8th Flight

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.

Trying to Speak the Language

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...

Ask for a nurse and this is what you get - Paperwork and Needles

Here is LT Vince Johnson and myself, ready to do what we do best.

TQ Surg In Action

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.

The Twinkie

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.

7th Flight

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.

In the News...

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.”
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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

Enroute Care Nursing in Al-Taqaddum, Iraq

Team Nursing

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.

Thinking of Home...

A New Photo of the Enroute Care Nurses

Here is almost all of us. All except LT Kurt Giometti, who couldn't make it for this photo.

6th Flight

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.

Today's Pic

We did an interview for the American Journal of Nursing, many pictures taken. Here is one of them...

Flight #5

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.

Happy Easter

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.

Follow up

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.

Pics from the 3rd Flight

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.