Some Guys Have All The Luck

As predicted, business did start to pick back up again the last couple days. Have had several gunshot wounds (GSW's) and one near-miss. One patient was shot in the left upper extremity. Somehow, he did not sustain a fracture nor did he have a neurovascular injury. Another patient was shot multiple times in both legs. He came in with a tourniquet on his right leg, but it wasn't applied quite as tightly as it should have been. It's what we call a venous tourniquet, which means the vein was occluded at the groin but he was still getting arterial flow to the leg. His leg was very swollen (as you can see in the picture) from all the venous engorgement. He lost a lot of blood from that wound. I explored it and found an injury to the distal superficial femoral vein, which we were able to repair. He had no arterial or neurologic injury, and for his fracture we placed him in an ex-fix. He's very lucky and should recover well.

Later that same day, we were all called urgently to the FST. One of the Polish helicopters crashed during takeoff right outside of our FOB, and we were anticipating multiple casualties. I'll never forget the smell of dust, fuel, etc... that was in the air when I first walked outside. Apparently, the tail of the bird caught the top of one of the hesco barriers, knocking it off-balance and bringing it down on its side. The rotors were shredded to pieces when they struck the ground. I prepared the team for 10 possible casualties (that's how many people the helo could hold), but we were not needed. Everyone was able to walk away unharmed; it was an awesome feeling! Many of the Polish people we work closely with knew some of the folks on that helicopter, and they were visibly shaken yet relieved at the joyous news.

Just earlier today, I received an ANA soldier who sustained a GSW to the butt. We knew this guy was injured the day before, but for various reasons no one could get to him. The weather was too horrible yesterday to get him by air and it was too dangerous to go after him by ground (at night). Today, the medevac guys were gonna go after him (the weather was better) but we had received word that some insurgents were planning an ambush. So the mission was delayed further until 2 Apache attack helicopters and some Special Forces guys could accompany the medical crew. Ultimately, he made it here (26 hours after being shot and having spent the night outside in 20 degree temps) and actually looked pretty good (other than being very cold). The bullet entered the right buttock and rested in the abdomen on his x-rays. He had a negative FAST but was very tender and had crepitus along the right side of his abdomen. I couldn't feel the bullet on exam, and even though I thought he would be sicker if he had a significant injury, I had to explore him to rule-out badness (wish I had a CT scanner). Anyway, he too was very lucky. The bullet never entered the peritoneal cavity; we were able to retrieve it from his abdominal wall. I gave it to him as a "souvenir".