'm not sure what to call them) everywhere.
As we flew over the desert, you could see these sand funnels, or mini-tornados, everywhere. They seemed about 20 yards wide, and 4-5 stories tall. They would just meander back and forth across the desert. There was always one or two within sight, usually more. I'm afraid the pictures are not very clear, click on the photo for a larger view.
Here is LT Stuart H. with me at the pistol range. I have more junk on my flak vest because it is set up for flights, not because I enjoy the extra weight.
Later on yesterday we had 13 Marines come in after a dumptruck exploded outside the building they were in. None were seriously hurt, very lucky. After this period of downtime, it is good to see that we as a group can 'turn it on' and go from a walk to a sprint immediately. One of the Marines showed me a picture of the crater left behind by the Vehicle borne IED, amazing.
Here is the complete crew at TQ from Great Lakes Naval Health Clinic. From left to right, back row: Capt(s) Kane, HM2 Nicholson, HM3 Ramirez, LT Giometti. Front row: Me, HN LaBondano, HM3 Smith. We have 3 other members deployed from Great Lakes in Iraq, all at other locations than here.
Had my 12th flight this morning, a Marine with injuries from and IED. Flight was smooth, rode in a CH-46, which was unusual since most night flights are done in the Blackhawks. Nice to have the extra room.
This was an interesting night (Saturday). Started late, with a TCN (third country national- not Iraqi or American) female who realized she was pregnant as the 1st of 2 children arrived. Regretfully, they were way too premature, and neither were able to survive. At the same time, 2 Marines that were injured by an IED arrived, one with severe (as severe as you can get) leg injuries, and the other with general shrapnel wounds. Both made it through surgery and will make it. Then another patient arrived (I'm going to be purposefully even more vague on this one), who received surgery and joined the 2 Marines and the mother in being flown out in multiple aircraft. Just like that, 3 nurse flights, and one really long night.
I wonder if we will look back as this night being the beginning of our summer surge in business?
Please feel free to check out a blog (CLICK ME) being put together by one of our nurses here, LT Patrick Harrison. He has been sorting through all of our pictures, and organizing them by time taken. Starting with our training in Camp Lejeune up until now. It is still a work in progress, there are an unbelievable amount of pictures he is working through (with the amount of pictures we take, some might think we were more tourists than fighting a war...)
Finally had another flight! Total of 18 days since the last one.
I flew with a Marine with significant injuries, but relatively (relative to what!! - apparently relative to almost dead) stable. The flight was smooth, all issues encountered were easily dealt with. A general directive was passed on to me recently that discouraged being too descriptive about the injuries we talk about on the blogs, so I'll do my best to follow that. I haven't exactly been overly descriptive so far, but will try to generalize more...
It is truly a joy working with the Army flight crews, all but 2 of my flights have been with them in the Blackhawks. Last night's flight was with the Medic from my very first flight, and I am continually amazed by their skills and knowledge. When not carting a nurse around to manage our (relatively) stabilized Patients (usually post-operating room), these are the men and women that are flying to point of injury, into hostile areas, to pick up the patient and stabilize before they ever even get to us.
It is no secret that this last month+ has been slow, and it sounds like traditionally over the last couple years that has been true, but never this slow. For that we are thankful. We also realize that traditionally, the next couple months are much busier compared to the rest of the year. We will see how that goes...
I took this photo during my last trip to Baghdad. It is out of the open tail door of the CH-46 I am riding in, and it is of another 46 that made the trip with us.
Last weekend we spent over 8 hours organizing all the clothes donations that we have recieved. What you see here is only a fraction of what we have. When patients (military, civilian, adults and children) are brought to us, their clothes are often already destroyed, or cut off by us. This is so we can quickly evaluate what is wrong and where the injury is. With these donations, we are able to outfit the patients with clothes to wear when they leave us. Along with clothes, we have been recieving toys for the children, who are very appreciative.
We have not been seeing as many civilians as we used to, so we plan on giving any extra clothes we have to some of our military members who have contact with the Iraqis, so all clothes will be used.
The picture is a little fuzzy, it was taken through a dirty helicopter window. This is a HUGE mosque in Baghdad that is under construction, you can see not all the domes are in place. It is hard to see, but just look at the size of the building in comparison to the other buildings around it. Some of them look to be ~5 stories tall, but they are tiny in comparison...
