Austere Medical Care – Tales from an 18 Delta: Part 1 – BY Charlie Martel

field care The skin at the site of the break was creased and like leather. “I can’t help you. You’re going to have to go to Pakistan.” “Can’t you just cut it off?”, he pleaded with me. The man had been in excruciating pain every day since breaking his leg in a car accident eight months ago. “Yes. Come back next Saturday.”

I presented the case to my surgeon in A-bad via SATCOM. “I agree with your plan. No pressure, but the record for a BKA (below the knee amputation) in the Civil War is 3 min.” Thanks Doc. I requested the necessary drugs and tools to be brought in on our next ring flight. On Saturday morning, the old man and his nephew showed up piggy back at my gate. Unfortunately, my supplies had not.

“Go get the Sawzall blades from the 18C kit and put them in a Pringles can with iodine”, I said to one of my minions. We were about to do some cold sterilization on construction tools. This seemed appropriate as we were also about to conduct a major surgical procedure in a mud hut on the Afghan/Pakistan border. Just then, a Blackhawk landed with my extra anesthesia drugs and a surgical ring saw.

We kicked the Marine PL out of his room in the qalat and turned it into a makeshift surgical suite. I directed one of my Afghan militia medics to start an IV. Miss. Next corpsman, miss, and the one after that. I went for a jug stick (after giving the poor guy an IM ketamine bump). I angled the 14 gauge needle into his neck, got flash, and advanced. The flash disappeared.

At the time, I thought I had blown the jugular vein. I later learned that jug sticks only give brief feedback in the flash chamber. I now had two options to get a line started on my patient: venous cut down or use this new thing in my bag called a FAST1. The FAST1 is a grip filled with a pressure sensitive needles and one medieval-ass spring loaded needle that shoots into the sternum. I had never used one before. TO BE CONTINUED

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