Surgical workload, Role 3 Multinational Hospital, Kandahar Airfield, Afghanistan

2 February 2007 – 11 February 2009

FLTLT Katrina Franke

SMO/AEOO TG633.9.3

Kandahar, Afghanistan May‐Nov 2008.

Objectives

•Australian Medical Officer role, Kandahar

•Hospital layout/ setting

•Surgical Statistics

•Medical Officer preparation

•Personal perspective

Senior Medical Officer, Australian Defence Forces, Kandahar Airfield, Afghanistan

May – November 2008

• SMO Australian Forces (RAAF position) – (primary care of ~180 troops, together with 3 Medassts)

• Aeromedical Evacuation Organising Officer (AEOO) Afghanistan

• Duty Medical Officer, Multinational Hospital, Kandahar Airfield– (1 x 10 hour, 1 x 14 hour shifts weekly)

• Women's Health Clinic, Shirzai Hospital, Kandahar.

Senior Medical Officer, Australian Defence Forces, Kandahar Airfield, AfghanistanMay – November 2008

•SMO Australian Forces (RAAF position) •(primary care of ~180 troops, together with 3 Medassts)

•Aeromedical Evacuation Organising Officer, Afghanistan

•Duty Medical Office, Role 3 Multinational Hospital•(12-24 hours weekly)

•Women's Health Clinic, Shirzai Hospital, Kandahar.

Surgical cases2 February2007 – 11 February 2009 (740 days)

2155 cases

– 1885 adults (87.5%)

– 269 paediatric (12.5%)

– 1 canine

Surgical breakdown by population2 February 2007 – 11 February 2009

Surgical breakdown by population2 February2007 – 11 February 2009

ONALITY SURGICAL CASES

Nationals 850 (39.4%)

460 (21.0 %)

on 373 (17.3%)

346 (16%)

nees 64 (3.0%)

not specified 62 (3.0%)

2155 (100%)

Surgical Cases breakdown – coalition2 February2007 – 11 February 2009

Coalition surgical breakdown2 February2007 – 11 February 2009

ONALITY SURGICAL CASES

can 146 (39%)

dian 127 (34%)

h 48 (13%)

alian 11 (3%)

11 (3%)

30 (8%)

Operation number per day2 February2007 – 11 February 2009 (740 days)

NUMBER OF OPERATIONS NUMBER OF DAYS

11 1

10 2

9 3

8 8

7 16

6 39

5 73

4 121

3 140

2 152

Case Length2 February2007 – 11 February 2009

Average surgical case length – 117 min– Vascular surgery – 212 mins– Neurosurgery – 180 mins– Oral and maxillofacial surgery – 160 mins– Orthopaedic – 120mins– General surgery – 108 mins– Plastic surgery – 96 mins

Injury types2 February 2007 – 11 February 2009

Injury / Operation types2 February2007 – 11 February 2009

Extremity injuries (518)• amputations – upper and lower limb • ORIF, Ex Fix • closed reductions

Injury / Operation types2 February2007 – 11 February 2009

Neurosurgery / Head and Neck (476)• Craniotomy, Maxillofacial ORIF, Eye Enucleation,

Neck exploration, Soft tissue injury repair

Injury / Operation types2 February2007 – 11 February 2009

Torso Injuries (382)• Thoracotomy, Laparotomy, soft tissue injuries

Vascular repairs (56)• lower limb – femoral/popliteal/saphenous (34),

Radial/brachial (18), jugular (2), ulna (2)

Injury / Operation types2 February2007 – 11 February 2009

Laceration repair / Incision and drainage (623)Burns (19)

re‐deployment preparation/training

Military requirements– EMST, FWAME, OHS, Aviation Medicine– ? RWAME

Emergency/trauma medicine – Trauma training e.g.. Royal Adelaide Hospital– ED shifts

re‐deployment preparation/training

Remember EMST principles TeamworkFlexibility

Acknowledgment

CAPT Ken Iwassa – Canadian ForcesSQNLDR Mary Langcake – RAAF SR