YOKOSUKA NAVAL BASE, Japan — All three passengers were on ventilators; all critically injured in Iraq.

A ventilator ran out of oxygen and the only Navy nurse aboard — bulky with protective gear and responsible for everyone — rushed to change the tank while keeping steady on the helicopter flight.

“Imagine ICU nursing in a tent. Times that by 10 flying around in a helo. And you’re the only one there,” said Cmdr. Jennifer McCoy, describing Navy flight care nursing. “I have the utmost respect for these people.”

Over speakerphone from Iraq on Thursday, McCoy described being a combat nurse there to 20 of her medical colleagues from U.S. Naval Hospital Yokosuka. McCoy, the head of Yokosuka’s medical-surgical department, went to Iraq in October to be nurse manager of the Joint Theater Trauma System. Her voice accompanied a presentation on combat medical care and Centcom’s JTTS program.

JTTS’ senior nurse, she is charged with getting the “right patients to the right place at the right time.”

This means improving communications, patient processing and plenty of data collection, she said — although she warned against the temptation to back-burner paperwork in a combat environment.

“En-route care documentation is horrific,” McCoy said. “Some people adopt this war-zone attitude that documentation is not important. But we go by the rule that if it isn’t documented, it didn’t happen.”

Some 40 percent of today’s injuries come from improvised explosive devices, she said; 35 percent of them occur on arms and legs left vulnerable by personal protective equipment.

And six in 10 of her unit’s patients are Iraqi, which presents other challenges, McCoy said: “Cultural, dietary and safety concerns. And the translation services are worse than Japan.”

Hypothermia is a major concern even in the desert, she said, and emergency rooms are kept at 82-85 degrees. Body bags are used to insulate hypothermic patients.

Hospitals also are seeking more whole blood now, instead of the standard packed red blood cells. They are dispensing rFactor7, a coagulant that carries a $2,000 price tag, to save lives, she said.

However, when people ask her, “How bad is it?” McCoy returns, “Not that bad.” The food is good and you get plenty of exercise, she said. She extended for an additional six months and will return to Yokosuka in the fall.

“People say you either leave weighing 300 pounds or able to lift 300 pounds because your only entertainment is eating and working out,” McCoy said.

She misses “her” corpsmen, she said, many of whom were able to chat with her Thursday.

“Corpsmen have a motivation that is hard to beat,” McCoy told those listening in. “You should hold your head high.”

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