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12th Evacuation Hospital, 1 January 1970 - 15 November 1970

Books and Documents

Department of the Army

Headquarters, 12th Evacuation Hospital (SMBL)

APO San Francisco 96353

Army Medical Department Activities Report

(RCS MED 41 (R4))

1 January 1970 - 15 November 1970

RICHARD C. HARDER

LTC, MSC

Commanding


TABLE OF CONTENTS

I.      MISSION

II.     ORGANIZATION

III.    PERSONNEL

IV.   OPERATIONS AND TRAINING

V.    MATERIAL

VI.   CONSTRUCTION

VII.  PREVENTIVE MEDICINE

VIII. PATIENT CARE AND EVACUATION

IX.   ASSISTANCE PROVIDED CIVILIAN AND NON-US MILITARY PERSONNEL

X.    OTHER

XI.   INSPECTIONS AND VISITS


I

MISSION

The stated mission of the 12th Evacuation Hospital (SMBL) under the applicable Table Of Organization and Equipment is "to provide hospitalization for all classes of patients within the combat zone." This mission has been accomplished during the report period; however, an added mission has been concurrently accomplished. That mission has been, and is, to provide an extensive medical and surgical consultation service on an outpatient service basis. Further, this hospital performed extensive emergency medical treatment of recently wounded or injured patients. This treatment is at a significantly high level so as to require an expended Emergency Service.

The 12th Evacuation Hospital (SMBL) provides specialized treatment in designated specialties in meeting its comprehensive health care mission. These specialties include: anesthesiology, cardiology, internal medicine, ophthalmology, otorhinolaryngology, radiology, general surgery, maxillofacial surgery, oral surgery, orthopedic surgery, urology, dental service, physical therapy, pathology and clinical laboratory service.

II

ORGANIZATION

The 12th Evacuation hospital (SMBL) is organized under Table of Organization and Equipment (TOE) 8-581E, dated 8 June 1964, and Modified Table of Organization and Equipment (MTOE) 8-581EP08, dated 5 March 1970, and implemented by Department of the Army General Order number 127 dated 8 April 1970.

a.    30 Medical Corps Officers (1 Col, 2 LTC, 9 Maj, 18 Cpt)

b.    2 Dental Corps Officers (2 Maj)

c.    8 Medical Service Corps Officers (1 Maj, 4 Cpt, 3 Lt)

d.    63 Army Nurse Corps Officers

e.    1 Army Medical Specialist Corps (1 Maj)

f.     1 Chaplain Corps Officer (1 Cpt)

g.    1 Warrant Officer (1 WO)

h.    30 Non-Commissioned Officers (1 E9, 2 E8, 19 E7, 2 E6, 1 E5)

i.     169 Other Enlisted Personnel

Total:  305

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III

PERSONNEL

The following is a list of individuals occupying key command, staff, and operational positions during calendar year 1970:

A. Commanding Officer:

(1) COL Leon M. Dixon, MC, 1 January 1970 to 27 April 1970.

(2) COL Francisco Quinones-Acosta, MC, 28 April 1970 to 10 November 1970.

B. Executive Officer:

(1) MAJ John B. Kelly, MSC, 1 January to 4 July 1970.

(2) LTC Richard C. Harder, MSC, 5 July 1970 to 10 November 1970.

C. Chief, Professional Services:

(1) LTC Franklin M. Soriano, MC, 1 January 1970 to 17 April 1970.

(2) LTC George M. Pomerantz, MC, 18 April 1970 to 1 July 1970.

(3) LTC Fernando Diaz-Ball, MC, 2 July 1970 to 10 November 1970.

D. Chief Nurse:

(1) LTC Helene D. Carroll, ANC, 1 January 1970 to 20 June 1970.

(2) LTC Margeret B. Nelson, ANC, 21 June 1970 to 1 September 1970.

(3) LTC Roberta W. Smith, ANC, 2 September 1970 to 10 November 1970.

E. Chaplain:

(1) CPT Patrick J. Adkins, CH, 1 January 1970 to 2 July 1970.

(2) CPT Gerald P. Pinder, CH, 3 July 1970 to 10 November 1970.

F. Command Sergeant Major:

(1) CSM Frederick Crauswell, 1 January 1970 to 14 April 1970.

(2) CSM John G. Trump, 15 April 1970 to 10 November 1970.