The ambulance below reminds me of the one from "Mother, Jugs and Speed", which only EMT's will understand the reference...
Here is an article (CLICK ME) in today's USA Today on the spate of Helicopter incidents when we 1st arrived here, and what has been done to make our flights safer.
Here is a picture that was printed in the Stars and Stripes article in the 1st couple weeks we were here (see March 20th).
Each morning the Nurses and Ward Corpsmen meet for patient turnover and to hear whatever may need to be passed. There were no patients on the ward, so we met here versus our normal location in the building
Recently our ward census has been very low, I hope this is a reflection of the improvement in the local area as it becomes more and more controlled by those Iraqis interested in developing their country peacefully.
Had a rather unique transport recently. I escorted an Iraqi VIP with significant recent trauma, in both a helicopter and a large airplane, in order to get him to a neighboring country. This was so he could receive a higher level of care in a civilian hospital. I have few pictures I can share, but the country I took him to looks just like Iraq. All Sand.
The flight involved 4 bases, one helicopter, one C-130 plane, and 7 hours. The picture is from the C-130 enroute to our destination.
This is a picture of one of the helicopters here, the pilot is obviously a fan of Dale Earnhardt Jr. Normally the Commanding Officer's helicopter is numbered '00', but when you are in charge, you can change things up. Along with the number, the major sponsors for the car are included, and inside there are chrome kickplates. I have never seen chrome on a helicopter before, it was apparent that the flight crew took great pride in this bird.
Part of our quest to qualify for the Fleet Marine Force Officer Qualification is to get signed of on being introduced to a helicopter, and being taught how to properly egress in event of emergency. Boy, somewhere in my Flight Nurse Training I think this was covered...
Here I am with LT Stuart H in the back of a CH-46.
We started on the same ward at Portsmouth, Virginia 6 years ago. Small Navy.
Had my 9th flight last night. Took an Iraqi Army guy to Al-Assad. He had a gunshot to both lower legs, the surgeons did a great job restoring circulation to his feet, which the initial injury had interrupted. Flight was smooth, no problems.
The heat has really come to the forefront when planning for how we package out patients for transport. When we first arrived here, we needed to take action to keep our patients warm. Now, just being outside will warm our patients, even in a helicopter with the doors open and strong draft. If you would like to simulate riding in a helicopter, I'd suggest sitting in front of 4-5 hair dryers, and turn them on (on low for a night flight, high for a day flight.) After sitting in front of them for ~30 minutes, you have now simulated a flight.
About 2 weeks ago we had some high winds during the day, which in the desert means a sandstorm. After the winds died down, this is what it looked like outside. Quite unusual, I have never seen yellow air before. It is around 4:30 in the afternoon, several hours before sunset.
Here is a picture of the 3rd kind of helicopter that brings us patients. I believe the official designation is UH-1, and has been around since Vietnam. We do not do any Nurse flights on this bird.
A group calle Bandshe stopped by to give a concert for the base. MWR (morale welfare recreation) does a pretty good job around here keeping different events available to keep busy. From bringing in the occasional band, having footbal players stop by for autographs, movie nights, sports tournaments, etc.
Had my 8th flight last night. Took an Army Soldier that was hit by an IED, amputated left leg at the knee, and a head injury, to Balad in a Blackhawk. Flight was busy, but smooth.
I'm trying to repeat some of the Arabic medical related phrases I have written down in my pocket brain, must of worked because he understood what I was trying to say. That didn't stop everyone from making fun of my (successful)attempt...
Here is LT Vince Johnson and myself, ready to do what we do best.
Here is a picture taken during one of our mass casualties. If you look closely (click on the picture to see a larger image), you can see the bottle of milk on the 1st table belonging to the child being treated there. There are only 4 patients at the time of this picture, we have had as many as 16 at one time. It looks a little chaotic, but every person has a job, and everything the patient needs is addressed. Prior to our arrival here, the previous group had a mass casualty of around 60 people at one time, so we try to be prepared for anything.
Here is a good photo of where we work, Al-Taqaddum Surgical. One of the staff members showed this photo to his son, who then said "Dad, you work in a twinkie". A new name for where we work was born.
It has been a very busy couple days.
Thursday we had a mass casualty of 15 patients after a dump truck exploded at an Iraqi checkpoint. 1 American and 14 Iraqis came through our facility.
