NSA Station Hospital, Da Nanag: A Personal History - Part 2
The whole area of Receiving I intimidated. Large signs in the open covered outdoor triage beside the main walkway shouted in red OFF LIMITS and USE OF CAMERAS PROHIBITED. This was the first overflow triage. The main Receiving I Quonset hut was beside it.
OFF LIMITS greeted you in red at the door to the main Receiving I Quonset. Inside, the place was all business. On either side of the hut near the rounded ceiling, pipes extended the length of the room suspending bottles of Ringer’s lactate, ready for use. Pairs of saw horses lined both sides below the pipes, pulled out to support stretchers bearing casualties as they arrived. Jelcos and other equipment filled bins along the walls, and there was a cardiac board that doubled as a pinochle table. Along the front wall, near the door, hung Unit Ones, flak jackets, and helmets. The wall was lined with suction machines for chest tubes. The floor was concrete, stained brownish red, a drain in the center. The room was incredibly cold, and a sickly green light from bare overhead fluorescent tubes bathed the grayish interior.
A complement of corpsmen and stretcher bearers was assigned to Receiving I. The bearers, mainly Seabees or seamen from the fleet, kept the triage clean, moved the patients from the chopper to triage to X-ray and pre-op, and sometimes performed medical procedures we taught them in case we were overloaded.
Receiving I corpsmen were at the top of the pecking order, a special bunch. But you had to prove yourself, and they doubted new personnel, especially those who had served on medical wards. It was mostly learning by doing, and the corpsmen who had served on surgery wards had a shorter learning curve.Receiving I Photos
Only one MD oversaw Receiving I, a junior surgeon on twenty-four hour duty, who called the duty senior physician if surgery was required. There were no nurses, no anesthetists, and the doctor was not on premises until needed. When casualties came in the corpsmen assessed the situation and began IVs using 14-guage Jelcos, usually one in each arm and one in the neck. Corpsmen did venous cut-downs, inserted chest tubes, inserted tracheal tubes and performed other emergency surgery. They were also on call to handle emergency ambulance runs and occasional chopper runs.
There were three triage areas. The main one was the Quonset hut. The first open unit outside was set up much as the Quonset hut, saw horses below pipes suspending bottles of Ringer's lactate ready for use. As with the Quonset, vials of emergency fluids, mainly for those in cardiac arrest, were also at hand, but I believe the sterile pack with chest knife was only kept inside.
Across the walkway, the third area was full of saw horses and pipes, but IVs were not kept ready. This was for overflow mass casualties, and when it was needed personnel from other areas, like the laundry or pharmacy, would be brought in to set up IVs and haul stretchers. During the Tet offensive the three areas were full most of the time, and stretchers were lined up along the walkway waiting for X-ray or to get into the pre-op, which was also full.
The drill with wounded was well worked out. Corpsmen and stretcher bearers ran to meet the chopper, with the bearers carrying empty stretchers in case the wounded were just stacked up on the floor of the chopper, which often happened, particularly with the CH-46, or if the wounded were on tanks or amtraks. Sometimes a CH-46 would be so loaded with wounded I wondered why those on the bottom didn't suffocate.
The wounded were brought in and their stretchers placed on the saw horses. Clothes and boots were cut off, blood pressure and pulse taken and written on bare chests in black marker. Three IVs with Ringer's were started and blood taken for cross matching at the blood bank, though sometimes this was difficult when the pressure was so low blood wouldn't flow. I remember seeing corpsmen do femoral sticks to find blood and start an IV, only to later have to restart it when pressure would build up enough to force the blood back into the bottle, having hit the artery and not the vein. Sometimes what flowed from wounds was Ringer's lactate. Seeing chests with 0/0 and 0 in black marker was not uncommon.
Circling above the room in my mind's eye, I can see the concrete floor covered with clotting blood like great mounds of liver, naked young men littering the room on blood stained green stretchers while desperate corpsmen shout at them: "Make a fist!" starting an IV in the forearm, or "Bear down like you have to take a shit" trying to force up the vein in the neck.
During mortar and rocket attacks we stayed with the wounded and hoped for the best. There were enough hits on the chopper pad just outside the triage that the Seabees finally put up a pair of barricades of stacked railroad ties in front of the main Quonset hut and the outdoor triage to stop shrapnel. Fortunately, none of the triages ever took a direct hit, though wards and an OR did.