The applicable Table of Organization and Equipment was extremely out of date. There were numerous errors in the Modified Table of Organization and Equipment. Many key MOS's which are vitally needed to accomplish the mission of this hospital were not authorized in the TOE. An example of this is a 91H20 Orthopedic Specialist. The updating of the TOE and MTOE was started in October under the TAAD's Program.

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The enlisted strength was at all times sufficient to accomplish the mission. For brief periods key enlisted and technical personnel were not readily available but these vacancies were quickly filled as replacements came into the command.

The civilian local national (LN) work force at this hospital constitutes a vital segment of the total personnel picture. The civilian labor force consists of three types of personnel based on method of payment: permanent hire LN paid from appropriated funds, daily hire paid on a day to day basis from assistance-in-kind funds and house maids paid from non-appropriated funds collected from individuals using the maid service.

Permanent hire LN are authorized by a TDA and Program 6, a conversion of military positions to civilian positions. Skilled labor is difficult to find in Cu Chi District (Hau Nghia Province), however all skilled labor positions were filled during 1970.

IV

OPERATIONS AND TRAINING

The 12th Evacuation Hospital (SMBL) continued to provide medical support for the 25th Infantry Division and attached units plus elements of the 1st Air Cavalry Division and the 1st Infantry Division in the III Corps tactical area of the Republic of Vietnam. From its location at Cu Chi Base Camp, the hospital provided medical support during the Unnamed Campaign - 1 January 1970 to 10 November 1 970.

As noted under paragraph I, hospital operations are characterized by receipt and treatment of very recently wounded personnel. Since many engagements with the enemy were conducted in the immediate vicinity of Cu Chi Base Camp, casualties resulting front such contacts were evacuated by helicopter directly from the site of injury to the hospital. This has resulted in participation in medical care heretofore more noted in battalion aid stations and division clearing stations, helicopter (Dustoff) support was provided by the 159th Air Ambulance Company.

In addition to its operational mission within the combat zone, the unit also engaged in weekly training periods. Normal unit training was conducted in CBR, Military Justice, weapons familiarity, and maintenance procedures. Further, the medical and administrative and nursing staffs engaged in weekly professional and in-service education and training programs.

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On 9 October 1970, BG Thomas informed the Commander that the hospital would close. On 12 October 1970, a message was received outlining some of the details. The initial stand down date was 25 November 1970, with deactivation on 15 December 1970. Subsequently these dates were moved to 15 November 1970, and 4 December 1970. The latter dates were more appropriate for coordinating closing plans with the 25th Infantry Division. No U.S. Military patients were admitted after 8 November 1970. The last patients in the hospital were evacuated on 10 November 1970. An appropriate closing ceremony was conducted by the Commander at 1800 hours 9 November 1970. As a part of the ceremonies, the color guard members were introduced to all hospital personnel. The closing activities progressed on schedule. A final report on the steps was submitted to Headquarters, 68th Medical Group.

V

MATERIAL

During calendar year 1970, the 12th Evacuation Hospital (SMBL) received Medical Supply support from the 1st Advanced Platoon, 32nd Medical Depot, and other logistic supplies through the 25th Supply and Transportation Battalion. Engineer support came from the 94th Engineer Battalion. Utilities support was provided by Pacific Architects & Engineers, and Self-Service support came from the 758th S&S at Phu Loi.

Medical supplies presented no major problems during the calendar year. There were isolated instances in which it was difficult to obtain pajama tops and pajama bottoms. New Biologicals which were brought into the supply system presented problems due to the fact that they were not available in sufficient quantities. These items included Gentamycin and Cidex. During the peak malaria season it became difficult to obtain quinine Dyhydrochloride in sufficient quantities.

Self-Service items have continued to be difficult to obtain through normal supply channels. Padlocks have been a major problem to obtain and this has presented a constant security problem. An attempt was made to procure those items from DSU but there appears to be a long wait for filling of those requisitions. With the cutdown of construction within Vietnam it has been extremely difficult to obtain cement, lumber, nails, and paint. The unit has had to resort to self-help on many projects because the request has been disapproved by Post Engineers. The unit continues to use whatever resources are available to maintain the hospital in a normal status.

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Mess installation equipment has not received adequate servicing. Refrigerators have not been serviced properly. Pacific Architects & Engineers have stated repeatedly that they lack sufficiently trained personnel to perform these functions.