Friday we had 9 patients come in at once after another vehicle borne IED. 1 Iraqi and 8 Marines. 8 of the patients were flown out to a higher level after initial stabilization, 6 of those needed to be accompanied by an ERC Nurse due to being intubated and relatively unstable. 2 nurses took 2 patients each, quite an impressive feat when you consider that 1 patient tends to keep you busy for the 25-40 minute flight, and 2 more nurses took one patient each.
I took a Marine with severe trauma to both legs, an arm, abdominal trauma, and facial fractures. Flight went smoothly, I was in an Army Blackhawk, and they flew at a low altitude the entire trip to Baghdad. Lots of maneuvering, one of the best rides (in a rollercoaster type point of view) that I have had yet. It was a day flight, evening specifically, so ground fire is definitely a concern. I do not know if we were actually shot at, but the flares went off several times when we got near Baghdad. Flight crew didn't seem overly concerned, which is a good indication I did not need to be either.
Please follow the link for an article about Navy Enroute Care Nursing with quotes from 2 of our nurses here at TQ.
Volunteer Navy Nurses Serve as Skyway Angels
or cut and paste the following address into your browser address bar:
http://www.usmc.mil/marinelink/mcn2000.nsf/main5/92253599E321409A852572C200170567?opendocument
And here is the text version without pictures:
Marine Corps News
Volunteer Navy nurses serve as Skyway Angels
April 19, 2007; Submitted on: 04/19/2007 12:11:27 AM ; Story ID#: 200741901127
By Cpl. Wayne Edmiston, 2nd Marine Logistics Group
AL TAQADDUM, Iraq (April 19, 2007) -- The Merriam-Webster Dictionary defines an angel as an attendant spirit or guardian.
In famous art, artists often depicted angels as human-like beings, with white robes and wings, serving as transporters of messages from other celestial beings.
Many seriously wounded service members in Iraq can testify angels aren’t always dressed in white. Several wear tan flight suits and their wings are merely the rotors of soaring aircraft.
These particular angels remain faithful to the Merriam-Webster definition by serving as attendant spirits, as well as guardians – guardians of life.
These guardians are called en-route care nurses and fly onboard casualty evacuation helicopters to stabilize and monitor patients being transferred to a larger treatment facility.
When Operation Iraqi Freedom first started, patients were often accompanied by a hospital corpsman, or no caretaker at all. Medical professionals in Iraq knew there had to be a change.
Lieutenant Cmdr. Troy L. King, an enroute care nurse with Al Taqaddum Surgical Detachment, 2nd Maintenance Battalion, 2nd Marine Logistics Group (Forward), was one of the ground level participants when nurses began jumping aboard with flight crews.
In 2004, medical personnel realized that in-flight patients were not receiving the same quality of care that they would at established facilities, according to King.
“So they started flying nurses with them,” he said.
The nurses who initially began flying were, and even to this day are, volunteers. They volunteer to fly with patients without the extra flight pay and flight status other aircraft crewmembers receive.
Lieutenant Lora A. Martin, an ERC nurse with the detachment, explained the process the patient and nurse must go through prior to boarding the aircraft.
“The people we transport often are treated in the OR (operating room) because of how serious their injury is,” the North Platte, Neb., native explained. “Being in the OR is critical because that is where we get our most valuable information on our patients.”
During the flight, the nurse is continuously monitoring the patient’s vital signs, adjusting ventilators, giving donated blood to the patient, giving pain medications and keeping them stable.
The possibility of a breathing tube moving out of place or a power failure in the aircraft knocking out vital life-preserving machinery is one of many worries rushing through the heads of the nurses onboard, Martin explained.
This process can be even more difficult when flying over enemy territory where the risk of hostile fire can become a hindering factor, or at night, when the only light the nurses have to work by is the faint blue cabin light.
Once they arrive at advanced care facilities in Al Asad, Balad or Baghdad, they turn the patient over to the local staff and ERC nurses begin the trip back.
The job has obvious satisfaction. Seeing their patient arrive alive is always a plus, but not every story has a successful conclusion for these nurses, and some patients don’t always make it to the next echelon of care.
When the mission is accomplished, the patient often will never remember the nurse who kept them alive during that golden period, but the nurses often remember their patients.
“I have seen some of my patients in the news and there are a couple of patients I remember who I know are still alive,” said King, a Hemphall, Texas, native. “Patient survival is the most rewarding part of my job.”
