(This is the final article in a five-part series on the 54th Chief of Engineers’ visit to the Transatlantic Afghanistan District)
The 54th Chief of Engineers and USACE Commanding General, along with USACE Command Sergeant Major spent just 48 hours on the ground in Afghanistan and in that short amount of time touched base with almost all of the engineer regiment in theater.
Command Sergeant Major Brad Houston was able to take a special tour at Bagram while the Commanding General was in Kabul.
Craig Joint Theater Hospital (CJTH) hosted CSM Houston to the Path of the Patient, which took him on a typical route a patient would take when arriving to the hospital.
On this particular day there was an actual patient coming into the hospital and CSM Houston saw how the En Route Patient Staging System (ERPSS) worked. This team of professionals is responsible for coordinating and moving all Aeromedical Evacuated patients to and from the hospital along with the responsibility for safely and securely escorting our Afghan nationals who are being discharged from the hospital or are returning for follow-up medical services.
Warrior’s Way begins the journey patients take into the hospital. As the U. S. flag adorns the ceiling of the emergency bay, it’s a calming effect that allows that “sense of home, sense of pride” instilled in so many of the patients who have had to take this path.
Deputy Commander Clinical Services (DCCS) personnel explained the triage system, under the stars, of the flag that is, while the Trauma Czar, who serves as the medical director of all trauma care at CJTH explained their role in the triage and immediate resuscitation of injured patients, along with deciding the course of care, treatment, and disposition for all trauma patients. The Trauma Czar is also responsible for coordinating operative cases for all the patients, along with critical care provider for all ICU patients; ventilator management, dialysis, and other organ support functions/procedures.
CSM Houston was introduced to members of the Patient Administration and Disposition(PAD) team learning that they are the ones who clear all patients and bags before they enter the facility and assigning trauma names to allow the staff to expedite and pre-order ancillary services such as laboratory testing, radiology imaging, and medications.
Standing in one of the largest Role III Trauma Emergency Departments (ED) in the Area of Responsibility, where the temperature was a scorching 89 degrees, CSM Houston saw the first patient contact for all battle injuries coming through CJTH, to include treating patients from Foreign Operating Bases (FOBs) all over Afghanistan. The Trauma bay is kept at a temperature between 85 to 95 degrees, has 6 beds and team that consists of the Trauma Czar, ER Doctor, 2 Registered Nurses, 1 Tech, and Respiratory Therapist, along with all specialists’ doctors as needed.
Outside the Trauma Bay nine chairs are lined up and when needed these team of subspecialists fill the seats. Those specialists include general, trauma, orthopedics, neurosurgery, urology, Ear Nose & Throat, ophthalmology, and vascular.
Also outside the Trauma Bay are 4 more beds where most patients are no-emergent with like twisted ankle, belly pain, headache, but some are more emergent like heart attack or stroke.
Continuing on the Path of the Patient individuals on this tour were shown where the Laboratory, Pharmacy, Operating Room, and Logistics folks were located. They were also taken by the Intermediate Care Ward (ICW) which is a 19 bed unit with expansion capabilities up to 30. An important role among this team of hospital professionals are the six linguists who foster communications between the health care team and the patient/family members. They translate daily communication as well as written discharge instructions into either Dari or Pashtu.
CSM Houston was given a thorough tour on this Path of the Patient as he was shown the continuity of care process from before they entered the hospital up to the time they were discharged. From Intensive Care Unit Facilities to the Outpatient Clinic it was clear that this team of professionals maintained a steady path.