Utilities have been a constant problem due to inadequately trained personnel. Pacific Architects & Engineers has had to return repeatedly to repair utilities which could have been repaired by trained personnel the first time. Electrical wiring has shorted out after Pacific Architects & Engineers has put in wiring and many times when reefers, containing important biologicals, have gone out, it has taken Pacific Architects & Engineers several hours to come and repair the problem.

Air conditioners have been a constant repair problem. Pacific Architects & Engineers does not have sufficient compressors to repair the air conditioners and once the compressor goes the air conditioner is dead-lined. Due to insufficient personnel, Pacific Architects & Engineers has not been able to service these air conditioners on a regular basis and therefore presenting maintenance problems.

The breakdown of surgical sterilizers has continued to he a problem for the Central Material Section. A team from the 1/32nd Medical Depot has come down and assisted when problems arose. Recently the unit acquired two highly competent Medical Equipment Repairmen and this problem has been alleviated.

VI

CONSTRUCTION

Major Construction

Major construction during 1970 consisted of construction of a drainage sump for the Mess Hall and a Patient Latrine which included showers, sinks, and flushing toilets.

Minor Construction

Minor construction to include facility addition and improvement included:

Tiling of the Emergency Room and Operation Room floors. The portion of the Emergency Room that housed the Medevac (Dustoff) radios was partitioned into a lounge area for the radio operators and Emergency Room Staff.

Billet and ramp areas were rewired and new lighting equipment was installed.

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All wards and clinics were air conditioned.

Bunkers were up-graded and refortified. Bunkers declared unsafe were filled in.

New drainage ditches were dug throughout the hospital area and billets were improved through self help.

A small play house was built and gym equipment (swings etc.) were procured for the young Vietnamese patients in the hospital.

Central air conditioning was installed in buildings 4173 and 4174.

Hot water heaters were installed in the Surgical Ward and Building 4173.

All now construction was curtailed during the 1st half of 1970 due to initial phase down

The Executive Officer, 12th Evacuation Hospital (SMBL) was a member of the Cu Chi Base Development Board.

VII

PREVENTIVE MEDICINE

Medical Statistical Data

The health, well-being and physical fitness of personnel assigned to the 12th Evacuation Hospital (SMBL) during 1970 was at a high level. The monthly active duty army strength fluctuated between 301 and 333. The Monthly report of daily non-effectiveness rate per 1000 average strength active duty army varied between 3.7 and 18.0 with an average of 6.8. This is reflected by the 243 total admissions, of which 213 were in the disease category, 29 were in the non-battle injury category, and 1 was as a result of hostile action. These admissions were accounted for in descending order of prevalence by common respiratory disease (97 cases), diarrheal diseases (36 cases), non-battle injuries (29 cases), FUO (9 cases), skin diseases (4 cases), psychiatric character and behavior disorders (4 cases), infectious hepatitis (1 case), and as a result of hostile actions (1 case). There was not a single case of malaria, which reflects on the cooperation and -acceptance by the personnel of the weekly chloroquine-primaquin chemoprophylaxis.

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Environmental Sanitation

Mess facilities consistently maintained a high degree of sanitary standards. Food storage and refrigeration wore satisfactory. Garbage and trash disposal was adequate. Mess personnel and Vietnamese civilian food handlers were carefully screened, chest x-rayed and periodically reexamined. During the month of August a drainage sump was constructed which vastly improved waste disposal.

Bathing and washroom facilities in the WOQ were very satisfactory as were patient facilities behind the C Ramp, after the construction of a new patient latrine.

Local hire personnel were employed full time to provide care and clean up in all latrines. This did much to improve sanitation. However, burn-out latrines were still used throughout the hospital.

Preventive Measures And Personal Hygiene

Immunization and weekly anti-malaria chemoprophylaxis with chloroquine-primaquin was strictly adhered to and was well accepted by all personnel. Personal hygiene among personnel of 12th Evacuation Hospital remained at a high level.

VIII

PATIENT CARE AND EVACUATION

Patient Care

1. Hospital Statistics

From 1 January 1970, to 10 November 1970, there were 7543 patients admitted to the 12th Evacuation Hospital (SMBL). 3373 patients or 44.7% were wounded in action. 3024 patients or 40.09% were for disease. 1146 patients or 15.19% were admitted for non-battle injuries. 56 patients or 8.70% were Civilian War Casualty Program (CWCP) patients.

