Medical challenges
Volume 11, No. 56, November 16, 2006
By Graham Davis
 |
|
Sea change: Col Jeffery Brock (right) and AB Zami Burns examine an injured US sailor in HMAS Ballarat’s medical bay in the Persian Gulf. The recent health conference covered all aspects of military medicine.
Photo by AB Bradley Darvill
|
MORE than 550 health professionals, 400 of them from the ADF, have attended a hard-hitting conference co-hosted by the Australian Military Medicine Association (AMMA) and Defence Health Services.
Held at the Brisbane Convention and Exhibition Centre from October 19-22, Military Health: The Challenge, was the second conference conducted by AMMA and Defence Health Services, the first being held in Sydney four years ago.
Delegates from China, the US, the UK, New Zealand, and Indonesia joined Australian doctors, nurses, medics and associated professionals. Issues raised will now become important matters for discussion for ADF senior management and government.
The conference heard from a leading British medical planner, Maj-Gen Mike Von Bertele, that Australia needed to debate whether it would accept large numbers of casualties if it were to enter large-scale conflicts. “Australia is slightly risk averse. You don’t want things to go wrong,” he said.
A visiting US disaster expert gave his opinion that there was “zero hope” of providing enough hospital beds during a pandemic. He said it might be necessary to improvise makeshift hospitals in schools and auditoriums.
He suggested that in such large-scale emergencies, many patients would remain in their homes and medics would monitor their treatment remotely using Internet “camera-in-the-home” technology.
Two senior US Army speakers told of the Armed Forces Longitudinal Technology Application, a super computer system which allows health personnel to keep track of members’ health status and location. When a soldier was wounded, a corpsman or doctor would record the incident in a hand-held entry computer, including details of what treatment was given and where the soldier would be sent for further treatment. The two US speakers also told of the introduction of dog tags with a computer chip.
An Australian expert told of the problems created in the Middle East by sandflies and the measures taken by those working in the open and inside. Temperatures up to 55 degrees Celsius created environmental concerns.
There was a bouquet for three nurses who introduced a pilot scheme in which undergraduate personnel could be given a taste of Defence through a series of night-time lectures.
An Air Force nurse told of having to improvise at the Balad hospital when patients being repatriated from Iraq to the US military hospital in Germany needed to be kept warm, but where supplies of blankets were temporarily exhausted. “We put beanies on them or put them in a body bag and cut a hole for their faces,” she said.
Prof Dianna Horvath, CEO of the new Australian Commission on Safety and Quality in Health Care, applauded Defence for the way it debriefed its personnel after an incident and suggested civilian health institutions needed to do the same.
Ethics and privacy were discussed at the conference, with one speaker expressing concern about personnel in an operating theatre with cameras and where images might end up.
Toil and blood
Volume 11, No. 56, November 16, 2006
WHEN ADF members go into a foreign country they give their time, their experience, their friendship and even their blood.
ADF surgeon Lt-Col Justin Bessell told the military health conference of the lengths Australians went to in order to save the life of a 35-year-old Timor-Leste man attacked with a sword earlier this year.
Lt-Col Bessell, who was attached to the Australian military hospital in Dili, said the man – who had wounds to the thigh and shoulder – had been dropped at the terminal entrance at the airport by a motorcyclist.
“Some RAAF airfield defence members found him in a pool of blood and packed his wounds with field dressings. They noticed an ambulance outside and had the driver take the man to our field hospital,” he said.
While operating on the patient, it was realised he would need more blood, and quickly. ADF members stepped forward and gave their blood, which was quickly tested by the on-site pathology team.
In all, 14 sachets of whole blood and fluids were used on the patient, who was later flown to Darwin Hospital where he made a full recovery.
Balad had gone to the dogs
Volume 11, No. 56, November 16, 2006
WHEN US Army environmental health expert Lt-Col Shawn Boos arrived at Balad hospital in 2003, he spent his first 14 days sleeping in the open, in a bag, with just his face exposed.
He didn’t need a shoulder shake, a bugle call or an alarm clock to wake him. “It was a wild dog licking my face,” he said.
Lt-Col Boos told of the threat from the often rabid and always flea-ridden dogs when he delivered his paper, “Environmental health and preventative medicine challenges from Kuwait to Baghdad, February to July 2003”, at the medical conference.
He said the animals posed a threat to coalition personnel. As a result it was necessary to use personnel with veterinary experience to euthanase the dogs, with the hope of sparing any animal that was a family pet.
He said the dogs roamed in packs, ranging from five to 15 animals.
Apart from the dog menace and threats of attack by terrorists, Balad personnel also had to cope with sandflies and dust storms.
Breathing easy on deployment
Volume 11, No. 56, November 16, 2006
INTENSIVE care nurse Capt Ben Mackie, 2HSB, has a wealth of knowledge on what an IED can do to the human body – particularly the lungs.
He’s been to Iraq twice, serving for four months in the US hospital at Balad, 80km north of Baghdad. The hospital is the principal treatment and evacuation centre for coalition personnel in the region.
“Every day we’d have a blast lung injury come in,” he said of his time in Balad.
Capt Mackie presented a paper on blast lung injuries to the recent Defence Health conference in Brisbane and noted that there was little research or worldwide discussion on the topic.
He suggested to the conference that there would be few, if any, hospitals in Australia that had protocols to treat blast lung injuries.
He said that medical teams in Iraq had developed protocols and were using the German-designed device, the Novalung, to save lives.
Among the protocols was the partial or total shutting down of the patient’s own damaged lungs (allowing them to repair) while blood oxygenated externally was pumped into their system via major veins.
This way vital oxygen continued to support the brain and other major organs.
