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Naval Hospital Ship Heads for Home After Treating Casualties of Gulf War

Naval Hospital Ship Heads for Home After Treating Casualties of Gulf War Naval Hospital Ship Heads for Home After Treating Casualties of Gulf War The US Navy Ship Comfort is on her way home from the Persian Gulf after a 4-month tour of duty that brought aboard more than 600 injured soldiers and civilians. Earlier this month, the ship discharged its last 65 patients—all Iraqi civilians, who were released to shoreside US military hospitals or to Iraqi facilities. Most of the ship's 1200-member medical and support crew flew home in late April and early May, leaving a skeleton crew of 340 to take her to port in Baltimore. As one of two hospital ships in the US fleet, the Comfort provides all the facilities seen in a big city tertiary care center—freezers with blood stored at − 82°F, an oxygen generator, a helipad, a CT scanner and x-ray machines, and 12 operating rooms. US Navy Ship Comfort is a floating hospital that provides all the facilities seen in a big city tertiary care center, including a blood bank, a CT scanner and x-ray machines, and a dozen operating rooms. (Photo credit: Courtesy of USNS Comfort Public Affairs) And then there is the equipment unique to a hospital at sea—lifeboats, desalinating equipment to supply fresh water, D-rings welded to the floor for lashing down equipment during heavy seas. Walls are lined with bright orange hand-held oxygen canisters that provide 15 minutes of air in case of fire. Space aboard a floating hospital is at a premium: Each of 16 wards holds 40 bunks. The most seriously injured patients get the bottom bed; others have to scramble above. A walking blood bank A walking blood bank Every member of the Comfort's crew, including 63 merchant marines, has been blood typed. "The crew can function as a walking blood bank at a moment's notice," said CDR Tommy Stewart, NC, USN, a nurse on the Comfort who also serves as her fire chief. A walking blood bank Fortunately, the medical staff never needed to tap into that ocean of blood. CAPT Charles Blankenship, MC, USN, said that there were several "pretty busy" periods, but the crew was never overwhelmed. If it had been, the captain, a general surgeon, would have jumped in and helped out. A walking blood bank "Acute triage wasn't that much of a problem for us," said Blankenship on satellite phone from the ship's bridge. "We had a few patients come in who were really urgently ill and had to go directly to the OR. But with the number of ORs that we have . . . we really didn't have to do the type of triage that you would have to do if you were overwhelmed." A walking blood bank During its tour, the Comfort lost "two or three" patients, said Blankenship, all Iraqi civilians who were septic after several days in the field before they arrived on the Comfort. About 200 Iraqi civilians and soldiers received treatment on the ship. On alert On alert Beginning March 22, the night that the bombing of Baghdad began in earnest, the ship went on alert for worst-case scenarios, including mass casualties from chemical or biological weapons. Those nightmares never materialized, but there were several 6-hour shifts in which 30 to 50 patients came aboard, said Blankenship. CDR Linda Nash, NC, USN, evaluates an Iraqi patient in the casualty receiving area aboard the hospital ship USNS Comfort. More than 600 injured soldiers and civilians were treated on the Comfort during the ship's 4-month tour of duty in the Persian Gulf. (Photo credit: Courtesy of USNS Comfort Public Affairs) On alert "Nearly all of those patients . . . had combat-related injuries and had to be reoperated on for internal injuries, or have their wounds cleaned and sewed up and have fracture work done," said Blankenship, who went on to describe the military's three-tiered medical care system. Forward teams treat injured soldiers with quick-and-ready procedures designed to prolong life until air or ground transport can ferry them to what the Marine Corps calls "surgical company" facilities—temporary hospitals that evoke images from the television show M*A*S*H, or at least an updated version of those Korean War–vintage field hospitals. On alert After life- or limb-saving surgery at these level-2 facilities, patients needing additional care are flown via helicopter to the Comfort. "Our role as a level 3 [facility] is the first level at which you have the subspecialties of medicine and surgery," said Blankenship. Seriously injured US patients are stabilized until strong enough to fly to Germany or to the United States. Those with lesser injuries get treated and sent back to their combat units. On alert Blankenship said that during the busy periods, the ship's medical crew made "several good saves." The most dramatic made use of the ship's newest acquisition, a fully equipped angiogram suite. During supply operations in Iraq, a marine slipped beneath a truck, which crushed his pelvis. By the time he landed on the Comfort, emergency teams had transfused seven units of blood. On alert "We were able to take him to the angiogram suite and locate the areas that were bleeding, then we put the coils in to stop the bleeding," said Blankenship. "And that saved his life. If we had tried to operate to control his bleeding, he would have died." The soldier was eventually flown to the intensive care unit at the National Naval Medical Center in Bethesda, Md, home to most of the Comfort's medical staff. From "ghost town" to hospital From "ghost town" to hospital Blankenship, too, is stationed in Bethesda, where he divides his time between operating, teaching, and maintaining the readiness of the Comfort's crew. The ship's home is a dock in Baltimore harbor, some 40 miles north of Bethesda. When called to duty, Blankenship and his crew must transform what one officer called a "ghost town" into a fully functioning hospital within 5 days. From "ghost town" to hospital To that end, Blankenship organizes quarterly orientation trips and annual exercises, called "fast cruises," in which the ship runs dockside at quarter capacity for 5 days. Actors play the part of patients, while nurses and physicians train for handling the unexpected: floods, fires, power outages, and mass casualties. From "ghost town" to hospital It was just such a scenario that launched the Comfort on its previous mission. After the destruction of the World Trade Center, the Comfort sailed to New York City. From "ghost town" to hospital Ironically, on the morning of September 11, 2001, Blankenship and another officer were in Orlando, Fla, listening to New York's emergency operations director at a meeting on the management of consequences of weapons of mass destruction. By noon, Blankenship knew that the Comfort would be sailing. From "ghost town" to hospital He rented a car and drove 900 miles, arriving at Bethesda two hours before buses rolled into Baltimore. His wife met him with his seabag, and by the afternoon of Septemeber 12, the Comfort was under way. Giving comfort from pier 92 Giving comfort from pier 92 While the ship's medical facilities were not needed, it played another crucial role. "You might say we were the ‘Comfort' Inn for the rescue workers," said Blankenship. Giving comfort from pier 92 Delivered to the Navy in 1987 as one of two converted supertankers, the $294 million, 894-foot long, 10-story high ship loomed large in Manhattan harbor, its white hull and red crosses visible between the canyons of towering skyscrapers. Giving comfort from pier 92 It also loomed large in the crazed, stressful lives of rescue workers. Parked at Pier 92 on the West Side of Manhattan for a month, the ship offered 24-hour coffee, meals, laundry service, showers, and beds. Giving comfort from pier 92 "We had just about every berthing space and every ward space on the ship"—more than 2000 beds—"filled with people from all over the world," said Blankenship. Psychologists and counselors constantly walked the ship, talking to workers and keeping an eye out for people who needed help. Giving comfort from pier 92 Some 18 months later, the Comfort has fulfilled her latest mission. Blankenship sounds both relieved and wistful when he says that his 26-year Navy career will be winding down when he steps off the Captain's bridge, temporarily in Baltimore, and then for good in June 2004. Giving comfort from pier 92 "It's been a very gratifying job," he reflected. "I've gotten to take the ship out in many different operations and missions. And I guess the best part is training the crew and having them do their job without having to do anything. It's neat to kind of sit back and watch them work." http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA American Medical Association