There were 7758 dispositions. 5248 patients or 67.65% were returned to duty. 1057 patients (13.75%) were evacuated out of country. 1292 patients (16.65%) were evacuated in-country. 161 patients died representing a mortality rate of 2.13%.

The average length of hospital stay per patient was 6.5 days.

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There were 20,087 patients treated at the outpatient clinic. There were 3,564 dental patients treated.

Forty two Medcap sessions were conducted and treatment was rendered to 3,209 Vietnamese patients.

There were 41,486 x-ray procedures and 164,791 laboratory procedures performed and 11,097 units of whole blood were transfused.

2. Surgical Service

5,177 patients were admitted to the Surgical Service of which 3373 (65.15%) were WIA, 1105 (21.34%) were NBI, and 699 (13.51%) were in the "other surgery category."

2,029 patients (39.19%) were U.S. Military and 3,148 patients (60.81%) were non U.S. Military. This latter category being comprised of Vietnamese Armed Forces, Free World Forces and enemy casualties, Vietnamese civilians, U.S. civilians and other foreign nationals.

Of the U.S. Military patients admitted 941 patients (46.38%) being wounded in action, 596 (29.37%) had non-battle injuries, and 492 (24.25%) had various surgical conditions categorized as "other surgical conditions." Of those wounded in action, 147 (15.00%) were returned to duty, 511 (52.14%) were evacuated to U.S. medical facilities in the PACOM, 308 (31.44%) were evacuated in-country either to other U.S. medical facilities for further treatment or stabilization prior to further disposition, or to convalescent centers for recuperation and reconditioning prior to return to duty. Thom were 14 deaths among those wounded in action representing a mortality rate of 1.42%. Of those patients with non-battle injuries 208 (33.9%) returned to duty, 247 (40.34%) were evacuated out of country, 153 (25.01%) were evacuated in-country, and 4 expired in the hospital representing a mortality rate of 0.66%.

Of the non-U.S. Military admissions, 2,432 (77.35%) were WIA, 509 (16.19%) were NBI, and 203 (6.46%) are in the "other surgical category." Of those WIA's, 521 (20.92%) were returned to duty and 98 (3.33%) died. Of those NBI's, 259 (50.00%) returned to duty and 14 (2.70%) died.

A total of 5,418 operative procedures were performed, 4,004 were major operations. 1,414 were minor operations. Those operations consisted of 3,576 debridements, 753 delayed primary closures, 425 thoracotomies (83 open thoracotomies and 342 closed thoracotomies), 951 laparotomies, 1,142 fractures, 379 major amputations, 189 minor amputations, 147

vascular injuries, 10 craniotomies, and 201 eye injuries, with 11,097 units of whole blood transfused.

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A total of 4,209 anesthetic procedures were administered.

There were 134 deaths in the Surgical Service. This represented a mortality rate of 2.59%. There was a total of 5,069 dispositions from the Surgical Service, of which 1,562 (30.81%) returned to duty, 578 (11.40%) were evacuated out of country, 688 (13.57%) were evacuated in country, and 2107 (39.83%) were in the "other dispositions" category.

On the average about 12-14 physicians comprise the professional staff of the Surgical Service, consisting of 5-6 General Surgeons, 1 Thoracic Surgeon, 3-4 Orthopedists, 1 Urologist, 1 Ophthalmologist, 1 Otorhinolaryngologist and 1 Oral Surgeon. The ENT and Oral Surgeons worked closely and treated jointly maxillo-facial and hand-neck in­juries, excluding intracranial and spinal injuries.

Each subspecialty service conducted and maintained its respective out-patient clinic.

The Emergency Room is under the direct supervision and control of the Chief of Surgery who acts as triage officer and assigns priorities for resuscitation, surgical operations and evacuations. In the absence of the Chief of Surgery, these duties are performed by the first call, second call surgeon and so on in ascending order. This arrangement was devised by the Chief of Professional Services and was found to he the best method to deal with the demands of mass casualties and near mass casualties. When available, 1-3 General Medical Officers were reassigned to the Emergency Room. This contributed to a most efficient operation in terms of casualties and sick call. In addition, it left the surgeons free for post-operative care and administrative duties. This calls attention to the necessity of at least three, preferably four, General Medical Officers to staff the Emergency Rooms of a busy evacuation hospital.

