Medics Unite to Save Young Afghan Girl’s Life

 

Story and photo by Sgt. Stephanie Hall, 4th Public Affairs Detachment

BAGRAM, Afghanistan – Everyone who saw the condition she was in was sure is was too late to save her life, but they had to try. A 10-year-old Afghan girl who had lost a leg when she stepped on a landmine, and her other leg was so badly damaged that it had to be amputated, was brought to the U.S. Army Hospital on Bagram Air Base August 16.

Zahida, a young girl from the Konar province, was handed from a medical evacuation team aboard a helicopter into the capable hands of Bagram’s Front Line Ambulance drivers, and then sped to the hospital. One leg was blown off, the other too badly damaged to be saved, but the critical factor shoving her closer to death was the fact that she had lost a lot of blood.

When Capt. Scott R. Cvecko, commander of the medical laboratory team at the 452nd Combat Support Hospital, first saw her, he didn’t think she was going to live. “There was no way she was going to make it,” he said. “(She) looked horrible. She had no blood, (so) she looked dead.”

“By the time she got here, she lost a lot of her blood volume,” said William T. Wester, the 452nd Combat Support Hospital surgeon who operated on Zahida.

When they ran tests, the laboratory technicians found that she had a dangerously low amount of red-blood cells flowing in her blood stream. “Between 40 and 50 percent of your blood should be red blood cells,” said Cvecko. “Hers was 10 percent.”

They knew they had to get the life-saving red-blood cells back into her system, but when the surgeons pumped two units of pre-donated blood from the United States into Zahida, they ran into a problem.

With pre-donated blood, “one of the things that happens when you give multiple transfusions is the serums in your blood that allow you to clot get diluted, so patients can get to where they can’t clot,” said Wester.

Although it is rarely done, the medical staff at the hospital decided that the only way to save this girl’s life was to give her whole blood, which is an undiluted product with all the necessary clotting factors, along with units of fresh-frozen plasma, said Cvecko. The only problem was that the lab didn’t store whole blood.

The medical team had to think fast because the young girl was still rapidly losing blood, so while the surgeons were initially stabilizing her, and while the plasma thawed out, the laboratory team set up a makeshift donor center and sought out volunteers to donate blood. Spc. Kyle P. Ziegler was the medical lab technician with the 452nd CSH who set up the donor operation center and drew the blood.

“We were able to get the donor operations set up and going before we could even get the plasma thawed,” said Cvecko. Four units of whole blood were drawn from four donors “in the time it took to thaw out the fresh frozen plasma, which is about 30 to 45 minutes,” he said.

“The (surgeons) spent some time stabilizing her, and then they took her to surgery, but by then we had the plasma and whole blood ready to be transfused,” said Cvecko.

Zahida’s condition was so critical that two units of whole blood were transfused into her body that day without being tested for compatibility, said Cvecko, but that’s where they ran into a stroke of luck.

“When you’re transferring whole blood, it’s not like red-blood cells where some types can be universal. It has to be the same type as the donor,” said Cvecko. “The patient was an O positive, which was a break for us, because most people have type O blood, so we had a larger pool to choose from,” he said. The other two units were given to her in the following two days.

The donors were Capt. Patricia Rose-Liana, a nurse with the 452nd CSH, Staff Sgt. Bruce Cherney, a combat medic with the 452nd CSH, (get name and job and unit) and Cvecko.

After everything was added up, the total sum of saving Zahida’s life was 15 units of whole blood, plasma and pre-donated red-blood cells. “That’s a lot of product to give to a (10-year-old) girl,” said Cvecko. “We pretty much replaced her entire blood volume twice during the course of her injuries. When you lose that kind of blood, you could have brain damage,” said Cvecko. “I’m amazed she lived.”

Not only did this little girl live, but is also well on the road to recovery, and without brain damage, said Cvecko.

“She’s doing well now,” said Wester.

Zahida said through a translator that she is well, and that she is glad for the doctors and the nurses who give her toys and ice cream all the time.

“There are very good doctors and nurses (here) who took care of (Zahida) and saved her life,” said Mohammed, Zahida’s father, through a translator.

This bitter-sweet outcome serves as a reminder for Wester and his colleagues that they are in a war-torn country where on a daily basis, people are being severely injured or killed by landmines, and “unfortunately there’s a lot of kids who get hurt,” said Wester. “It’s a sad thing, but we’ve saved some lives; that our mission.”