MERT

#21
In terms of the type of injuries, I think that she was referring to people surviving injuries that previously would have meant they died at the scene, during evacuation or shortly after arriving at hospital.

I don't think that before Bastion anyone had seen more traumatic injuries in live patients, or as many. I heard it said that one would see more serious trauma in a 3-month tour in the Role 3 than a trauma surgeon would see in an entire career.



Because the thinking, both in military and civilian medicine, was that blood was something that was only used in hospital. It generally takes ages for new ideas to be adopted. Take, for example, civilian air ambulances. Started in Germany in the mid-60s, only reached here in the very late 80s/early 90s, and still not funded as part of the NHS.

Then there's cost; before UORs these things might be considered, but then discarded on the grounds that they might not be used.



A number of paramedics left after tours - I don't think anyone had a major drama during a tour.



Train a limited number of paramedics; then cut the numbers training during Herrick for money-saving; utilise the ones you have on back to back tours in the busiest trauma system in the world; sit back and watch them leave for less stressful, better paid jobs outside. Or long-term MH-related sickness.



MERT can carry four patients. They often did several missions in a 24-hour period. There were times when there seemed to be a never-ending stream of casualties coming in - both our side, en forces and civilians. I don't think it's an unrealistic number, allowing for DM journalistic embroidery. In one month on my last tour we saw over 20 patients with bilateral traumatic amputations.

But of course, if you think you could do better....
Of course I can do better. Ich bin ein arrser.
 
#22
"At one point both the MERT teams were working 24 hours a day for ten days without a break"

I don't entirely buy this claim. It would imply no sleep for ten days, which is barely credible. Nobody denies the commitment, dedication and professionalism of the MERT - but I suspect that this includes time "on call" (and asleep) - certainly in 2007 (on H6 at least) the MERT was rarely tasked during the dark hours.
MERT med teams were on immediate readiness for 12 hours, followed by 12 hours on very short notice, so that it was possible to have two teams available very quickly.

I think it would be a mistake to imagine that 'on call' (for MERT, this meant being mostly confined to their crew room), or able to sleep, means proper rest. I've seen MERT teams almost collapsing with fatigue after fighting to save someone's life in the back of the Chinook - but they had to be ready to do it again, at once. They didn't complain.

Like so many things in the armed forces in general and Herrick in particular, it was the commitment and dedication of the crews that made MERT the world-leading service that it was, not the clerks and copy-boys of the MOD.

Across the board the number of medical and nursing staff now reporting MH problems is rising; it's my view that to some extent the medical services on Herrick were victims of their own success. Everyone was stretched; everyone was aware that what they were doing was absolutely essential to the overall success of the mission. Their was most certainly a 'buzz' about being part of a team that was not only the busiest trauma centre in the world, but had the highest survival rate. No wonder no-one wanted, at the time, to raise the spectre of stress, and be perceived as a weak link.

I know some people who suffered in silence, and only now are getting the treatment they need. A lesson for the future, but - like training paramedics - not one I am convinced the heirarchy have learned.
 
#24
MERT med teams were on immediate readiness for 12 hours, followed by 12 hours on very short notice, so that it was possible to have two teams available very quickly.

I think it would be a mistake to imagine that 'on call' (for MERT, this meant being mostly confined to their crew room), or able to sleep, means proper rest. I've seen MERT teams almost collapsing with fatigue after fighting to save someone's life in the back of the Chinook - but they had to be ready to do it again, at once. They didn't complain.

Like so many things in the armed forces in general and Herrick in particular, it was the commitment and dedication of the crews that made MERT the world-leading service that it was, not the clerks and copy-boys of the MOD.

Across the board the number of medical and nursing staff now reporting MH problems is rising; it's my view that to some extent the medical services on Herrick were victims of their own success. Everyone was stretched; everyone was aware that what they were doing was absolutely essential to the overall success of the mission. Their was most certainly a 'buzz' about being part of a team that was not only the busiest trauma centre in the world, but had the highest survival rate. No wonder no-one wanted, at the time, to raise the spectre of stress, and be perceived as a weak link.

I know some people who suffered in silence, and only now are getting the treatment they need. A lesson for the future, but - like training paramedics - not one I am convinced the heirarchy have learned.
Typical that the medical fraternity perhaps didn't look after themselves as well as they could.

I know some of the civvy nurses contracted at basra bailed at the point where they joined the dots between the life changing injuries they were seeing and reality of getting idf'd

I'm presuming there is a strong guilt element. "I'm safe in a camp while the patients we are receiving are living in fobs and literally risking life and limb I shouldn't admit to stress"
 
#25
Unexpected numbers? We were briefed prior to H08 that we could expect on average 1 dead per week and 1 life changing injury (single/double/triple/quad amp or sight) per day "with luck, it won't be you but learn your drills for your mate". That little stat stuck with me...
 
#26
MERT med teams were on immediate readiness for 12 hours, followed by 12 hours on very short notice, so that it was possible to have two teams available very quickly.

I think it would be a mistake to imagine that 'on call' (for MERT, this meant being mostly confined to their crew room), or able to sleep, means proper rest. I've seen MERT teams almost collapsing with fatigue after fighting to save someone's life in the back of the Chinook - but they had to be ready to do it again, at once. They didn't complain.

Like so many things in the armed forces in general and Herrick in particular, it was the commitment and dedication of the crews that made MERT the world-leading service that it was, not the clerks and copy-boys of the MOD.

