Trauma treatment in a Role 1 medical facility in Afghanistan

• Published in: BMJ military health Vol. 159; no. 2; pp. 119 - 122
• Main Authors: Vedel, Pernille Nygaard, Helsø, I, Jørgensen, H L, Lauritzen, J Bruun, Nissen, L Ravnborg
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.06.2013
• Subjects: Adult; Afghan Campaign 2001; Child; Critical Care; Denmark; Emergency medical care; Emergency services; Explosives; Hospitals; Humans; Injuries; Intubation; Intubation, Intratracheal - statistics & numerical data; Military Medicine; Military personnel; Military Personnel - statistics & numerical data; Military training; Mortality; Nurses; Patients; Physicians; Studies; Trauma; Wounds and Injuries - epidemiology; Wounds and Injuries - therapy; Denmark; Afghanistan; Medical Education & Training; Medical Ethics; Trauma Management
• ISSN: 0035-8665; 2633-3767; 2052-0468; 2633-3775
• DOI: 10.1136/jramc-2013-000051

Background Most of the emergency care delivered in Afghanistan is currently provided by the military sector and non-governmental organisations. Main Operating Base (MOB) Price in Helmand Province has a small medical centre and due to its location provides critical care to civilians and military casualties and this article describes the patterns in trauma patient care at the MOB Price medical centre regarding the types of patients and injuries. Materials and methods The study population consists of 64 consecutive critically injured patients treated in MOB Price during a 4-month period from September to December 2010. The outcomes were battle-related injuries, treatment received before arriving to MOB Price, types of injury and treatment. Results There were 35 civilians (12 children and 23 adults), 28 Afghan National Security Forces and one International Security Assistance Force soldier; they were divided into three groups (civilian adults, civilian children and military). 22% of the patients suffered fragmentation injuries and civilians were more likely to incur fragment injury than military personnel (OR (95% CI) 7.04 (1.4 to 34.8)). Regarding intubation, there was a trend towards more civilians needing it than military personnel and significantly more children than adults underwent intubation (OR (95% Cl) 51 (5.2 to 498.5)). Gunshot wounds (GSW) occurred in 30% of the patients. Civilians patients had a lower OR for GSWs than military patients (OR (95% CI) 0.35 (0.1 to 1.1)). Other trends in injury types and treatment were apparent but did not reach significance due to the small number of patients. Conclusions Both civilians and military personnel benefitted from the in-theatre Role 1 medical facility treatment. The most frequent injuries were fragmentation damage and GSW.