Anesthesiologic and Surgical Experiences of the Spanish Role 2 Enhanced in Herat, Afghanistan

Abstract

Background: In 2001 the Council of Ministers of the Kingdom of Spain authorized the participation of Spanish military units in the International Security Assistance Force (ISAF) in support of the Afghan government. Four years later, Spain assumed control of the Forward Support Base in Herat (Afghanistan). Because of its capabilities, personnel, and equipment NATO considered it as the medical reference installation for the four provinces that form the western region of Afghanistan. Objectives: The current report aimed to describe anesthesiology and surgical experiences of Role 2 Enhanced (Role 2E) in heart, Afghanistan, from March to May 2014. Patients and Methods: An observational, descriptive, retrospective study was conducted from March to May 2014. The civilians and military personnel wounded by firearm or explosive detonation in western Afghanistan, who were treated at the Role 2E in herat were included. There were no exclusion criteria. Results: Seven hundred and forty five patients including 181 Afghan civilians, 82 non-Afghan civilians, 24 Afghan police and military, and 458 military ISAF, were treated during the study period. There were 10 combat casualties among them. All patients were male and aged 2530 years; seven had been injured by an explosive and three by firearm; five with head-neck wounds, two with wounds in the upper limbs, two in the abdomen, one in the thorax, and one in the lower limbs. The New Injury Severity Score (NISS) was one mild, five moderate and four severe. There were 14 surgical patients (seven wounded in combat and seven non-combat casualties, and 12 patients were admitted to the Intensive Care Unit (ICU). None of them died. A total of 12 general anesthesias, 11 regional anesthesias (three intradural anesthesias, three interscalene blocks, one axillary block and four femoral blocks) and six local anesthesias with sedation were performed. Conclusions: During the study period, 745 patients were treated, including 10 combat casualties. Twelve general anesthesias, 11 regional anesthesias (three intradural anaesthesias, three interscalene blocks, one axillary block, four femoral blocks), and six local anaesthesias with sedation were performed. Twelve patients were admitted to the ICU. These anesthesiological and surgical experiences can be helpful in future military deployments.