'This is what we are trained to do,' say the medics battling to save lives in Afghanistan
An emergency alert comes in to the trauma department in Camp Bastion. Details remain minimal for now, but an elite team of medical experts spring into action.
At this stage all we know is an Afghan National has a bi-lateral amputation – both his legs lost to an Improvised Explosive Device.
While a helicopter team, known as Pedro, evacuates the man, the trauma team of 243 Field Hospital and 3 Medical Regiment assemble in Resus Bay 1. In this compact area wait an anaesthetist, radiographer, radiologist, operating department practitioner, junior doctor, consultant, senior nurse and three other nurses.
A yellow tape divides the room into a square with a smaller area just feet away which in minutes will be filled with surgeons, orthopaedic consultants, nurses and theatre staff. Outside the main doors to the 'ED' a team of front-of-house staff wait for the ambulance.
We hear the rotors of the helicopters, which always fly in pairs, land nearby and the sirens of the emergency services screeching.
In the distance, firemen lift the casualty from the aircraft to the ambulance. Within seconds the dull green wagon comes swiftly up the driveway to the hospital entrance and the doors spring open. Two stretcher bearers bring a trolley, which looks like a table frame with two bicycle wheels attached, over ready to rush him through the doors.
A relative of the man watches intently as the treatment process begins. Bay 1 becomes a hive of activity, doctors give the man a full body check, nurses administer pain relief and put the Belmont system – a device that administers blood at an extraordinarily fast rate – into action.
Having witnessed the rehearsals in a mock-up hospital in Yorkshire, seeing the incredible volunteers from across the South West at work I quickly forget the two-day journey to Afghanistan that finished only five hours earlier.
"This guy has a bi-lateral amputation so our priority now is damage limitation," Captain Darren Heddington explains to me outside the room. "In there now we have between £2.5 million and £3 million worth of staff working on this one patient. Treatment costs move into tens of thousands of pounds but if you make it in here with a pulse, 98.5% make it out alive."
Capt Heddington explains that in most instances trauma patients have a full head-to-toe CT scan within 15 minutes of arriving at the Role 3 facility before being taken for surgery – if the casualty is stable enough. But because of his extensive injuries, the Afghan man is immediately taken to surgery. His life has been catastrophically changed by the bomb blast – in all likelihood meant for allied troops operating in the area of Lashkar Gah.
Not long after his arrival, a second man arrives with a gunshot wound to the leg.
An hour later, a member of the Afghan Security Forces is helicoptered in after sustaining a gun-shot wound to the head.
Over the last week the team have seen several traumatic amputations and gun-shot wounds. As a result, platelet stocks dropped and an emergency donation drive is put in place to provide more platelets for the amputee after surgery is carried out. Taking the donations are Derriford Hospital nurses Major Rose Chapman and Sergeant Debbie Evans. They are assisted by their fellow nurses for the first time this deployment in an "emergency situation".
Sgt Evans, 49, explains: "This is what we have trained and trained to do, but now we are actually doing it for real.
"It's fantastic as we know the platelets will be used – we are doing it for a reason."
Platelets work like glue in terms of helping blood to clot – vital for catastrophic injuries like the ones the medics have seen today. But those working in the hospital don't stop at administering the care – they were first in the line after the call for donations.
Each and every time the emergency alert fires off, the team prepare to give yet another dose of their "second-to-none" care. They are objective in their care – every person who makes it to the hospital receives the professional standards of the team, whether they are British soldiers, allied forces, Afghan or even insurgents.
The double amputee survived the emergency surgery to stem the blood flow from his legs and was moved to the recovery ward. His treatment has only just begun.
Tomorrow Rebecca Ricks returns to the hospital, accompanying Major Chapman on her early morning ward rounds.