My memories of frontline casualty care.

[m_z_t]

 While my partner was resting, I was on duty near the entrance to the dugout.

It was the 7th day on the positions, and tomorrow we were supposed to head home.

The unusual silence surprised me. There were no drones or shelling for an hour and a half, maybe two.

“It’s because of the strong wind,” I realized.

Later, the wind died down. The guys from Aidar batallion, Hantz and Hyena, went to retrieve a fallen comrade. The time was around 5:30 PM.

“Damn. The weather’s getting better. It's a shitty time to go,” I told Mokryi, my partner. But Aidar guys are reckless, and who are we to advise them otherwise?

Half an hour later, there were frequent impacts in the direction Hantz went. "It's probably hitting them," we thought.

Soon after, Hyena runs in. He says that they were spotted on the way to the body, and heavy shelling and drops started during the process. Hyena had multiple but minor wounds. Hantz was in a more serious condition; he couldn’t move on his own.

I began giving Hyena aid. A few shallow shrapnel wounds. I washed the wounds with Chlorhexidine, bandaged them, and gave him a pill pack. Meanwhile, my partner was figuring out what to do about Hantz – where he was, his condition, and preparing equipment for his evacuation.

At some point, someone ran into the neighboring dugout, groaning. We realized it was Hantz. My partner went to him. A targeted, dense shelling began, along with drops.

The radio crackled – the guys said our "pencil cases" needed help. There were more wounded at other positions.

"Fucking hell, this is a nightmare…" So many wounded at once – an utter nightmare.

Two more guys run into our dugout: Vesna and Syzyi. They tell us their dugout took a direct hit. They managed to escape and reach us, but two more stayed behind, seriously wounded.

The shelling intensified; drones were dropping VOGs, grenades, incendiaries.

7 PM. “We need to hold on until nightfall,” I told the guys. "Just not gas," I thought to myself.

Mokryi yelled that he needed Tranexamic acid and saline. I gathered what he asked for, but didn’t want to run over, to avoid drawing unnecessary attention.

Meanwhile, the radio screamed for us to go and pull the guys out of the dugout that took the direct hit.

“We can't. It's too intense.”

I asked about Syzyi and Vesna’s injuries. Vesna was fine, but Syzyi had a chunk of skin torn from his thigh, and there was a tourniquet above the wound. No blood flow. I checked him thoroughly. No other injuries.

I gave him a pill pack. Applied a hemostatic bandage to the wound. Slowly loosened the tourniquet. No bleeding. Applied a tight dressing.

The radio continued to insist we retrieve the two seriously wounded.

We started hearing shots. The first thought was that we were being stormed. But then we realized it was the detonation of ammunition. We reported via radio that we couldn’t go yet. We tried making voice contact. We heard one of the wounded shouting – Dido.

Mokryi from the neighboring dugout noticed the ceiling of our dugout was on fire. He grabbed the bottles we’d been peeing into and started putting out the flames.

Around 8 PM, the explosions eased, the drones flew off, it began to darken, and my partner and an Aidar guy ran to get Dido. We helped bring him into the dugout and laid him on the bed.

Mokryi filled a syringe with Tramadol and handed it to me to inject. I wasn’t sure it was a good idea, but I followed the senior's orders.

Dido had a fracture just above the shin, with the leg bent at a 90° angle. A tourniquet was on his thigh.

I followed the protocol.

Massive bleeding – stopped.

Airways clear, the victim conscious and speaking.

I checked the chest for injuries. All clear. I didn’t check his breathing because it seemed normal visually, though maybe I should have.

I rechecked the limbs for injuries and asked him again where it hurt. He said just the leg. I wondered if I should tamponade the wound. Decided against it – the severance was too severe, and tamponading wouldn’t hold. I applied a tourniquet just above the wound. Asked him again when he applied the tourniquet. An hour ago. I loosened the thigh tourniquet. No blood flow.

I failed to measure his pulse and didn’t place a pulse oximeter.

Checked his head. Asked if he felt cold.

Gave him a pill pack. Bandaged small wounds on his leg. The other leg had a torn-off nail – bandaged that too. Applied thorough splinting.

He asked for pain relief and water. I gave him both.

Dido said Fragola was alive but couldn’t get out. Vesna and I decided to run for Fragola.

We brought him into the dugout, laid him on the floor. Mokryi injected him with Tramadol into the muscle.

We examined the soldier. A tourniquet and bandage on the shin, no bleeding. A torn wound on the thigh, no bleeding there either.

He was conscious, sat up, said something.

Then he lay down.

He started losing speech, rolling his eyes, struggling to breathe.

I tried to lift his jaw. Pressed with all my might – no luck, his teeth were tightly clenched. Inserted a nasopharyngeal tube.

“Maybe it's the Tramadol,” I said to Mokryi. I asked if he had Naloxone. He didn’t.

Mokryi drew up adrenaline into a syringe and injected it into the wounded man. I didn’t understand why.

We examined him fully again. No signs of pneumothorax or head trauma. Then we found a small hole near his pelvis, with some intestines visible.

I checked his pulse. I could feel my own pulse in my fingers. I failed to check his neck pulse.

Took Mokryi’s ambu bag. Started CPR.

The abdomen rose. But the patient didn’t start breathing on his own.

The lower abdomen swelled. Clearly, internal bleeding.

I realized we hadn’t done a thorough examination. But it wouldn’t have helped him much. We could have given Tranexamic acid to stop the bleeding. It probably wouldn’t have saved him. But it should have been done. A mistake.

Checked his pupils – no reaction to light. Checked for breathing – none.

About 20 minutes later, we decided to stop resuscitation. Covered his face with a sleeping bag.

Meanwhile, the Aidar guys arrived to evacuate Hantz and quickly carried him out.

We placed a catheter for Dido. It took me four tries, though the veins seemed good.

We set up an IV with 2 grams of TXA.

Dido vomited all the water he drank.

I gave him an antiemetic – Ondansetron. We gave more pain relief – Nefopam, also IV. Administered 500 ml of saline.

Dido asked about his leg.

“You’ll need a prosthetic. But below the knee, so that’s good. And no more frontline duty for you.”

About 30 minutes later, Dido calmed down and even fell asleep.

At dawn, we began evacuating him, which took almost 14 hours.

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[paserbyp]

God will save you!