This is the second in a three-part series.
Lindsay Mangum, NPR
A wounded soldier's journey can go from the battlefield to a field hospital at Balad Air Base — about 60 miles north of Baghdad — and then to an army medical center in Landstuhl, Germany, all in a matter of hours.
A wounded soldier's journey can go from the battlefield to a field hospital at Balad Air Base — about 60 miles north of Baghdad — and then to an army medical center in Landstuhl, Germany, all in a matter of hours. Lindsay Mangum, NPR
Guy Raz, NPR
Lt. Kevin "Brad" Mellinger, about 20 minutes after he was shot in the thigh. The high-velocity round shattered his femur.
Lt. Kevin "Brad" Mellinger, about 20 minutes after he was shot in the thigh. The high-velocity round shattered his femur. Guy Raz, NPR
Nearly 30,000 U.S. troops have been injured in Iraq — about half of them with permanent disabilities. In Iraq and Afghanistan, troops who are wounded in an attack have a 95 percent chance of surviving. It's the highest survival rate in the history of warfare.
Once a serviceman or woman is injured, they enter a kind of conveyer-belt of treatment that begins with an evacuation from the battlefield to the trauma ward at Balad Air Base. Soldiers then go to the U.S. Army hospital in Landstuhl, Germany, thousands of miles away. It's a cycle that sometimes takes just a few hours.
NPR's Defense Correspondent Guy Raz presents a three-part series on critical care in the war zone. Part One of the series starts on Morning Edition Thursday with a look at an Army helicopter unit that flies to the battlefield to rescue those injured. Part Two, which airs on All Things Considered Thursday, will examine the air force hospital at Balad Air Base, one of the most advanced combat field hospitals in the history of warfare. Finally, Part Three — which airs Friday on Morning Edition — will follow an injured soldier to a U.S. Army medical center in Landstuhl, Germany.
Guy Raz, NPR
A large American flag is the first thing patients see when they're wheeled off the chopper at the air force hospital at Balad Air Base. It's a sign that "everything's gonna be ok," said Col. Patrick Storms, commander of the Balad Medical Center.
A large American flag is the first thing patients see when they're wheeled off the chopper at the air force hospital at Balad Air Base. It's a sign that "everything's gonna be ok," said Col. Patrick Storms, commander of the Balad Medical Center. Guy Raz, NPR
Air Force Maj. James Eadie is the coordinating surgeon on-call one recent evening at Balad field hospital in Iraq. He has just been informed that four U.S. soldiers are coming into the trauma ward.
"OK, listen up," he shouts out to a crowd of about 30 medical technicians and doctors. "We got four patients coming in."
Three have taken shrapnel from an IED blast. One of them has been hit in the thigh by a high-velocity round.
At this moment, the clock starts ticking. Balad field hospital is located within Balad Air Base, about 60 miles north of Baghdad. It is the most advanced forward-operating combat hospital in the history of warfare.
Within minutes, four medics wheel gurneys into the E.R. One soldier's left thigh is wrapped in a blood-soaked bandage. Dr. Eadie races to his side.
"What's your name?" Eadie asks. "Mellinger," says the soldier. "Brad Mellinger."
"Ok, Brad, can you touch your toes for me?" asks Eadie.
Mellinger can't. His left femur is shattered in a hundred different pieces.
Twenty minutes before, Mellinger, who goes by Brad but is named Kevin, was running a reconnaissance mission on the banks of the Tigris River when he went down.
He's talking, which is a good sign. But he's in agony. A medic approaches the gurney and administers 10 milligrams of morphine.
Lt. Col. Jeffrey Bailey, the chief surgeon, takes notes. "He seems like a guy with a potentially life-threatening injury," Bailey says quietly.
The femur is the strongest and longest bone in the body. It's in a part of the body that holds the most blood; a wound to the femur can mean death by bleeding unless the circulation is temporarily cut off.
Dr. Jeff McNeil, a major in the Air Force, works to get the bleeding under control. It takes just minutes before McNeil can be confident that Lt. Kevin Mellinger will survive.
About 45 minutes later, McNeil will move to the operating room to clean out Mellinger's wound, washing out bits of bullet and bone fragments from his thigh.
"And then we'll get him on the next flight to the [U.S.] Army hospital in Landstuhl [Germany]," McNeil says.
Unprecedented Survival Rates
The case of Kevin Mellinger is instructive. It says a lot about how combat medicine has changed.
In Vietnam, a soldier with Mellinger's wound had a 33 percent higher chance of dying. In Iraq, he can count himself among the 95 percent of the wounded who live.
"It's a sad fact that surgery has advanced and benefited from all the tragedies and trials of war," said Lt. Col. Christopher Coppola.
Coppola, like all the other doctors at the Air Force medical center at Balad, is a specialist back home. He does pediatric surgery, but in Iraq he's a trauma surgeon.
Coppola says the kind of trauma he has seen here is incomparable to what he would see in the U.S. A single patient here may have a destroyed eye, shrapnel embedded in the body, massive chest wound and missing limbs.
"And so you come over here and work for four months, as we Air Force surgeons do, and it's as if you work in a busy trauma center for two years," Coppola said.
After Vietnam, the use of tourniquets went out of fashion. It often took six to eight hours to transport a Vietnam-era soldier from the battlefield to a trauma center. In that time, a tourniquet could lead to gangrene, infection and either an amputation or slow death.
But in Iraq, the combination of tourniquets, chemical blood-clotting pads and lightning-fast transport to this field hospital have resulted in unprecedented survival rates. Most often, the field medics — sometimes a young private-first class — are the first ones to treat the wounded.
"And they [the field medics] know not to waste time doing too many procedures," says Coppola.