BACKGROUND: In the war against the Taliban, Canada was the lead North Atlantic Treaty Organization (NATO) nation to provide medical and surgical care to NATO soldiers, Afghanistan National Army soldiers, Afghanistan Nation Police, civilians working in and outside Kandahar Airfield and Afghanistan civilians at the Role 3 Multinational Medical Unit (R3MMU) from February 2006 to October 2009. METHODS: We obtained data from the Joint Theatre Trauma Registry between May 1 and Oct. 15, 2009; 188 patients were admitted to the R3MMU intensive care unit (ICU). We analyzed the ICU data according to types and causes of trauma, mechanical ventilation prevalence, ICU medical and surgical complications, blood products utilization, length of stay in the ICU and mortality. RESULTS: The admitting services were general surgery (35%), neurosurgery (29%), orthopedic surgery (18%) and internal medicine (3%). Improvised explosive devices (46%) and gunshot wounds (26%) were the main causes of ICU admissions. The mean injury severity score for all patients admitted to the ICU was 37, and 81% of ICU patients required mechanical ventilation for a mean duration of 3 days. The main ICU complications were coagulopathy (6.4%), aspiration pneumonia (4.3%), pneumothorax (3.7%) and wound infection (2.7%). The following blood products were most used: packed red blood cells (55%), fresh frozen plasma (54%), platelets (29%) and cryoprecipitate (23%). The average length of stay in the ICU was 4.3 days, and the survival rate was 93%. CONCLUSION: The high survival rate suggests that ICU care is a necessary and vital resource for a trauma hospital in a war zone.
BACKGROUND: In the war against the Taliban, Canada was the lead North Atlantic Treaty Organization (NATO) nation to provide medical and surgical care to NATO soldiers, Afghanistan National Army soldiers, Afghanistan Nation Police, civilians working in and outside Kandahar Airfield and Afghanistan civilians at the Role 3 Multinational Medical Unit (R3MMU) from February 2006 to October 2009. METHODS: We obtained data from the Joint Theatre Trauma Registry between May 1 and Oct. 15, 2009; 188 patients were admitted to the R3MMU intensive care unit (ICU). We analyzed the ICU data according to types and causes of trauma, mechanical ventilation prevalence, ICU medical and surgical complications, blood products utilization, length of stay in the ICU and mortality. RESULTS: The admitting services were general surgery (35%), neurosurgery (29%), orthopedic surgery (18%) and internal medicine (3%). Improvised explosive devices (46%) and gunshot wounds (26%) were the main causes of ICU admissions. The mean injury severity score for all patients admitted to the ICU was 37, and 81% of ICU patients required mechanical ventilation for a mean duration of 3 days. The main ICU complications were coagulopathy (6.4%), aspiration pneumonia (4.3%), pneumothorax (3.7%) and wound infection (2.7%). The following blood products were most used: packed red blood cells (55%), fresh frozen plasma (54%), platelets (29%) and cryoprecipitate (23%). The average length of stay in the ICU was 4.3 days, and the survival rate was 93%. CONCLUSION: The high survival rate suggests that ICU care is a necessary and vital resource for a trauma hospital in a war zone.
Authors: Michael Alan Glenn; Kathleen D Martin; Diana Monzon; William Nettles; Vicky M Rodriquez; Daniel Lovasz; Tracy A Defeo; Stephen Flaherty Journal: J Trauma Nurs Date: 2008 Oct-Dec Impact factor: 1.010
Authors: Matthew A Borgman; Philip C Spinella; Jeremy G Perkins; Kurt W Grathwohl; Thomas Repine; Alec C Beekley; James Sebesta; Donald Jenkins; Charles E Wade; John B Holcomb Journal: J Trauma Date: 2007-10
Authors: John B Kortbeek; Saud A Al Turki; Jameel Ali; Jill A Antoine; Bertil Bouillon; Karen Brasel; Fred Brenneman; Peter R Brink; Karim Brohi; David Burris; Reginald A Burton; Will Chapleau; Wiliam Cioffi; Francisco De Salles Collet e Silva; Art Cooper; Jaime A Cortes; Vagn Eskesen; John Fildes; Subash Gautam; Russell L Gruen; Ron Gross; K S Hansen; Walter Henny; Michael J Hollands; Richard C Hunt; Jose M Jover Navalon; Christoph R Kaufmann; Peggy Knudson; Amy Koestner; Roman Kosir; Claus Falck Larsen; West Livaudais; Fred Luchette; Patrizio Mao; John H McVicker; Jay Wayne Meredith; Charles Mock; Newton Djin Mori; Charles Morrow; Steven N Parks; Pedro Moniz Pereira; Renato Sergio Pogetti; Jesper Ravn; Peter Rhee; Jeffrey P Salomone; Inger B Schipper; Patrick Schoettker; Martin A Schreiber; R Stephen Smith; Lars Bo Svendsen; Wa'el Taha; Mary van Wijngaarden-Stephens; Endre Varga; Eric J Voiglio; Daryl Williams; Robert J Winchell; Robert Winter Journal: J Trauma Date: 2008-06