Joint medical team works together, saves critically injured soldier

  • Published
  • By Staff Sgt. Dillon White
Staff at the Seth Michaud Expeditionary Medical Facility resuscitated, performed emergency surgery and stabilized a U.S. Soldier on June 8, prior to an eight-hour C-17 flight to Landstuhl Regional Medical Center, Germany, following an up-armored humvee roll-over in Djibouti.

The soldier was ejected from his vehicle and he suffered compound fractures of his leg and pelvis.

He was given immediate care by U.S. Army medics of the 2-16th Infantry Battalion after Seabees from NMCB 74 used heavy equipment to free him from the vehicle.

The patient was transported six miles from the accident location to the Camp Lemonnier EMF, a role 2 facility, where he underwent emergency surgery and transfusion of fresh whole blood from volunteer donors on base.

"Once the patient got here it was a fluid, smooth and organized resuscitation," said U.S. Navy Capt. Michael Matteucci, EMF Senior Medical Officer. "And it was directly due to training and drills we've been running and the professionalism of all the people."

"You would be hard pressed to find a more efficient resuscitation in any civilian trauma center," he added.
The medical team which provided care to the patient was comprised of U.S. Navy EMF medical professionals, assisted by a surgical team assigned to US Central Command and the Combined Joint Task Force- Horn of Africa Surgeon Cell.

The surgical team overcame two significant challenges before they could transfer the patient onto the C-17 for the 2,500 mile flight from Djibouti to Germany -- roughly the distance from New York to Paris.

"The biggest challenge is that this is not a high-volume trauma center," Matteucci said. "We drill for it. So unlike Afghanistan or Iraq, where you have three or four traumas a week, it's easy to become rusty and miss things, so that's why we have been drilling hard."

The next significant challenge was limited resources. The EMF does not have a CT scanner and the x-ray machine was inoperable.

"We adapted and used an ultrasound and a C-arm," Matteucci said. "The C-arm is specialized equipment designed for x-rays of small areas and fluoroscopy."

U.S. Navy Commander Jeffrey Lowell, EMF Surgeon, explained that the hospital staff had to move the patient lower on the operating table so the C-arm would clear underneath. The patient had 11 different operative procedures performed during the 5-hour emergency surgery.

While the surgical team operated, Maj. Ronda Dimaggio, U.S. Air Force Nurses Corps Aeromedical Evacuation liaison officer, arranged aircraft and crew from Theater Patient Movement Requirement Center-Europe.

The day after surgery, EMF staff and CCAT aircrew brought the patient on board the C-17 Globemaster. Within roughly four hours, teams passed on information, then transferred him from the EMF's monitor and ventilator to the on-board monitor and ventilator of the Critical Care Air Transport Team.

"We didn't miss anything -- which is one of the biggest risks in trauma -- if you miss something or overlook something and it doesn't get found and it gets worse," Lowell said. "When you have a Soldier who is going to be air-evaced 2,400 miles at 30,000 feet -- if there is problem undiagnosed, missed or incompletely treated -- that is a big problem and a bad time for something to present itself."

Once the patient arrived at LRMC, the surgery team conducted further surgeries.

The patient was later flown to Walter Reed National Military Medical Center, in Bethesda, where he was listed in critical but stable condition.

Lowell and Matteucci continue to receive updates about the patient's condition through a weekly web-based conference hosted by the Joint Theater Trauma Service. On June 15 they were told the patient was in stable condition and off the breathing machine.

These weekly teleconferences give medical personnel who provided care for a patient at all levels, from helicopter crews, and medics at battalion aid stations, to role 2, 3, 4 and 5 staff a chance to find out how patients are doing, exchange best practices and discuss lessons learned.

"Everyone is involved," Lowell said. "It's one of the best parts of the Joint Theater Trauma System, because you really get closure -- follow-up -- immediate feedback from world's experts -- no one is better at doing this than the U.S. military. So it's really great and people gave a lot of kudos for the team here for doing great things under difficult conditions."