Open thoracotomies were performed frequently during the whole year due to the assignment of more aggressive, younger and well trained General Surgeons. This aggressive approach is based on the recognition and acceptance of the destructive pathological effect and the inevitable early and late complications of high velocity missile wounds to the chest. Last year there were at least six cases of high velocity missile wounds which were treated conservatively only to have the patient die later of intrapulmonary parenchymal bleeding, intrabronchial bleeding or secondary bleeding, the terminal event being either hypoxia or exsanguination. This year complications due to high velocity missile wounds to the chest were almost entirely negligible.

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Last year the rear portion of one surgical ward consisting of four beds (expendable to six beds and one crib) was designated as the hospital Burn Unit where all patients with 2nd and 3rd degree burns comprising 10% or more of total body surface or with similar burns involving the respiratory tract, face, neck, genitalia, perineum, groins, axillae, hands and feet were admitted.

The Burn Unit was closed during the month of July and subsequently all burn patients were regulated to the 93rd Evacuation Hospital in Long Binh, RVN with the exception of phosphorus burns and cases of renal failure due to burns. These patients were regulated to the 3rd Field Hospital in Saigon, RVN.

The occurrence of "wet lung syndrome" and respiratory insufficiency in the severely traumatized and severely burned patients has been minimized by the prompt performance of tracheostomy end early initiation of ventilatory assistance with a Volume controlled respirator at the slightest indication of respiratory impairment. An SOP for aseptic technique in tracheostomy care and proper cleansing and sterilization of respirator connecting components was adopted to reduce the incidence of introducing infection into the respiratory tree.

Sepsis, Pseudomonas pneumonia, and bleeding stress ulcers accounted for many of the fatal postoperative complications. Invariably, a causal relationship was found. between these complications and concealed deep body-cavity abscesses or extensive surface wound suppurations. The most common organisms cultured from wound exudates and respiratory secretions was Pseudomonas aerogenosa followed by Klebsiella, Aerobactor, Paracolon bacilli and Staphylococcus aureus.

3. Medical Service

From January to October, 1970, there were 2276 military personnel were admitted to the Medical Service. The most frequent reportable cases were 357 Falciparum malaria, 183 cases of vivax malaria and 147 cases of hepatitis. There were 59 cases of shigellosis, 24 cases of apparent scrub typhus, 28 cases of infectious mononucleosis, 9 cases of intestinal amebiasis and 1 case of melioidosis.

The number of malaria cases increased in June and peaked in August (falciparum - 6 cases, vivax - 50 cases). There were no deaths or signi­ficant complications from malaria.

All hepatitis patients improved without major complications

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There were two U.S. Military deaths during the month of June. The first case was a 21 year old. white male who died with systemic staphylococcus infection involving the lungs and the central nervous system. The apparent primary source was a superficial abscess of the right flank. His disease was unresponsive to penicillin and high doses of keflin. The second case was a 19 year old white male who had signs of menin­gitis, type unknown. He was treated with penicillin and subsequently chloramphenical and steroids were added. He developed pseudomonas aeroginosa septicemia with left upper lobe pneumonia. This condition was unresponsive to colymycin or gentamycin and the patient died on the 25th day of hospitalization in spite of vigorous pulmonary resuscitative management.

The case of melioidosis presented with symptoms of cystitis and prostatitis. Urine and blood culture grew pseudomonas pseudomallei. There was good response with tetracycline. A recurrence of symptoms resulted upon discontinuation of medication. Again the disease was controlled with tetracycline and the patient was evacuated to Japan.

In addition to patient care, the Medical Service conducted medical clinics three times per week. An average of 12 patients per day were seen.

4. Nursing Service

During the month of February, the 30 bed unit C-2 that had been opened the previous month of November 1969, to handle a large influx of ambulatory self care type of patient was phased out because of the de­crease in patient load. Unit B-8, the second Intensive Care Unit that was opened in November 1969, to be utilized in the care and treatment of burn, orthopedic and vascular surgery cases was closed in July and the patients were integrated into other wards. The overall census of the hospital decreased during this time.

An Inhalation Therapy program was initiated in October under the supervision of the Chief Nurse Anesthetist.

