Spoken from the Front by Andy McNab Read Free Book Online

The aim is to help the small number of
soldiers who may succumb – who may die in transit –
because of the potential delay. And that's what the concept of
the MERT is all about. It is bolting a small, specialist
medical team on to an RAF evacuation team to produce
a link from the medic or young doctor on the ground, and
the all-singing-and-dancing hospital where a patient will
eventually end up.
    MERT dates back to the Balkans conflict, if not before. At
that stage we had an incident response team [IRT]. An IRT
was a way of getting specialist agencies to the site of an
incident. That was not only medical, also engineers, bomb
disposal, Military Police. That was when we were first
putting medical teams on helicopters to go forward and pick
casualties up. That was very much a local organizational
structure: it was not doctrine. That was when people first had
the idea of putting medics or any specialty on a helicopter
and maybe leapfrogging other medical nodes along the way
to speed up the casualty evacuation. In Iraq this was
continued in the early days of 2003–4. We would have
specialist RAF teams usually involving a paramedic and a
nurse, sometimes backed up by a doctor, depending on the
nature of the incident. The thing is those doctors were not
necessarily pre-hospital-care-trained to the standard of what
we have now in Afghanistan. It was a different war, different
situation. It worked reasonably well and they worked very
hard.
    Coming back to 2006, when we – 16 Medical Regiment –
deployed with 16 Air Assault Brigade, we had a lot of
experienced critical-care doctors including anaesthetists and
emergency medical care practitioners, A-and-E docs. Also,
they had the ethos that they really wanted to support 16 Air
Assault Brigade as much as possible in-field. 16 Medical
Regiment took this idea of a medical IRT and formalized it in
to a medical emergency response team [MERT]. It was
actually breaking new ground and, like all things when you
break new ground, there was a certain amount of resistance
to it. I would suggest that the one person who had the most
input in starting it was a chap called Lieutenant Colonel
Andy Griffiths – in the early spring of 2006. As well as Andy,
the other man who really pushed it was the commanding
officer of 16 Medical Regiment, Lieutenant Colonel Martin
Nadin – now a full colonel. They simply wanted to support
the troops on the ground as much as possible.
    The MERT is a concept. It is purely about getting the care
that the soldier requires to him or her as early as possible.
And that is really making sure that these critical interventions,
which can be life-saving, are done as quickly as
possible by having a team on the helicopter that mitigates the
extra length of time it takes. You can carry on doing the treatments
while evacuating them and see how they should be
treated when they get to the base hospital. The [MERT] team
make-up will vary depending on your resources and what is
going on on the ground. In the spring of 2006 in Afghanistan,
we had a four-person team and that was based around an RAF
paramedic, an RAF flight nurse, a senior clinician with critical-care
experience – probably an anaesthetist or emergency
medicine doctor – and the fourth member of the team was an
Operating Department practitioner [ODP]. In 2006, we were
averaging three shouts [medical call-outs] a day, but sometimes
we would do as many as five.
    One of the reasons why I do this job, and one of the reasons
other people do this job, is that in the military medical system
there is a huge duty of care for the soldiers on the ground.
Personally I think the NHS has lost that. The NHS does not
have that link with the general public any more and there are
lots of reasons for that. But we certainly still have that very
strong ethos of supporting the guys on the ground.
June 2006
    Colour Sergeant Richie Whitehead, Royal Marines
    We had a couple of attacks on the camp [Lashkar Gah] as they
[the Taliban]