Blown Away: From Medic to Combat Casualty

In the January edition of the Word on the Street podcast, host Rob Lawrence chats with Simon Harmer, who was a medic in the British Army who suffered life-changing injuries on October 26, 2009, whilst out on a patrol as the medic for the Coldstream Guards, a British Infantry regiment.

Simon activated an Improvised Explosive Device (IED) that resulted in life-threatening damage to both his legs and his right arm. As a result he lost his legs and endured five years of rehabilitation and surgery. What  Simon didn’t lose was his sense of humor.

What Saved My Life?

What saved my life, actually, five things are what saved my life. And maybe a little of something else that can’t be defined. I do not think I would have survived these injuries if I had received them in the UK. That isn’t a criticism of the National Health Service or the ability of the clinicians that work in the NHS, in fact many of the surgeons, doctors, anaesthetists, nurses, radiographers and medics have not only trained with the NHS, they work there on a full-time basis. I was extremely lucky to survive for the reasons I give below.

Basic Medical Training

Every serviceman and women of whatever cap badge or trade is trained to a certain standard. They are trained to treat a battlefield injury and they are taught extremely well. It’s a little bit more than basic first aid, but it’s not far off. Even the most junior servicemen is taught C.A.B.C. It is used as follows:

• C – Catastrophic Bleed. Treating a life-threatening bleed is paramount, blood is better inside the body not outside it.
• A – Open and clear the casualty's airway.
• B – Breathing – Make sure they are breathing and check they have no injuries on their chest.
• C – Circulation – Make sure they have no other bleeds; these tend to be slightly less life-threatening, but important none the less.

They are also taught the importance of applying tourniquets and administering pain relief like morphine. The ability to be able to follow this process cannot be underestimated.

The Tourniquet

This is applied to a severely injured limb after receiving a serious injury like a crush wound, gunshot wound or a blast injury. I had two of these used on me, one on each leg. I remember the left one being reapplied and the feeling that it was quite uncomfortable. I had to just suck it up and get on with it. A big bleed is the most preventable cause of death on the battlefield. Fifty percent of combat deaths and 80% of civilian deaths are due to uncontrolled bleeding. You can die from a femoral bleed in as little as three minutes, I was incredibly lucky that these relatively inexpensive items were being used.

The Combat Medical Technician

The training that the average Combat Medical Technician undergoes is immense. We were not professionally qualified, unless you had completed one of the paramedic degree courses. We were taught a great deal from primary healthcare, pharmacy, environmental healthcare, preventative healthcare, anatomy and physiology, and how to treat emergency conditions from gunshot wounds to broken arms from chest injuries to blast injuries. In not uncommon cases, we delivered this capability as a remote medic with the only back up coming from the other end of a radio or satellite phone. We took immense pride in our jobs and are an immensely proud cohort.

The Medical Emergency Response Team

The M.E.R.T was a Chinook helicopter, this was crewed but an incredible group of air crew and clinicians that included doctors, nurses and medics who were all very highly trained. This was an incredible asset to have out on operations. The bravery of the pilots who flew these massive helicopters cannot be underestimated. Many more people would have died if it hadn’t been used, from military to civilian, friend and foe. As medics we only based treatment on need not who that person was or was not. If it had not been for these "flying angels," I would not be alive today.

Camp Bastion Field Hospital

The field hospital was crammed full of incredible clinicians. Consultants and surgeons with many different areas and expertise, specialist nurses by the bucket load, and enough cutting-edge equipment with the knowledge to use it aplenty. There are loads of statistics out there to support all this, but I would like to draw your attention to just a few.

1. For the period April 1, 2006, to July 31, 2013, the survival rate for UK Armed Forces personnel at Camp Bastion was 99.6%. This was based on a total of 6,386 admissions for UK Armed Forces personnel to the hospital at Camp Bastion, of which:

• 28 (<1%) died of their injuries
• 2,746 (43%) were aero-medically evacuated back to the UK and
• 3,612 (57%) returned to their unit in Afghanistan

2. Defence statistics also receive field hospital admissions data for all other nations, including U.S. military, coalition forces and Afghan locals. For the period April 1, 2006 to July 31, 2013, the survival rate for all other admissions (including coalition military forces and Afghans) was 96%. This was based on a total of 13,547 admissions for non-UK admissions to the hospital at Camp Bastion, of which:

• 539 (4%) died of their injuries
• 13,008 (96%) left the field hospital alive (MOD do not track coalition or Afghan populations after they have left the UK military hospital).

These figures are incredible. More information can be found at Defence Statistics Health. The whole team who worked in the field hospital were amazing, from the management team to the clinical team to the teams who arranged and then flew us out (Thanks, Jo Potter.)

The last thing I wanted to mention, which I suppose could be the sixth "thing" that kept me alive and that was the desire to live, the bloody minded need to get back home and reunite with my family and friends. The way I live my life now is my way of repaying this massive debt I feel I owe to all those people who kept me living. I live my life to the fullest.