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FAST
response to blast victims
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LCDR
Paul Luckin treats a patient onboard a C130 enroute from
Bali to Darwin.
Photo courtesy of LCDR Luckin
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At 10am
on Sunday October 13, the Fly Away Surgical Team (FAST) was mobilised
in response to the death and injury of Australian civilians in the
Bali bomb blasts.
FAST is a group of 12 specialist anaesthetists and intensivists
in south-east Queensland drawn from the Navy, Air Force and Army
Reserves, available for deployment at immediate notice.
Six ADF doctors, including RAN anaesthetist LCDR Paul Luckin, left
Brisbane that evening. Accompanied by a team of nursing officers
and medics, they arrived in Darwin shortly after midnight.
At RAAF Darwin Medical Flight, more nursing officers and medics
were assembled and prepared the large quantity of medical equipment
and supplies required. C130 aircraft from RAAF Richmond arrived
and were configured to carry multiple stretcher cases. Medical supplies
were embarked, including trauma packs, resuscitation and intensive
care equipment, emergency airway control and ventilation equipment
and large quantities of intravenous fluids.
LCDR Luckin said, “As information came in from Bali and RAAF
Command, we were briefed and formed into two aero-medical evacuation
(AME) teams. We knew there were many casualties, and at this stage
the expectation was that each AME team would make a number of trips.
“The first AME was airborne by roughly 2am, while the second
was airborne by 2.45am. The last supplies loaded were two very large
cold boxes full of blood.”
The teams reached Bali before dawn. An area beside the terminal
had been cordoned off and patients on stretchers had been laid out
in rows. Ropes strung from pillars ran along the rows, serving to
hold bags of intravenous fluids.
“The patients were almost all very seriously injured. The majority
had extensive burns, commonly 40% or more of their body surface
area.
“Most had lung injuries, from the high-pressure waves from
the explosions. Almost all had multiple shrapnel wounds with imbedded
metal, glass, wood, stone, and other debris. Some had fractures,
head injuries, or had already had emergency surgery. Many had ruptured
eardrums, rendering communication difficult. Some patients required
assisted ventilation, via a tube into the lungs.”
The aim was to resuscitate and stabilise casualties as rapidly as
possible, and prepare them for immediate evacuation. As soon as
a doctor felt a patient was ready, a small team would prepare the
patient for transport, and with the assistance of aircrew, load
them onto the C130.
“By about 7am, part of our team left with 15 casualties on
board. WGCDR George Merridew and I left at about 7.30am Bali time.
With 12 casualties on our aircraft, and our teams of nurses and
medics, we brought out the last of the patients at the airport.”
Resuscitation and treatment continued throughout the flight back
to Darwin. All patients required large volumes of intravenous fluids
to replace fluid lost through burns and other injuries.
“Morphine was the mainstay of our pain relief regime and allowed
most of the patients to have their first sleep. Their relief at
being under the care of the ADF was very moving.”
“Op Bali Assist demonstrated many things including how well
the ADF medical services worked together. When we wear the uniform
of our country we acknowledge the risk of harm to ourselves.
“We are not yet used to attacks on our civilians, at home or
abroad. These victims of the Bali bombing were our people. We went
to them, we treated them and cared for them, and we brought them
home, in the service of the nation.”
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