The Emergency Room service remained the busiest service in the hospital staffed with 5 ANC officers, 1 91C40, 7 91B20, 7 litter bearers, and appropriate Medical Corps officers. This activity accomplished the following during, the period 1 January 1970, through 10 November 1970.

patients seen                                          12,559

wounded in action                                    4,787

Debridement                                               336

Delayed Primary Closures                             18

Primary Closures                                        332

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Chest tubes inserted                                  244

I&D's                                                         39

Open Chest Massage                                    6

Tracheotomy                                                 1

Cut downs                                                128

Deliveries, O.B.                                            3

The five-room operating suite was staffed with five nurse anesthetists, ten operating room nurses, and thirteen enlisted operating specialists. Also assigned was one cast specialist. An average four rooms were used during the day with 2 or 3 rooms in use at night. The staff was adequate during the peak periods and had the capacity in emergencies to maintain three rooms continuously for 24 hours for at least a 5-7 day period.

Army Nurse Corps officers and 91C20 Medical Specialists continued to perform as aeromedical evacuation attendants to accompany seriously ill patients who were transported to other medical facilities by Army helicopter.

Two hospital wards were staffed with MOS 91C Medical Specialists. Nurse supervision was provided. Both ambulatory and semi-ambulatory patients were treated on these wards. The personnel assigned to these wards performed their duties in an outstanding manner.

The Civilian War Casualty Program ward of 30 beds was staffed with three Army Nurse Corps officers, four enlisted men, and one Vietnamese interpreter. Through the interpreter, the patients were taught to care for their tracheotomy tubes, dressing change and gastronomy tube feeding.

Awards for meritorious service were presented to Nursing Service personnel as follows:

           Bronze Star Modal                              Officers - 17

                                                                      EM - 25

           Meritorious Service Medal                   Officers - 1

           Army Commendation Medal                Officers - 19

                                                                      EM - 50

Deactivation:

On 9 October 1970, this unit was notified that it was scheduled for withdrawal from the Republic of Vietnam and ultimate deactivation. Pending receipt of L.O.I. the target date for standdown was 25 November 1970. On October 13 an initial unclassified briefing on standdown was

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given to the ANC officers and Assignment Preference Statements were distributed for completion. These forms were forwarded to the Chief Nurse USARMEDCOMV on 19 October 1970. On 20 October this unit received its L.O.I. from the 68th Medical Group. Wards B-8 and C-2, closed earlier in the year and left in mothballs for contingency were released to S4. Officer Efficiency Reports were initiated on all ANC officers as well as recommendations for awards and "letters of recommendation for award upon completion of foreign service tour." On 27 October verbal reassignment instructions were received from the Chief Nurse USARMEDCOMV on all ANC officers.

Ward Closings:

28 Oct.           Ward C-1 Vietnamese Civilian War Casualty Program ward closed. This was effected by discharge, intra-theater transfers, and intra-hospital transfers of patients.

30 Oct.           Ward C-3 Minimal Care ward closed.

4 Nov.             C-4 Surgical Ward and C-8 Medical Minimal Care Ward closed.

5 Nov.             B-2 Pre-Operative ward closed.

7 Nov.             C-5 Surgical and C-7 Medical wards closed.

8 Nov.             C-6 closed.

9 Nov.             Hospital census at 0700 hours was 20 patients. Ward B-7 Post-Operative ward closed.

10 Nov.           Last operating ward, B-6, closed with the evacuation of the five remaining patients.

On 9 November 1970, the Emergency Room capability was reduced to two unit spaces for Emergency Medical Care and was redesignated as an Aid Station staffed by 1 MC and 2 corpsmen. On 10 November hospital operating rooms, CMS, and all wards were signed over to supply.

Evacuation

As a means to control and prevent inappropriate or unnecessary evacuation of patients, all hospital physicians and nurses were instructed as to the meaning and importance of priority designators. Priority for evacuation during mass casualty situations was determined by the first call surgeon acting as triage officer or by his delegate. In all other situations, priority was determined by the attending physician.

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Evacuation policies were closely monitored by the Registrar acting in his capacity as administrator for all air evacuations. No patient was evacuated before his vital signs were stabilized, blood loss replaced, airway instituted, fractures splinted and bleeding controlled. Pure head injury patients with minimal and minor extremity or superficial body wounds were stabilized and transferred as soon as possible to a neurosurgical center hospital. Head injury patients with associated thoracic, abdominal, blood vessel and extensive extremity and bone injuries were retained, operated upon and evacuated as soon as they were stabilized. An ANC officer accompanied all serious head injury patients during evacuation. If the patient was unconscious, he was endotrachially intubated and given assisted ventilation with 100% oxygen through an Ambu Bag.

