Within 6 hours of arrival, we got our first patient, an 8-year-old Afghani boy run over by a civilian truck 4 days previously. He had been “treated” at the local hospital, but not well. He had an open femur fracture and extensive soft tissue injury of both lower extremities. All they had done for 4 days was splint his legs and wrap them in Kerlix. Our orthopedic surgeon was taking care of him when the second trauma came in. This was a 25-year-old soldier with a gunshot wound in the right lower quadrant. Fortunately, it was a through and through wound and other than requiring a small bowel resection, missed other important structures like iliac vessels, ureter and colon. He was evacuated the next day to Bagram.
The very next day, we had 3 Afghanistan Nationals (AN) brought in after being injured by an IED. One was a 9-year-old boy who was peppered over his entire anterior surface with shrapnel. He had been asked to roll a wheel barrow up to some of the Afghan security forces. The “bad guys” had hidden explosives in the wheel barrow and when he got close enough, they detonated it. What’s wrong with these people? We found that he had traumatic eye injury (hyphema), a hemopneumothorax, and intra-abdominal foreign bodies on CT scan. After a chest tube and exploratory laparotomy with small bowel repairs/resection and a cholecystectomy for shrapnel perforations, he was evacuated to Bagram because of foreign bodies in the left eye (they have an ophthalmologist up there).
Hope all is well back home and appreciate all the well wishes. Anyway, two days on the job and two serious pediatric trauma patients! Looks like I’m in the right place.