The theme of the day yesterday was head injuries. Several varieties; large lacerations from shrapnel, penetrating eye injuries, gunshot wounds, etc. We are really getting into a rhythm as teams. We have 15 min after patients arrive to get trauma survey done, bleeding controlled, IVs , dressings, and splints done, antibiotics and pain control on board, and paperwork done. We do not have opiates, so use sub-dissociative doses of ketamine, typically 25 mg or so, and an IV formulation of tramadol. When we have TXA we give it to anyone with significant bleeding. We are constantly cleaning and restocking in preparation for patients who may arrive without notice. Female patients here can only be cared for by women, so when needed we shuffle teams to create a “team pink” and have the ability to curtain off a bed in back. Between runs of patients the soldiers are feeding us very well. I had 4 breakfasts yesterday. Most meals are seved from a single large pot and eaten with fresh pita bread. I am continuing my tradition of no mystery meat like in Haiti. We are all well.
On April 25, 2015, a violent 7.8-magnitude earthquake struck Nepal, followed weeks later by a 7.3-magnitude aftershock,
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