title: Simultaneous surgeries in a split forward surgical team: a case study.
abstract: BACKGROUND
  The 541st Forward Surgical Team performed split-based operations, with one site in the city of Pol-e-Khumri. One evening, the 10-person team received two pediatric patients simultaneously and conducted simultaneous surgeries.
  
  
  METHODS
  The 3-year-old female sustained severe injuries to bilateral lower extremities and a puncture wound to her right forearm. The 13-year-old sustained fragmentary wounds to her left hand, left foot, right medial calf, and evisceration to her left lower quadrant. The patients presented in extremis after being taken to a civilian hospital initially, spending approximately 1.5 hours receiving no resuscitative therapy. The 3-year-old underwent amputations of bilateral lower extremities and a fasciotomy of the right forearm. The 13-year-old survived an exploratory laparotomy and irrigation and debridement of intra-abdominal wounds.
  
  
  CONCLUSIONS
  The successful completion of simultaneous surgeries, by a split forward surgical team at a remote location, for two critically ill patients is possible. It should not become the standard of care. Prior planning made this occurrence feasible and safer, but such situations put the patients at risk for complications.
authors.affiliation: 541st Medical Detachment, Forward Surgical (Airborne), 44th Medical Brigade, Building A-6634 Gorham Street, Fort Bragg, NC 28310, USA.
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Vanfosson
authors.forename: Jason M
authors.initials: JM
authors.lastname: Seery
mesh_terms: D000293:Adolescent; D055826:Afghan Campaign 2001-; D000671:Amputation, Surgical; D002675:Child, Preschool; D003646:Debridement; D005260:Female; D015276:Health Care Rationing; D006772:Hospitals, Military; D006801:Humans; D009104:Multiple Trauma / Q000601:surgery*; D010348:Patient Care Team / Q000458:organization & administration*; D014218:Triage; D014481:United States; D014950:Wounds, Penetrating / Q000601:surgery*