title: Battlefield casualties treated at Camp Rhino, Afghanistan: lessons learned.
abstract: BACKGROUND
  Operation Enduring Freedom is an effort to combat terrorism after an attack on the United States. The first large-scale troop movement (> 1,300) was made by the U.S. Marines into the country of Afghanistan by establishing Camp Rhino.
  
  
  METHODS
  Data were entered into a personal computer at Camp Rhino, using combat casualty collecting software.
  
  
  RESULTS
  Surgical support at Camp Rhino consisted of two surgical teams (12 personnel each), who set up two operating tables in one tent. During the 6-week period, a total of 46 casualties were treated, and all were a result of blast or blunt injury. One casualty required immediate surgery, two required thoracostomy tube, and the remainder received fracture stabilization or wound care before being transported out of Afghanistan. The casualties received 6 major surgical procedures and 11 minor procedures, which included fracture fixations. There was one killed in action and one expectant patient. The major problem faced was long delay in access to initial surgical care, which was more than 5 hours and 2 hours for two of the casualties.
  
  
  CONCLUSIONS
  Smaller, more mobile surgical teams will be needed more frequently in future military operations because of inability to set up current larger surgical facilities, and major problems will include long transport times. Future improvements to the system should emphasize casualty evacuation, en-route care, and joint operations planning between services.
authors.affiliation: Department of Surgery, 1st Medical Battalion/Naval Hospital Camp Pendleton, California, USA.
authors.forename: Tracy R
authors.initials: TR
authors.lastname: Bilski
authors.forename: Bruce C
authors.initials: BC
authors.lastname: Baker
authors.forename: Jay R
authors.initials: JR
authors.lastname: Grove
authors.forename: Robert P
authors.initials: RP
authors.lastname: Hinks
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Harrison
authors.forename: John P
authors.initials: JP
authors.lastname: Sabra
authors.forename: Steven M
authors.initials: SM
authors.lastname: Temerlin
authors.forename: Peter
authors.initials: P
authors.lastname: Rhee
mesh_terms: D000346:Afghanistan; D005121:Extremities / Q000293:injuries* / Q000601:surgery; D013502:General Surgery / Q000458:organization & administration; D006772:Hospitals, Military / Q000458:organization & administration; D006801:Humans; D008887:Military Medicine / Q000458:organization & administration; D008889:Military Personnel; D008952:Mobile Health Units / Q000458:organization & administration; D014194:Traumatology / Q000193:education / Q000458:organization & administration; D014481:United States; D014857:Warfare