Incoming Patient: Trauma #3309

It's a running joke here that the report you receive concerning an incoming patient rarely resembles what comes rolling in the door. It's like a game of telephone-so any information we receive is taken with a grain of salt. The report for trauma patient #3309 was surprisingly accurate. We were told it was going to be an AUP (Afghan Uniformed Police) with a gunshot wound (GSW) to the pelvis. The patient did in fact have a gunshot to his pelvis. The one major inconsistency with the report was the fact that the patient was not an AUP-he was a 12 year old boy.

Waiting for the MEDAVAC helicopter. The gentlemen with the flashlights will inspect the patient for weapons and unexploded ordnance.

From the beginning, the story we received from the patient (via our translator) didn't add up. The child claims to have been shot while watching a firefight from the roof of his home. He was found to have a cell phone (unusual for a 12 year old in Afghanistan) and a live 7.62 mm round in his possession. The trajectory of the projectile is inconsistent with the explanation of events. Clearly there is more to the story.

ATLS Station. Initial evaluation and resuscitation. Our medics are establishing IV access while the surgeon and CRNA assess the patient.

A GSW to the pelvis is an extraordinarily dangerous injury. There are a number of rather large blood vessels that are located in this area, and damage to any one of them can be life threatening. We were prepared for the worst but hoping for the best.

If you look closely, you can see the entrance wound by the surgeon's left hand. The exit wound is posterior-lateral right buttock area.

Believe it or not, this kid was lucky. If the bullet had traveled one inch in either direction, he would likely not have made it to us alive.

This is typical of Afghanistan. You rarely get the whole story. I still don't know the circumstances of why or how this child was shot. Likely, the child was obfuscating to protect either himself or someone else. What I do know is that this is the second child we've taken care of in less than two weeks that suffered a gunshot wound. Sadly, this is not an anomaly in Afghanistan. In the US, a child getting shot is a tragedy. In Afghanistan, it's just another day.


Major Randall Moore, CRNA
1980th Forward Surgical Team
FOB Sharana, Afghanistan