P Chapman. Operation Corporate-The Sir Galahad
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J R Army Med Corps: first published as 10.1136/jramc-130-02-04 on 1 January 1984. Downloaded from ) R Arm.r Mlu/ Corps 19804; 130: K4-8 8 Operation Corporate-The Sir Galahad Bombing Woolwich Burns Unit Experience Maj PChapman FRCS lEd) RAMC Senior House Officer in Burns and Pfast;o' Queen Elizaheth Military Hospital. Woolwich SUMMARY: During Military Operations in the South Atlantic to recover the Falkland Islands in 19H2. the troopship Sir Galahad was bombed. Initial treat ment of the injured in field medical units was followed by transfer to the hospital ship SS Uganda and evacuation to the United Kingdom where 48 patients were treated in the Burns and Pla.!ttics Unit, Queen Elizabeth Military Hospital. Woolwich. The treatment of these Ilutients is described and the mana"emcnt of war hurns discussed. Introduction On 8 June the Royal F leet Auxiliary SI R guest. Protected by copyright. GALAHAD was at anchor in Fitzroy Bay . The ISL Battalion Welsh Guards, support troops, their equipment and munitions were on board. They were awaiting disemba rkation for BlutT Cove as part of the force involved in the coming assault on Port Stanley when, at approximately 1700 hours local time, the ship was bombed by Argentinian Sky Hawk jets. At least one bomb exploded at the rear end of the tank deck which was the main assembly point for troops and their equipment ready to leave shi p. T he blast caused secondary detonation of a considerable amount of munitions, including mortar ammunition stored directly below the ship's main hatch forward of the superstructure. Troops were The Sir Galahad on fire in Fitzroy. killed or injured by flash, blast and secondary mis si les from multiple explosions. A total of 78 soldiers HECLA, HERALD and HYDRA for passage to http://militaryhealth.bmj.com/ were burnt. Within minutes of the attack a massive Montevideo and onward flight in RAF VC 10 air w evacuation of the ship was started, usi ng hel icopters. craft to the UK via Ascension Island. On arrival lifeboats, landing craft and inflatable rafts. Many in UK, wounded were held overnight at the Princess wounded troops were successfully carried ashore. Alexandra's H ospital, Wroughton. and then dispersed although all their equipment was lost. to other military hospitals in England. Medical facilities at Fitzroy were Jimited, as a ll the Field Ambulance equ.ipment had been lost On Management board the SI R GALAHAD during the bombing. Of the burnt soldiers who reached the UK, 27 First aid was given and the wounded evacuated as were considered sufficiently healed to be sent home soon as possible by helicopter to Ajax Bay where on sick leave, th ree were transferred to the RA F (he main shore-based medical facilities were stationed Hospital, Halton, and 48 were transferred to the in a disused refrigeration plant. Some of the injured Burns and Plastics Unit at the Queen Eli zabeth on October 6, 2021 by were transferrc:d directly to ships in San Carlos Military Hospital, Woolwich. Water. All were ultimately evacuated to the hospital The field medical documentation and hospital ship SS UGA N DA which itself was under pressure case notes of those patients treated at Woolwich to evacuate as many wounded as possible, to make were retrospectively analysed. Each soldier was inter room for the large numbers of casualties expected viewed to make good any omissions in the neces from the planned attack on Port Stanley'. T hose sarily brief field records and to provide background fit enough were therefore transferred from information for construction of the histori cal UGANDA to the smaller hospital transport ships, picture. It J R Army Med Corps: first published as 10.1136/jramc-130-02-04 on 1 January 1984. Downloaded from P Chapman 85 In the South A rlanrie measured on a hand-held battery-powered centri Immediate first aid at Fitzroy including hosing fuge, using a regime now known as the "Uganda down of burnt areas with cold water and applica Rule" (Table I)' . tion of basic field dressings2 • As all medical stores had been Jost in the ship. the two field surgical Table I teams from 2 Field Hospital, supported by 16 Field "The Uganda Rule" AmbuJance, had an extremely limited capacity ~ . Hourly haemalOcril Rate of infusion for However, shore-based infantry units, already estab 500 mls Dextran 70 lished and equipped, were on hand to provide intra > 60 2 hourly venous fluids, drip-giving sets and further field dressings. 50 - 60 4 hourly After receiving their basic first aid, casualties were <. 