-30-
The en-route care nurses of Al Taqaddum surgical stand in front of a UH-60 Blackhawk casualty evacuation helicopter here April 15. When Operation Iraqi Freedom first started, patients evacuated were often accompanied by a hospital corpsman, or no caretaker at all. Medical professionals in Iraq knew there had to be a change and began putting nurses on board. Photo by: Cpl. Wayne EdmistonThe en-route care nurses of Al Taqaddum surgical stand in front of a UH-60 Blackhawk casualty evacuation helicopter here April 15. When Operation Iraqi Freedom first started, patients evacuated were often accompanied by a hospital corpsman, or no caretaker at all. Medical professionals in Iraq knew there had to be a change and began putting nurses on board. Photo by: Cpl. Wayne Edmiston
A UH-60 Blackhawk casualty evacuation helicopter sits in front of Al Taqaddum surgical here March 26. When Operation Iraqi Freedom first started, patients evacuated were often accompanied by a hospital corpsman, or no caretaker at all. Medical professionals in Iraq knew there had to be a change and began putting nurses on board. Photo by: Cpl. Wayne EdmistonA UH-60 Blackhawk casualty evacuation helicopter sits in front of Al Taqaddum surgical here March 26. When Operation Iraqi Freedom first started, patients evacuated were often accompanied by a hospital corpsman, or no caretaker at all. Medical professionals in Iraq knew there had to be a change and began putting nurses on board. Photo by: Cpl. Wayne Edmiston
Here are LT Kurt Giometti, LT Lora Martin, LT Patrick Harrison, and myself preparing a patient for flight. What you do not see here is all the Corpsmen that are intricately involved in patient care, without them we could not do what we do. It just so happens that all the nurses pictured above used to be Corpsmen before going over to the Dark Side.
Here is almost all of us. All except LT Kurt Giometti, who couldn't make it for this photo.
Had my 6th flight early this morning, flew an Iraqi army guy that was shot in the chest to Baghdad. No problems. Got to see the sunrise while in the back of an Army Blackhawk, took many pictures that I'll try to put together later. I don't think anyone shot at us, but the flares shot off fairly often for a while (the flares shoot off automatically if the computer percieves a threat). The photos above are not from this particular flight, but from previous flights. Kurt Giometti is helping prep a patient for flight by pushing in some blood, I'm giving a medication to keep the patient paralyzed. The 1st photo is that of a Blackhawk.
We did an interview for the American Journal of Nursing, many pictures taken. Here is one of them...
Flew my 5th patient last night in an Army Blackhawk, an Iraqi Army that was shot in the chest. I flew him to Baghdad, I have yet to see Baghdad during the day. Other nurses say it is a pretty city, I'll have to wait...
The flight went smooth, from Baghdad, we flew to Tikrit to drop off another stable patient. That was over an hour to there, then back to TQ. Total 3 hours from when I left to when I got back. I got back around 2am, which worked out well that I could call home at a decent hour for Sarah, I'm 9 hours ahead of Central time.
Hope you all had a happy Easter. We had a fairly slow day up until around 8pm, when 5 Americans and 3 Iraqis came in after an explosion hit a convoy and a building nearby. All that made it to us will be fine, I regret that there may have been some Iraqis in the collapsed building that didn't make it to us.
For the most part, every day here is just like the one before. Hard to tell what day of the week it is without a calender. Kind of like that movie, 'Groundhogs Day'. Who new Easter fell on Ground Hogs day?
Mark Green, one of the nurses in Ramadi, spent the day with us when his ride back was delayed. From Left to right: Lew Dyers, Mark Green, Me.
The 12 year old I flew last week returned to us from Balad, he is doing much better. He and his father are very grateful for the care he recieved. He is paralyzed from the waist down from the bullet, but his one kidney he has left is working well. He went home yesterday afternoon. We hear from our Iraqi translators that they are seeing a shift in the attitudes of many of the local population. The translators have been here for a while, and have said that they now see that the local population wants to be seen at our facility if the are sick/injured, whereas before they did not trust us when we first arrived. Some have said that they now see that the bad guys are not doing what they promised to do for the local population.
This is all anecdotal, I have not yet had any personal conversations with the Iraqis about this, but I do see how grateful they are to recieve the care we give them, like the father (who is a teacher) of this 12 year old.
