Saving Lives Up Front: Forward Resuscitative Surgery
By Captain Bruce L. Gillingham, MC, USN, and Captain Harold R. Bohman, MC, USN
Southeast of Baghdad, stretcher bearers moved the wounded Marine lance corporal—in shock and drifting in and out of consciousness—from the CH-46 medevac helicopter into a resuscitation tent. Rapid evaluation revealed an AK-47 gunshot wound in his upper right flank just to the side of his flak vest. After being taken to surgery almost immediately, the full extent of the Marine's injuries became apparent: the bullet had torn apart the lower right portion of his liver, part of the large bowel, and the muscles of his back before exiting and leaving a gaping hole. Doctors packed the liver and the hole in his back to stop the profuse bleeding, removed the destroyed portion of his bowel to control contamination, and replaced his lost blood with intravenous fluid and transfusions-and his vital signs slowly stabilized.
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