Naval Hospital Ship Heads for Home After Treating Casualties of Gulf War

JAMA , Volume 289 (20) – May 28, 2003

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Publisher
American Medical Association
Copyright
Copyright © 2003 American Medical Association. All Rights Reserved.
ISSN
0098-7484
eISSN
1538-3598
DOI
10.1001/jama.289.20.2635
Publisher site
See Article on Publisher Site

Abstract

Naval Hospital Ship Heads for Home After Treating Casualties of Gulf War The US Navy Ship Comfort is on her way home from the Persian Gulf after a 4-month tour of duty that brought aboard more than 600 injured soldiers and civilians. Earlier this month, the ship discharged its last 65 patients—all Iraqi civilians, who were released to shoreside US military hospitals or to Iraqi facilities. Most of the ship's 1200-member medical and support crew flew home in late April and early May, leaving a skeleton crew of 340 to take her to port in Baltimore. As one of two hospital ships in the US fleet, the Comfort provides all the facilities seen in a big city tertiary care center—freezers with blood stored at − 82°F, an oxygen generator, a helipad, a CT scanner and x-ray machines, and 12 operating rooms. US Navy Ship Comfort is a floating hospital that provides all the facilities seen in a big city tertiary care center, including a blood bank, a CT scanner and x-ray machines, and a dozen operating rooms. (Photo credit: Courtesy of USNS Comfort Public Affairs) And then there is the equipment unique to a hospital at sea—lifeboats, desalinating equipment to supply fresh water, D-rings welded to the floor for lashing down equipment during heavy seas. Walls are lined with bright orange hand-held oxygen canisters that provide 15 minutes of air in case of fire. Space aboard a floating hospital is at a premium: Each of 16 wards holds 40 bunks. The most seriously injured patients get the bottom bed; others have to scramble above. A walking blood bank A walking blood bank Every member of the Comfort's crew, including 63 merchant marines, has been blood typed. "The crew can function as a walking blood bank at a moment's notice," said CDR Tommy Stewart, NC, USN, a nurse on the Comfort who also serves as her fire chief. A walking blood bank Fortunately, the medical staff never needed to tap into that ocean of blood. CAPT Charles Blankenship, MC, USN, said that there were several "pretty busy" periods, but the crew was never overwhelmed. If it had been, the captain, a general surgeon, would have jumped in and helped out. A walking blood bank "Acute triage wasn't that much of a problem for us," said Blankenship on satellite phone from the ship's bridge. "We had a few patients come in who were really urgently ill and had to go directly to the OR. But with the number of ORs that we have . . . we really didn't have to do the type of triage that you would have to do if you were overwhelmed." A walking blood bank During its tour, the Comfort lost "two or three" patients, said Blankenship, all Iraqi civilians who were septic after several days in the field before they arrived on the Comfort. About 200 Iraqi civilians and soldiers received treatment on the ship. On alert On alert Beginning March 22, the night that the bombing of Baghdad began in earnest, the ship went on alert for worst-case scenarios, including mass casualties from chemical or biological weapons. Those nightmares never materialized, but there were several 6-hour shifts in which 30 to 50 patients came aboard, said Blankenship. CDR Linda Nash, NC, USN, evaluates an Iraqi patient in the casualty receiving area aboard the hospital ship USNS Comfort. More than 600 injured soldiers and civilians were treated on the Comfort during the ship's 4-month tour of duty in the Persian Gulf. (Photo credit: Courtesy of USNS Comfort Public Affairs) On alert "Nearly all of those patients . . . had combat-related injuries and had to be reoperated on for internal injuries, or have their wounds cleaned and sewed up and have fracture work done," said Blankenship, who went on to describe the military's three-tiered medical care system. Forward teams treat injured soldiers with quick-and-ready procedures designed to prolong life until air or ground transport can ferry them to what the Marine Corps calls "surgical company" facilities—temporary hospitals that evoke images from the television show M*A*S*H, or at least an updated version of those Korean War–vintage field hospitals. On alert After life- or limb-saving surgery at these level-2 facilities, patients