Wright-Patt medics play integral role in removing unexploded ordnance from patient

  • Published
  • By Laura McGowan
  • 88th Air Base Wing Public Affairs
WRIGHT-PATTERSON AIR FORCE BASE, Ohio --  It's not often that an individual can say they survived and improvised explosive device attack and the operation to have unexploded ordnance taken from their head. It's equally not that often that a doctor and medic can say they were instrumental in the ordnance's removal from the patient, and they also survived the surgery.

On March 18, at Bagram Air Field, Afghanistan, Major Jeffrey Rengel, an anesthesiologist deployed there from the 88th Air Base Wing Medical Center's surgical operation squadron, Wright-Patterson AFB, Ohio, assumed care of a patient after a CT scan was completed during the early evening hours of 5 or 6 p.m. Initially in the operating room were Major Rengel and Technical sergeant William Carter, also from the 88th SGOC.

Sergeant Carter prepared the instrument stand for the surgeon who would remove the device.

"At the time, we were unaware of the unexploded ordnance in the patient," said Major Rengel. "I proceeded as I normally would [by] monitoring the patients vital signs and administering medication to provide a general anesthetic for the patient, ensuring adequate oxygen delivery to the patient and controlling blood pressure."

However, he said that within a few minutes everything changed. He said, "We were told of the potential unexploded ordnance in the patient, and the operating room was evacuated except for myself." He said Sergeant Carter wanted to stay and would have gladly stayed behind to assist him, but he was ordered to leave.

Sergeant Carter said, "You hear about this type of thing on television and read stories about it in the news, but to actually see the way people react in this type of situation is remarkable," said Sergeant Carter, a Fort Myers, Fla. native. "It was a real concentrated effort on everyone's behalf to ensure that we were all safe and the patient was safe as well."

He said, "I was in and out in my [body armor], making sure that personnel from the adjacent operating room operating room did not have to pass through the cordoned area."

After they were told to don their body armor and helmet, Major Rengel said. "I proceeded to turn off any electrical devices currently in use to decrease the chance of detonating the ordnance." He said, "This included all of the patient's monitoring devices."

Major Rengel said, "I resorted to a manual blood pressure cuff and placed a portable battery operated pulse oximetry (which measures heart rate and oxygen content in the patient) on the patient's foot and as far from the ordnance as possible."

"I also converted the patient to a total intravenous anesthetic, manually counting the drips per minute to estimate my medication doses." He spent a total of about 30 minutes alone in the OR prepping the patient for surgery and said it was like taking the practice of anesthesia back 30 years.

After Major Rengel's manual preparation of the patient, the trauma surgeon then entered the OR with an explosive ordnance technician. Major John Bini, 455th Expeditionary Medical Group/Task Force Medical East, trauma director, who is deployed from Wilford Hall Medical Center, Lackland Air Force Base, Texas. After the surgery, which lasted several hours, Major Bini removed the ordnance and placed in the EOD technician's bag.

With the UXO safely removed, Major Rengel said, "I was able to turn on all electrical devices and go back to our standard monitoring of the patient, and we went on to complete the craniectomy."

Major Rengel has been deployed since November 2009 and is scheduled to return to Wright-Patterson near the end of May. He said he has is very familiar with dealing with head trauma and frequently see and deal with head injuries in Afghanistan. He said that dealing with this particularly unique head injury was something he would not want to encounter again in his career. He said that during the 30 minutes he was in protective gear attending his patient, he did momentarily contemplate what was going on. He said he allowed himself a moment to worry and think about his wife and kids and to offer up a quick prayer.

"I thought about our brave men and women [who] put themselves in harm's way every day far and above the position I found myself in at the time," he said. "With that thought, I went to work doing what it is we do every day, and that is take care of our patients and get them back to their families."

(Editor's note: TSgt. Carter's first quote contributed from an April 2, article by Staff Sgt. Richard Williams, 455th Air Expeditionary Wing Public Affairs. Additionally, the patient was discharged from the hospital, and at the time of his discharge, he was able to walk and eat on his own as well as communicate.)