IX

ASSISTANCE PROVIDED CIVILIAN AND NON-US MILITARY PERSONNEL

Medical Civic action Program (MEDCAP)

There were 42 MEDCAP sessions conducted in Cu Chi: 3,200 Vietnamese patients were treated. A MEDCAP team consisting of 1-2 MC's, 1 DC, 2 ANC, 1 NCOIC, 3 medical specialists, 1 dental assistant and 2 interpreters were sent to the village on Thursday afternoons when security permitted.

Civilian War Casualty Program

656 Vietnamese indigenous civilians injured as a direct result of war were admitted. One 30 bed ward was designated for those patients and was invariably filled to capacity.

X

OTHER

Laboratory Service

The Laboratory Service operated during this reporting period with an average staff of ten enlisted personnel and two officers. We experienced a two month period of acute personnel shortages when we operated with a total strength of seven. During this time we processed 34,707 laboratory test procedures. Since January 1970, the laboratory has expanded its services to include extensive Bacteriology Identification and cross-matching. The Chemistry Department was increased by the introduction of 8 additional procedures. This expansion allowed the laboratory to offer a total of (80) eighty specific laboratory tests to the

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professional staff, an increase of twenty (20) test procedures during the year. A total of 164,791 tests were performed, an increase of over 50,000 for the same reporting period. 642 cases of malaria were diagnosed by specific species. 2,797 patients were transfused with over 11,000 units of type specific blood.

XI

INSPECTIONS AND VISITS

The annual General Inspection was conducted by the USARV IG Team on 12-14 August 1970. The hospital received an overall rating of Satisfactory (based on a satisfactory-unsatisfactory rating scale) while being rated excellent in 40 areas and satisfactory in 4 cases.

The Command Maintenance Inspection was conducted by the USA MEDCOM V (P) CMMT Team on 10 July 1970. The overall rating was 88%, the highest score given a hospital by that team to that date.

The Commanding Generals and Deputy Division Commanders of the 25th Infantry Division, 1st Air Cavalry Division, and 9th Infantry Division made frequent (often weekly) visits. These visits continued to provide a morale booster for the patients.

LTG McCaffrey, Deputy Commander, USARV, visited the hospital on 23 July 1070. He expressed his appreciation to the staff for the excellent care given his son who had been a patient here.

Numerous other military dignitaries visited the hospital during the last year. BG Thomas, USARV Surgeon and. CG, USA MEDCOM V (P), visited on 27 January 1970, to award the hospital a plaque signifying the 30,000th patient treated; on 26 February 1970, with RADM Voices, USN; on 6 June 1970; and on 9 October 1970, to notify the hospital of closure plans. Members of his staff made periodic visits including LTC Stuart S. Roberts, USARV Surgical Consultant, who made three visits; COL Verdan, USARV Medical Consultant; Maj Tuter 44th Medical Brigade Historian; LTC Baggan, MEDCOM Dietitian; LTC Van Horn, MEDCOM Physical Therapist; COL Murphy, Chief Nurse, MEDCOM; Maj Kielman, MEDCOM Operations; and LTC Conley, MEDCOM Anesthetist.

Additional visitors included BG Bernstein, incoming MACV Surgeon and the RVN Minister of Health; LTC Swan, WRAIR (Walter Reed Army Institute of Research) who spent five weeks here photographing surgical procedures for Army Research; MG Cooper, Engineers; Maj Harvey, an Australian Army MC Officer; and Gen Thoung, ARVN Army CPS.

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Many entertainment and tour groups visited the staff and hospital patients including Bob Feller and other members of the 1970 Major League Baseball Tour, National Basketball Association players, and NCAA college football stars.

Regular visits were made by key personnel of the 68th Medical Group including Col Edwards and Col Moyar, Commanders.

Regular visits by key 12th Evacuation Hospital personnel were made to the hospital's subunit, 185th Medical Detachment, in Phu Loi. The 185th Medical Detachment was transferred to the control of the 24th Evacuation Hospital on 1 November 1970.

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