Welcome Home From Vietnam, Finally

#7) The ED

The wounded died from the inhibition of oxygen delivered to the body’s tissues. We administered packed red cells and salt solution to reverse blood loss shock. Wounds or trauma to the chest may cause a leakage of air into the chest cavity that, in excess, may collapse that lung and inhibit the return of blood to the heart. It’s called a tension pneumothorax and may be fatal. Our rule was to place a drainage tube empirically into the chest cavity before surgery if there were the slightest chance a collapse would occur under anesthesia. We encouraged the corpsmen to perform procedures above their pay-grade. These corpsmen, nurses, and docs worked as one to accomplish all the tasks required for life-saving. They took vital signs, placed large tubing into veins for blood and salt solution administration, set up the chest tube drainage, drew blood samples, bagged the intubated patient. They replaced IV solution bags, squeezed the blood bags to infuse more rapidly, and stabilized fractures.They gave pre-op meds and antibiotics, placed a urinary catheter to measure output, checked blood oxygen levels, did multiple x-rays to localize metal fragments and definite bone fractures. And they also checked peripheral pulses to rule out arterial damage and read the chest x-ray to rule out injury or fluid overload.