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The Journey Through Trauma

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Old 04-04-2006, 04:15 AM
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From the pages of the Los Angeles Times (Part Two of a Special Three Part Series)

The Journey Through Trauma
U.S. troops who survive the critical 'golden hour' after being seriously wounded in Iraq owe their lives to a fast-acting team of battlefield medics, pilots, nurses and surgeons.

By David Zucchino, Times Staff Writer
April 3, 2006


As Lance Cpl. Ryan Buchter lay bleeding in the Iraqi desert, his fate hinged on the efficiency of a medical lifeline that stretches halfway around the world. From that moment forward, hundreds of strangers would work to save him.

Buchter's platoon was in a village called Husaybah on Nov. 8, searching for the enemy. He was standing in the doorway of a farmhouse when an insurgent inside rolled a grenade at his feet.

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The explosion shredded Buchter's left leg as superheated shrapnel tore through muscles and tendons. More shrapnel crushed his right hand and sliced into his nasal cavity.

Buchter groped for his nose but couldn't feel it. He thought it had been blown off. He leg was so shattered that he was certain he would lose it, and he imagined being left crippled at age 20.

"And not once did I cry," he recalled later, "until I thought, like, I was going to lose my leg and stuff."

A Marine applied a pressure bandage to Buchter's leg, trying to stop the bleeding. Another wrapped his hand and pressed gauze against his pulverized nose. The Marines quickly loaded Buchter into an armored vehicle, which delivered him to a medical aid station nearby.

Buchter survived the "golden hour" — the 60 minutes following a serious battlefield wound, when the speed and competence of emergency treatment can mean the difference between life and death. Ordinary fighting men teamed with doctors, surgeons and nurses to keep him alive.

His fellow Marines — what the military calls his "battle buddies" — were able to stanch his bleeding by putting their combat lifesaving training to quick use. Exsanguination, or bleeding to death, is the leading cause of death for American troops in Iraq.

As a military doctor examined his leg inside the aid station, Buchter was alarmed by the concerned look on the man's face.

"If I lose my leg, I'm coming back to get you," he told him.

The doctor assured Buchter that his leg would be saved. "You've got my word," he said.

Then a surgeon arrived and warned Buchter that he might indeed lose his leg. The best option to save it, he told him, was a very painful and sometimes disfiguring surgery called a fasciotomy, the extensive cutting and cleaning of the wound.

"And I was like, 'Cut me up if you have to. I just don't want to lose my leg,' " Buchter recalled.

The medical odyssey of this Marine was just beginning. Buchter was now a patient in a virtual assembly line of care. It begins with soldiers and medics on the battlefield and shifts quickly to helicopter crews who pluck the wounded from kill zones. It continues to surgeons and nurses and X-ray technicians at desert facilities, and to virtual flying hospitals that airlift the wounded from Balad to a U.S. military hospital in Germany.

It leaps the Atlantic to major military medical centers in Texas and Washington, D.C. It passes through military hospitals from New York to California. It culminates with months of painstaking physical and occupational therapy in hospital wards and private homes. About 17,400 wounded have been treated since the war began three years ago.

The fulcrum for treatment in Iraq is the U.S. Air Force Theater Hospital in Balad. In addition to the troops brought directly to the hospital, any seriously wounded American must make a stop in Balad to be flown for treatment in Germany. The facility is housed inside three dozen tents and three trailers on the packed sands of a former Iraqi air force base 50
 
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