• MOD home
• defence for...
• about defence
• defence news
• A - Z index
• contact us
• help

Search defence:

Search Scope:

Bastion radiographers make sure they are the "doctor's eyes" (VIDEO)

A People In Defence news article

20 Dec 07

An integral part of the medical staff who treat casualties on arrival at the field hospital in Camp Bastion are two military radiographers. The x-rays they provide can mean the difference between life and death. Report by Danny Chapman.

L-R: Chief Petty Officer Ian Lindsey and Lieutenant Jo Horn TA, radiographers at Camp Bastion field hosptal use their x-ray machine in a real time incident
[Picture: SAC Kimberley Waterson RAF]

The radiographers are right there in the Accident and Emergency Ward when casualties are brought into the hospital, day or night. Using a state-of-the-art portable x-ray machine they take images of the patients' wounds, often straight away, providing essential information for the clinicians and surgeons.

Royal Navy Radiographer Chief Petty Officer Ian Lindsey, aged 28 and normally based in Haslar Hospital in Portsmouth, explains the importance of his job:

"Radiography is vital to the field hospital. Without us they'd have to resort to medical practices from 2-300 years ago. It would set them back this far. We're the doctors' eyes, looking inside the patient's body."

But CPO Lindsey and his colleague Lt Jo Horn don't just take x-ray images, as Lieutenant Colonel Banerjee, the General Surgeon at Bastion's field hospital explains:

"They take part in all the decisions that we make about various investigations we require, in order to come to the right conclusions as to what treatment we require to give these patients, to save their lives.

"Without them, from the point of view of taking the pictures and also assisting making the decisions as to what pictures to take and what would be useful and helpful to make our treatment decisions, we would struggle to provide the quality of care we are providing."

See Related Links>>> to watch the latest video footage of the Camp Bastion radiography team

Chief Petty Officer Ian Lindsey studies an x-ray at Camp Bastion hospital
[Picture: SAC Kimberley Waterson RAF]

Among the first to see a casualty they are also an extra pair of hands in the emergency ward, often among the medics moving the patient from stretcher to bed. The type of injuries that the medics at Bastion deal with and that the radiographers have to x-ray include minor injuries, such as people stubbing their toes or dropping things on their feet, as well as major cases which can include gun shot wounds, Improvised Explosive Device blasts and severe traumatic amputations ie. loss of limbs:

"In terms of trauma, we see no comparison back home, we don't have gun shot wounds on a daily basis," said Lt Horn.

"If the patient has been involved in a blast injury, we do a chest x-ray straight away to help the clinician know if there are problems in the airway."

Lt Horn, aged 36, is a Territorial Army (TA) medic with 306 Field Hospital and has been a radiographer for six-and-a-half years.  She's been in Bastion since September 2007.  Military Medics deploy on operations for three months. And it's normally a busy three months.

They are the only two radiographers in Bastion and so work an on call rota every other night. It is not uncommon for both radiographers to be called in at night to deal with serious casualities:

"We have to ensure the service is available 24 hours a day," Lt Horn explains. "Some days it is constant from the time we come in at 8am and the doctors do their rounds, which means they might need some x-rays.

"On a bad day we can have up to 16 patients, but it's peaks and troughs. When there are no casualties there is lots of admin. We have to check the equipment daily and send images and reports back to the UK constantly."

Lieutenant Jo Horn checks the CT scanner in the new field hospital at Camp Bastion
[Picture: SAC Kimberley Waterson RAF]

The job of the radiographers in Bastion though is very different from their roles in the UK according to Lt Col Banerjee:

"Traditionally they live in the x-ray department. We might send an x-ray request to that department and we may never see a radiographer.

"It's completely different here. These guys are standing right there next to me in the resuscitation room or in the operating theatre with the patients. We know them very well and they're advising us minute by minute while we're operating on the patients as to what may be useful in terms of investigation."

Helping the radiographers provide that investigation are new digital x-ray machines, which work like digital cameras, producing images straight away:

"It's an excellent service," says Lt Horn. "The clinicians love the digital system, it gives them an image straight away and you can lighten and darken the images so highlighting bony anatomy and soft tissue. It's the latest system we have back at home and makes our job a lot easier."

