Notorious for battles in every clime and place, Marines do not stop training when the heat is on. North Carolina summers average a heat index in excesses of 100, which combined with training or physical activity leads to heat-related injuries seen throughout Naval Hospital Camp Lejeune and its clinics. Using new technology, clinics are refining their skills to provide faster services for heat casualties.
"Marines train the way they fight. We do the same ‘we train the way we heal," said Cmdr. Trevor Carlson, Camp Geiger Branch Medical Clinic department head. "You don’t ever want the first time a corpsman treats a gunshot wound to be on the battlefield; it’s the same with heat casualties. You don’t want the first time they treat one to be when it counts."
The Geiger clinic, responsible for the care of School of Infantry - East students and staff, sees more heat casualties than any other clinic. Although performing to the same Marine Corps Base Order heat causality handling, Geiger has refined the process due to their high operational tempo.
"Geiger is like a seasoned emergency room team ‘they communicate and respond well to the casualties coming in," Lt. Cmdr. Heather Kirk, deputy director of Branch Clinics.
Like a gunshot wound, heat injuries can mean life or death. The seriousness of this injury can be felt on every level.
"It is our job to save their life," said Hospital Corpsman Korbin Townsley, a New Orleans native, who has treated eight heat casualties in the last week. "If they come in with a high temperature, they have a potential of dying."
During physical activity, the body’s core temperature rises. As it rises, the body regulates itself by producing sweat, but sometimes this isn’t enough to cool the body down. A core temperature of 107.5 can result in irreversible brain damage and 109 could result in a coma or death.
"If we are not quick enough, they could have brain damage and not be the same person they used to be," said Hospital Corpsman 3rd Class Michael Barber, a Los Angeles Native who has been in the Navy four years. "We train with the Marines and take care of them the way we want them to take care of us that’s what family does."
The significance of getting the temperature down quickly can be seen in the recovery time of the patient the difference of 30 minutes could mean days more in recovery. One provider reflects on her experience with a previous command.
At a different facility we had a service member come in with a 109 temperature. He was transferred to the local hospital, which was a 30 minute drive, said Kirk.
"He ended up spending four days in the hospital because he his core temperature was not brought down quickly enough."
Camp Geiger had three Marines come in last week with 109 temps. They spent one night in the Multi-Service Ward for observation, explained Lt. j.g. Brent Booze, the clinic’s division officer, whose clinic treats more heat injuries than any other clinic at Camp Lejeune. Their recover was directly related to how quickly the Marines’ core temperature was lowered.
"In fact, yesterday we had a Marine come in with a 109 temperature. He was found fit to go home from the emergency room the same day," said Booze, who is responsible for the 20,000 Marines who train at SOI each year.
In order to get the clinic’s proficiency level to where it is, Booze credits their training and the simulation mannequin, named Wifi.
Wifi, so named because of its Bluetooth capability, is an interactive mannequin. He blinks, sweats, vomits and sheds tears, if that is what the scenario calls for. Additionally, Wifi is one of a kind at the hospital, because his temperature, blood sugar and blood pressure respond to treatment. Booze explains Wifi also responds to questioning, moans and grunts accordingly.
"If you treat two patients quickly and properly while removing their need for hospital stay, you have paid for one Wifi," said Booze, who received Wifi to his clinic in January and has been training clinic staffs all over the base. Wifi can be programmed with real or fictitious scenarios to test reaction skills and abilities. In the demonstration given, Wifi was programmed to mimic a specific person seen last November, who was brought in from a command run.
"November is outside our typical heat season, which goes from 31 May and extends until Oct. 2, so we really weren’t looking for or expecting a heat casualty," said Booze. "He came in with 108.6." Little did we know that he had been trying to cut weight and was on thermogenic, so his body wasn’t responding as quickly as we would like to treatment."
This made for a unique scenario. Wifi is programmable for most heat cases a corpsman might run across, which is why many prefer getting their feet wet with him.
"Training with this guy gives you the opportunity of training and honing your skills without the chance for loss of life," said Townsly, who added that this training gives way to professional excellence knowing how to do your job well when you are needed.
When the call comes in that a heat casualty is inbound, the team huddles and roles are assigned. This is important, explains Booze, especially when there are multiple casualties on their way.
"Every team member has a voice and are able to speak up if they don’t like something that is going on," he said. If there are multiples on the way, they change up how they might conduct business.
"In addition to our huddle, we also alert (emergency medical services) and the hospital that there is a possibility that their services will be needed," said Carlson. "We also communicate with the emergency department. This is an important step, because they might have a mass casualty taking place and need us to send our patient elsewhere."
In addition to a team huddle prior to a casualty coming in, Booze explains that the clinic prepares for them every morning during the heat season.
"The duty comes in every morning and changes the pools of water outside, changes out the ice in each cooler, and ensures everything is in place,â€ he said. "We try to always be ready."
One corpsman explains that corpsmen never know when they will be called upon to serve.
"We were on our way back from the exchange. We passed a group of Marines who were out (physically training) on River Road," said Hospital Corpsman 3rd Class Laurence Lau, a Dallas native who has served in the Navy for six years. "A Marine had dropped to the ground. He had a 102 temp when we picked him up in our vehicle and began to seize. We were able to call ahead and get him to the clinic quickly enough to get help."
It is situations like this one that iterates the need for constant and consistent training, explained Carlson.
"You never know what is going to come in next," he said. "So, we train to always be ready."