Across the board the number of medical and nursing staff now reporting MH problems is rising; it's my view that to some extent the medical services on Herrick were victims of their own success. Everyone was stretched; everyone was aware that what they were doing was absolutely essential to the overall success of the mission. Their was most certainly a 'buzz' about being part of a team that was not only the busiest trauma centre in the world, but had the highest survival rate. No wonder no-one wanted, at the time, to raise the spectre of stress, and be perceived as a weak link.

I know some people who suffered in silence, and only now are getting the treatment they need. A lesson for the future, but - like training paramedics - not one I am convinced the heirarchy have learned.

It'd probably be a good time to establish your credentials. I get the impression from other posts that you're a 'first responder' (your words, I think).

Does this mean that you're a civvi paramedic who's worked on MERT?
 
#27
It'd probably be a good time to establish your credentials. I get the impression from other posts that you're a 'first responder' (your words, I think).

Does this mean that you're a civvi paramedic who's worked on MERT?
Nah. He's done a St.John's course and bought a copy of this from the Oxfam bookshop*
61IBToF-QjL._SX355_BO1,204,203,200_.jpg


*Do you ever read people's posts? :rolleyes:
 
#29
Lads don't get me wrong in no way did I intend to be belittle the amazing work the MERTs do but I'm surprised / disappointed at just how (institutional) the British forces were for what the met at even the most basic level in Afghanistan. Especially considering their experience
 
#30
It'd probably be a good time to establish your credentials. I get the impression from other posts that you're a 'first responder' (your words, I think).

Does this mean that you're a civvi paramedic who's worked on MERT?
See my avatar - ex-RAF Flight Medic. Two Herrick tours in the Role 3. Now a volunteer CFR.
 

Forastero

LE
Moderator
#31
Lads don't get me wrong in no way did I intend to be belittle the amazing work the MERTs do but I'm surprised / disappointed at just how (institutional) the British forces were for what the met at even the most basic level in Afghanistan. Especially considering their experience
It's less about institutional rigidity and more about clinical governance. Whilst the two may not seem dissimilar, the latter is designed to protect patients. It could be argued that not carrying blood on a MERT may be seen as an odd practice but when set against resuscitation protocols, a scarce resource and the ability to transport it around safely it can make more sense to keep it in the hospital where it can administered more safely whilst undergoing lifesaving surgery rather than risking the loss of it in the chaotic environment of a Chinook. It's a moot point as they started carrying it anyway but the medical world is beset with issues such as these that are not always easy to resolve, despite how simple and obvious it looks at face value.
 
#32
The MERT crews used to share camp 252 with the EOD group, my tent was two down from theirs, which did resemble M*A*S*H. I never really spoke to them, but did pass pleasantries as I passed.

I wonder if they made the connection when they scooted me up.
 

greyfergie

MIA
Book Reviewer
#34
It's less about institutional rigidity and more about clinical governance. Whilst the two may not seem dissimilar, the latter is designed to protect patients. It could be argued that not carrying blood on a MERT may be seen as an odd practice but when set against resuscitation protocols, a scarce resource and the ability to transport it around safely it can make more sense to keep it in the hospital where it can administered more safely whilst undergoing lifesaving surgery rather than risking the loss of it in the chaotic environment of a Chinook. It's a moot point as they started carrying it anyway but the medical world is beset with issues such as these that are not always easy to resolve, despite how simple and obvious it looks at face value.
There isn't one 'blood' it can get pretty complicated
 
#35
It's less about institutional rigidity and more about clinical governance. Whilst the two may not seem dissimilar, the latter is designed to protect patients. It could be argued that not carrying blood on a MERT may be seen as an odd practice but when set against resuscitation protocols, a scarce resource and the ability to transport it around safely it can make more sense to keep it in the hospital where it can administered more safely whilst undergoing lifesaving surgery rather than risking the loss of it in the chaotic environment of a Chinook. It's a moot point as they started carrying it anyway but the medical world is beset with issues such as these that are not always easy to resolve, despite how simple and obvious it looks at face value.
I wasn't just talking about MERT
 
#36
The MERT crews used to share camp 252 with the EOD group, my tent was two down from theirs, which did resemble M*A*S*H. I never really spoke to them, but did pass pleasantries as I passed.

I wonder if they made the connection when they scooted me up.

Probably not. Given your idea of being pleasant, that was probably very fortunate for you.

'oooh look, it's Dingerr'

'Aye. Not looking good for him, is it? Get your fags out lad, it's your crash'

'Is it fùck, I got em out in the chopper, it's Smudger's crash... Smudge, SMUDGE, fags out'

Etc.
 

CD05

Old-Salt
#38
The MERT crews used to share camp 252 with the EOD group, my tent was two down from theirs, which did resemble M*A*S*H. I never really spoke to them, but did pass pleasantries as I passed.

I wonder if they made the connection when they scooted me up.

I was an army paramedic who worked on the MERT cab dingerr and believe me mate when we picked our own up we genuinely did remember people we had seen around various places which is not a nice feeling!

With regards Charlie Thompson I had the honour to work with her and many other outstanding medical professionals and from what I remember she was the SO1 MERT and double hatted as the OC as well. Not that anyone will believe me on here but she is pukka her facts and figures are pukka and to my knowledge she hasn't looked to publish any books!

The bloods issue was initially down to legality funnily enough you don't just decide "ah I could've used blood on that last job il just go grab some now!" And if you research it you will see that there's some air ambulances in the UK that still can't carry blood or blood products.


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