There are, however, challenges to working in a tented hospital, challenges which are specific to the radiographers. Because the x-ray machine is portable, unlike the static ceiling mounted systems found in NHS hospitals, the range of exposures is more limited, but as Lt Horn explains:

"We don't have any problems, and it hasn't let us down. It could be a problem with x-raying a more chunky person, but there aren't too many chunky people in the military."

The tented environment also doesn't provide any lead protection, so they have to use other methods to protect themselves and the patients, including wearing lead lined gowns. In the summer temperatures of Helmand, working three to four hours in these gowns can be quite uncomfortable.

Keeping the equipment cool in summer can also be a problem, as like any equipment, overheating is not good for the x-ray machines. There is air conditioning in the hospital, however, to keep casualties warm the A & E ward is kept warm.

The x-ray machines provide 2D images. In one of the only solid built buildings currently completed in Camp Bastion is the radiographers' CT scanner, a state of the art piece of equipment providing 3D x-ray images. It is housed in four walls because of the high radiation doses it emits.

The CT scanner, sometimes called the CAT scanner (which stands for Computerised (Axial) Tomography), provides a complete picture of what is happening inside. It works likes an x-ray machine, but takes different pictures of the body which are fed together in a computer to make 3D images.

It has been in Bastion since January 2007, before which time patients requiring this level of scan would need to be sent to Kandahar. The presence of a neurosurgeon at Bastion makes the CT scanner a necessary piece of kit, and enables the medics to do a lot more there and then:

Lieutenant Jo Horn TA watches the progress of a CT scan in the new field hospital at Camp Bastion
[Picture: SAC Kimberley Waterson RAF]

"Obviously for the chest and limbs, which are of course 3D structures, the CT scanner is very useful," said CPO Lindsey. "With 2D images you can see fragments, but you can't see how it fits with the body structure around. It gives far more information."

"The CT scanner compares to anything you'd have back in the UK," added Lt Horn. "It gives exactly the same service providing us with cross sectional images of patients."

The CT scanner is linked to the UK by satellite so images can be sent back to radiologists in order to report straight away, sending their analysis back to Bastion. The Bastion radiographers send all the x-rays they take back to radiologists in the UK, but as Lt Horn says:

"Clinicians here are most of the time happy to go on what they see themselves, but sometimes they need a report for formality or to get the go ahead for certain operations."

Dealing at such close hand with some of the horrendous injuries that are encountered at Bastion could prove traumatic in itself for some, especially for Lt Horn who says she has to turn away from the TV when Casualty is on!

"You just deal with it. Everyone has their own way. But you focus on the job and don't look at it other than just your job."

"We sit down and chat about it," adds CPO Lindsey. "We ask others did we do everything we could have done. But when you're at work you actually visualise what the external injury might look like inside and form a picture of it in your mind, anticipating what the x-rays will reveal."

One of the most rewarding aspects of their job, which is also different to how it would be in the UK is that the radiographers in Bastion get to work with and follow the patients through their entire rehabilitation, from the point of arrival when they might be unconscious to seeing them walking around the wards.

It is a three year university course to become a radiographer and although they are from different Services, Lt Horn and CPO Lindsey actually met at the Defence College of Management and Technology affiliated to the University of Cranfield, when they were undertaking training.

And although they only undertake three month deployments, there is quite a small cadre of military radiographers – 36 Regulars and 26 TA, Royal Naval Reserve and RAF Auxiliary – so their tours come around quite often.

But for the chance to actually advise clinicians in the operating theatres and the exposure to injuries they wouldn't face in the UK, professionally the experience of Bastion for the radiographers is second to none:

"I've done one tour every 18 months," said CPO Lindsey. "I enjoy it. The experience is brilliant. I miss my family obviously. But for professional satisfaction there is nothing better than being on tour. This experience is always something I'll look back on. You can't put a value on experience."

"I don't think anything matches this in civilian life in terms of challenges," added Lt Horn. "It's a very rewarding job and I don't think there's a comparison back in the UK in terms of professional challenges.

"It's good to know you are making a difference in terms of treating the casualties and as being part of a team."

• Accessibility
• Freedom of Information
• Copyright
• Your Privacy
• Security Policy
•