Inside Kandahar Combat Hospital: Saving Lives and Limbs

PHOTO Dr. Richard Hilsden is a captain with the Canadian forces, part of the multi-national team of doctors, nurses, and medics staffing the U.S.-run hospital.

The combat hospital at Kandahar Air Field may lie deep in Taliban country, but as far as military hospitals go, it is cutting edge.

Doctors there use advanced technology and medical techniques once unheard of this close to the battlefield to ease wounded soldiers' pain, to salvage limbs and to save lives.

In fact, about 98 percent of coalition soldiers who get to the hospital alive survive after treatment.

In the minutes before the injured arrived recently, the trauma team nurses prepared the treatment bays, hanging IV fluids and checking equipment. The doctors reviewed what little information they'd been given about the patient on his way.

Kandahar O.R.
Kandahar O.R.

"He has a traumatic amputation of the right leg below the knee," said Dr. Richard Hilsden, the trauma team leader. "Other than that, we have no other information."

Hilsden is a captain with the Canadian forces, part of the multi-national team of doctors, nurses and medics staffing the U.S.-run hospital. Hilsden had been in Kandahar for only a month. He practices family medicine back in Canada.

When an ambulance pulled up, Hilsden quickly assessed the soldier, an American. His right foot was gone, lost in an attack on his guard tower by a rocket-propelled grenade.

Pfc. Kelly Beechinor, 23, was just one week shy of heading home.

Once in a trauma bay, Hilsden called in orthopedic specialists to assess and stabilize the soldier's leg injury. Surgery would be essential, but the doctor's immediate concern was the soldier's pain.

To help with pain management, Dr. Kevin Brady, an Army lieutenant colonel with the Pentagon's Joint IED Defeat Organization, was visiting Kandahar to teach the staff about the latest developments to treat pain.

He brought with him the technology to do nerve blocks -- knocking out pain close to the source.

"Up to this point, the technology hasn't been widely dispersed throughout the combat zone," said Brady.

"[Our] organization has a mission to train the force and to get equipment and technology down range into the hands of the soldiers, sailors, airmen and Marines so that they can do their jobs rapidly and effectively."

Brady teamed up with Hilsden to help the U.S. soldier following his surgery. Using a stimulator, a small device that delivers a weak electronic pulse, Brady was able to locate the nerves in the soldier's leg.

When he saw the knee twitch, he knew he had found the right spot.

"We are seeing patellar snap, so that's the key that we are actually getting the femoral nerve," Brady said.

He then inserted a catheter to deliver pain medication directly to the nerve.

"These patients, because of the nature of the combat injuries, can get multiple surgeries," he said. "This catheter, then, will give pain relief for the ride home. And then it can be used for subsequent procedures."

Rediscovering Old Remedies

While doctors are heralding such high-tech tools for battle zone medical care, a more rudimentary technique increasingly is saving lives.

Like many of the injured, when Beechinor arrived at the hospital, he was wearing not one but three tourniquets to help stop the bleeding from his injuries.

In the civilian world, tourniquets have a bad reputation, blamed for causing additional damage. Nowadays they are rarely used.

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