These are pics from the one day flight I did, the one with the 12 year old. You can see what our patients look like when strapped into the helicopter. We use several different medications to keep them unconscious and paralyzed, mainly to avoid further injury, or re-injury of what the Surgeons just fixed. We are breathing for them, with a small portable ventilator strapped onto the stretcher with everything else. You can see the door gunners in another photo, and what it looks like out the back door, which remains open during the flight. The last photo is during a temporary stop to get fuel on the way back.
Had my 4th flight last night, an Iraqi with a messed up leg and hand from a bomb. Took him to Al-Assad (Army hospital Level III), the first nurse from our group to go to their new facility. Normally the helicopter that takes us to the hospital brings us back, not this time. Due to an oversight in paperwork (that no one knew we had to do anyways), a return trip was not officially requested, so it was not provided (Go Army!!). After 6 hours, 3 military bases, a ride in an ATV, SUV, Pick-up truck, CH-46 and CH-60 helicopter, I made it back to my room at 2AM. Originally they were going to have me stay overnight and fly back the next night, but through cajoling, bullying, and several helpful people, I made it back the same night. Patient was fine, no problems.
Had my 1st day flight, took a 12 year old Iraqi boy that was coming out of school and happened to walk into the middle of a firefight between Iraqi Army and Insurgents. He was shot in the left flank. The Surgeons had to remove a kidney and part of his colon, worst part is he was unable to move anything below his waist, paraplegic. Took him to Balad, no problems. No one even shot at us, I'm feeling that the bad guys don't feel I'm a worthy target, rejected by the enemy. ;)
Here we are, by a CH-46, flown by the Marines. The group photo is of the 6 nurses here that fly the Enroute Care missions. We will be recieving another 3 ERC nurses this week, as Al-Assad is closing down due to the Army opening up a level 3 facility to replace our level 2 that is there. From left to right, we have me, LT Kurt Giometti, LCDR Robin Cross, LT Lora Martin, LCDR Lew Dyer, and LTjg Mark Laquihon. The Original 6.
With me is Sean Barbabella, one of our two ER docs. We worked together at Portsmouth a couple years back. Sarah said I need to put more pictures of me on here... As you can see, my hair is getting shorter and shorter with each time I go to the barber.
I'd imagine that thess are not the types of vehicles you normally see in a parking lot. The chow hall is the large building with the double roof, there is a layer of sand bags in there to help protect against incoming mortar rounds. The chow hall has extremely good food, every Wednesday is steak and lobster, frequent stir fry, and an incredible dessert area (I'm avoiding that one until I lose a few more pounds). The majority of the service staff are civilian contractors from other countries, India and the Phillipines are well represented.
I had my 2nd flight early Wednesday (1am), an Iraqi Police that was shot in the chest. The surgeons opened up his chest, tied off the bleeding vessels in his lungs, and gave him to me to take to Balad. The transport was busy, but smooth. With help of our Anesthesia staff, I was prepared to give blood and many medication enroute to keep the patients blood pressure up. Balad is an Air Force level 3 facility, I'm at a level 2. This means they have more logistical support, more staff, and more specialists. From the level 3 they are flown out to Germany (Americans, not Iraqis) if needed. Balad is a tent structure, compared to Baghdad's actual hard structure. Baghdad is an Army facility.
We care for working dogs here, they hold rank, just like the rest of us, and they receive the same care we do. If needed, we will take them into the OR to provide any care we can. This was a particularly tragic situation, as the Marine handler and the dog were both the victim of an IED, the dog was the only one to survive. The blood on the ground is from our furry patient, the bandage over the muzzle is for injuries, not as a muzzle. Canines are used in many roles here, from security to sniffing out IEDs/bombs to keep the rest of the unit safe.
www.stripes.com/article.asp?section=104&article=44425
(You will have to cut and paste this into your browser, I'm having difficulties getting an automatic link to work)
Here is a news article in the Stars and Stripes, I'm in one of the pictures. The one in the ER, 3rd one down. I'm on the bed on the right, face to the camera. The online photo is smaller than the one in the actual paper.
Yesterday I was primary flight, meaning I'm 1st up for any flights. Not a thing came in. I'm like the anti-black cloud, I bring peace and quiet wherever I go. Good for the people around here, not very exciting for me. I guess I will have to continue to poach the other nurse's flights.