needing additional care are flown via helicopter to the Comfort. "Our role as a level 3 [facility] is the first level at which you have the subspecialties of medicine and surgery," said Blankenship. Seriously injured US patients are stabilized until strong enough to fly to Germany or to the United States. Those with lesser injuries get treated and sent back to their combat units. On alert Blankenship said that during the busy periods, the ship's medical crew made "several good saves." The most dramatic made use of the ship's newest acquisition, a fully equipped angiogram suite. During supply operations in Iraq, a marine slipped beneath a truck, which crushed his pelvis. By the time he landed on the Comfort, emergency teams had transfused seven units of blood. On alert "We were able to take him to the angiogram suite and locate the areas that were bleeding, then we put the coils in to stop the bleeding," said Blankenship. "And that saved his life. If we had tried to operate to control his bleeding, he would have died." The soldier was eventually flown to the intensive care unit at the National Naval Medical Center in Bethesda, Md, home to most of the Comfort's medical staff. From "ghost town" to hospital From "ghost town" to hospital Blankenship, too, is stationed in Bethesda, where he divides his time between operating, teaching, and maintaining the readiness of the Comfort's crew. The ship's home is a dock in Baltimore harbor, some 40 miles north of Bethesda. When called to duty, Blankenship and his crew must transform what one officer called a "ghost town" into a fully functioning hospital within 5 days. From "ghost town" to hospital To that end, Blankenship organizes quarterly orientation trips and annual exercises, called "fast cruises," in which the ship runs dockside at quarter capacity for 5 days. Actors play the part of patients, while nurses and physicians train for handling the unexpected: floods, fires, power outages, and mass casualties. From "ghost town" to hospital It was just such a scenario that launched the Comfort on its previous mission. After the destruction of the World Trade Center, the Comfort sailed to New York City. From "ghost town" to hospital Ironically, on the morning of September 11, 2001, Blankenship and another officer were in Orlando, Fla, listening to New York's emergency operations director at a meeting on the management of consequences of weapons of mass destruction. By noon, Blankenship knew that the Comfort would be sailing. From "ghost town" to hospital He rented a car and drove 900 miles, arriving at Bethesda two hours before buses rolled into Baltimore. His wife met him with his seabag, and by the afternoon of Septemeber 12, the Comfort was under way. Giving comfort from pier 92 Giving comfort from pier 92 While the ship's medical facilities were not needed, it played another crucial role. "You might say we were the ‘Comfort' Inn for the rescue workers," said Blankenship. Giving comfort from pier 92 Delivered to the Navy in 1987 as one of two converted supertankers, the $294 million, 894-foot long, 10-story high ship loomed large in Manhattan harbor, its white hull and red crosses visible between the canyons of towering skyscrapers. Giving comfort from pier 92 It also loomed large in the crazed, stressful lives of rescue workers. Parked at Pier 92 on the West Side of Manhattan for a month, the ship offered 24-hour coffee, meals, laundry service, showers, and beds. Giving comfort from pier 92 "We had just about every berthing space and every ward space on the ship"—more than 2000 beds—"filled with people from all over the world," said Blankenship. Psychologists and counselors constantly walked the ship, talking to workers and keeping an eye out for people who needed help. Giving comfort from pier 92 Some 18 months later, the Comfort has fulfilled her latest mission. Blankenship sounds both relieved and wistful when he says that his 26-year Navy career will be winding down when he steps off the Captain's bridge, temporarily in Baltimore, and then for good in June 2004. Giving comfort from pier 92 "It's been a very gratifying job," he reflected. "I've gotten to take the ship out in many different operations and missions. And I guess the best part is training the crew and having them do their job without having to do anything. It's neat to kind of sit back and watch them work."

Journal

JAMAAmerican Medical Association

Published: May 28, 2003

Keywords: ships,gulf war, 1991

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