Scientific paper
Combat trauma experience with the United States Army 102nd Forward Surgical Team in Afghanistan

Presented at the 90th Annual Meeting of the North Pacific Surgical Association, Portland, Oregon, November 14–15, 2003
https://doi.org/10.1016/j.amjsurg.2004.02.001Get rights and content

Abstract

Background

The United States Army 102nd Forward Surgical Team (FST) was deployed to Kandahar Airfield, Afghanistan, from August 2002 to March 2003, in support of Operation Enduring Freedom. The unit's primary mission was to provide trauma surgical support to units of the 101st and 82nd Airborne Divisions, to coalition special operations units, and to allied Afghan militia forces. The FST's mission was expanded to include humanitarian assistance.

Methods

The mission was accomplished in the austere environment of Kandahar Airfield, Afghanistan. The FST was set up in a corner of the abandoned Kandahar International Airport terminal. The team's supporting facility was a 44-bed combat support hospital at Bagram Airbase near Kabul. Patients arrived by ground ambulance, local transportation, and MediVac helicopter. Evacuation of casualties, when necessary, was by fixed-wing aircraft. Patient data were retrospectively reviewed.

Results

The team performed 112 surgeries on 90 patients during the course of 7 months. Three patients were female (all children). Twenty patients were <19 years old. Trauma accounted for 78% of cases; the remainders were nontrauma or elective cases. Sixty-seven percent of these surgeries were performed on Afghan militia and civilians, 30% on United States soldiers, and 3% on other coalition forces. Mechanism of injury included gunshot wounds (34%), blasts (18%), motor vehicle crashes (14%), stab wounds (5%), and other trauma (7%). By physiological system, the trauma cases were broken down into extremity (44%), head and neck (17%), multisystem (13%), trunk (8%), and vascular (3%).

Conclusions

“Damage control” operations necessitating multiple trips to the operating room were the norm. Hypothermia from blood loss was often exacerbated by exposure before evacuation and prolonged transport in helicopters. This was aggressively treated with passive, conductive, and active rewarming techniques. Stabilization and evacuation to higher echelons of care was common.

Section snippets

Methods

The United States Army 102nd FST was created in fall 2001 in the aftermath of the World Trade Center attacks. In the ensuing months, the unit prepared for deployment. Training included a 1-month rotation at the United States Military's Advanced Trauma Training Center at the Ryder Trauma Center at the University of Miami, Florida. The Advanced Trauma Training Center was created to allow FSTs to experience real-world trauma training and team building in the setting of a busy stateside level I

Results

The team performed 112 operations on 90 patients during the course of 7 months. Data on patients were collected sequentially and reviewed retrospectively. Twenty of the patients were <19 years old. Trauma accounted for 79% of cases; the remaining cases were nontrauma or elective. Sixty-eight percent of these surgeries were performed on Afghan militia and civilians, 29% on United States soldiers, and 3% on other coalition forces (New Zealanders and Romanians). Only 3 patients were female, and

Comments

Sophisticated trauma care can be delivered on the modern battlefield using techniques developed and refined during the last 60 years in both military and civilian trauma settings. Our FST was effective as the initial echelon of care after the combat lifesavers on the ground, the medics, and soldiers in the maneuver units. FSTs can also be adapted to the strategic and tactical situation to provide expanded surgical and holding capabilities as was done in the case of the 102nd FST in Afghanistan.

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This is an original work by the authors. The opinions expressed are the authors' alone. They do not necessarily reflect the opinion of the United States government, the Department of Defense, the United States Army, or Madigan Army Medical Center.

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