Busy Week

We have been really busy the last couple of days. We have had several ANA and ANP patients with mostly penetrating trauma secondary to GSWs or IEDs. We had an ANP soldier last night that had a crushed pelvis from an MVA (not sure what caused it). He was very cold and vascular access was difficult. I was able to get a subclavian CVL and an axillary arterial line after one of our critical care nurses (MAJ Jeff Genner) got an airway established. It was an unbelievable injury. Our surgeons did an excellent job with him. They were able to pack the pre-peritoneal space with combat guaze (not sure what is in it, but it is good for stopping bleeding) to obtain hemostasis in addition to applying an external fixator to the pelvis. The pelvis was very unstable at multiple points, so it was very difficult. Our goal was to get the patient stable enough to make the flight to Bagram. We were able to fly the patient to Bagram after surgery, however, he coded for 15 minutes during the flight. With this patient, we activated our "walking blood bank". This is a neat concept where we have prescreened donors (American soldiers) on the post donate whole units of type specific blood for our patients that are in need of a massive transfusion. When I give the blood to the patient in surgery it is still warm from the donor. One of the trauma surgeons from Bagram was visiting our FOB and donated a unit himself after he broke scrub. Anyway, it was a labor intesive case for me and I was very tired after it was done. Anyway, that's about all I have to say about that. Today, I thought I would post some pictures of the Bazaar that we have on the FOB 2 times per week. In one picture, you will see "my best friend" (at least, that's what he keeps telling me), a little boy who sold me a couple of necklaces. He always wants me to come look at his shop. The Afghans are good salesmen, and they always like to say, "How much would make you happy?" when you ask them the price of something. Of course, the amount that makes me happy and them happy are two different things. I have bought several items at the bazaar to include a rug (Afghans are known for their wool rugs), chess set (made of lapis, a stone that is mined in Afghansitan), several small jewelry items and a marble tea set. The last picture is of several members of my team who were invited to eat Afghan food (rice with some fruit in it, sheep meat, and some non-rising bread that resembles a thick soft tortilla) with some of the locals and polish translators. The man seated next to me is Dr. Hundard (local national, Tajik I believe, Anesthesiologist who serves as a translator for us, he speaks 7 languages) and across from him (wearing the woodland camo uniform of the ANA) is Dr. Hashiem who is the ANA family practice/internal medicine physician. The food is very good and I don't turn down any invitation to eat local food. I think that will wrap it up for this post.