5U 6 hourly transported by helicopter as quickly as possible, many within half an hour, to the medical unit at Ajax Bay. Space and resources at the refrigeration Surgery on the UGA NOA was necessarily kept plant in Ajax Bay were also limited, so about half 10 a minimum. The most severe facial burns were the patients were transferred to medical holding treated with eyelid split-skin grafts and tarsorraphies facilities prepared aboard FEARLESS, INTREPID for corneal protection. A few escharotomies were and ATLANTIC CAUSEWAY. carried out, as well as emergency surgery for other injuries. Parenteral prophylactic antibiotics, started At Ajax Bay patients were routinely given intra guest. Protected by copyright. muscular penicillin and booster doses of tetanus at Fitzroy jf available, or otherwise at Ajax Bay. 4 were continued orally for five days. toxoid • Morphine was available for pain relief. Hand burns were cleaned with cetrimide solution and put into plastic bags containing silver sulpha diazine cream until the supply of bags ran out. The remaining patients were given saline-soaked field dressings until plastic bags were again available on the Uganda. Other areas were treated with saline soaks which were replaced with occlusive silver sulphadiazine dressings on UGANDA. Faces were left exposed after cleansing. Other injuries such as shrapnel wounds were debrided and treated as required. Fourteen patients with greater than 10% burns were resuscitated with intravenous fluid drips begun either at Fitzroy or later at Ajax Bay. Eight of these were catheterised. Of a further 19 patients with 6- http://militaryhealth.bmj.com/ 10 % burns, nine required intravenous drips, and two of these were also given a urinary catheter. A fig. 2 Skin grafting in South Atlantic total of 10 patients required catheters, three of which were inserted at Ajax Bay and the rest on board the hospital ship UGANDA. The main fluids Two patients, one who developed a haemo used at Fitzroy and Ajax were sodium lactate ami pneumothorax, and the other who required revision Polygeline. of a traumatic below-knee amputation. received As most had been exposed to flash and smoke ion blood transfusion at Ajax Bay_ Blood was given to the confines of the ship, steroids were administered. two other patients on the UGANDA with 26% and before transfer to the UGANDA, to 29 patients. 45 % burns respectively. In the relatively calm condi roughly half of whom had one dose of hydrocorti tions of the SS UGANDA, blood was cross matched on October 6, 2021 by sone 100mg intramuscularly, the rest having I gram before transfusion, although at Ajax Bay group of Methylprednisolone intravenously six hourly_ compatible blood was used without waiting for the Most patients were transferred by helicopter to result of emergency cross match. No transfusion the hospital ship UGANDA within 24 hours. Here reactions have been reported so far. intravenous resuscitation was continued using Dex tran 70 in those still with high haematocrit levels In the United Kingdom many hours after injury. The drip rate was con- The Queen Elizabeth Military Hospital, Woolwich • trolled by reference to hourly haematocrit levels received 48 burns cases from the SIR GALAHAD, J R Army Med Corps: first published as 10.1136/jramc-130-02-04 on 1 January 1984. Downloaded from Operarion Corporate- The Sir Gafahad HomiJifl g amongst other casualties from the South Atlantil.:. rc-grafting. Surgery was carried out to other areas as The Burns and Plastics Un it at Woolwich has 28 shown in Table Ill. Kirschner wires were used on ordinary beds a nd six high care beds in a self five patients to prevent finger joint contracture. Of contained burns ward. At the first indication of the the faces only two required any grafting. the re expected casualtie.."i all routine plastics patients were maining superficial Hash burns ht=aling conservatively moved from th~ Unit and booked operations were with exposure. Twt=nty-five patients had superficial postponed. Spare beds \vere made available on a hand burns which healed sufficiently with conserva general surgical ward for overflow of the less severe tive management to allow them to be sent home cases, and extra nursing staff were transferred from on sick leave within three weeks of injury. other parts of the hospital. The day-to-day run · In early July the last two patients arrived, delayed ning of the Unit was carried out by the Army Con· in one case by septicaemia in a 45 % body surface sultant in Burns and Plastic Surgery assisted by one area burn, and in the other by revisionary surgery junior doctor. On days when large numbers of to a traumatic amputation of the leg. The former casualties arrived together, junior doctors from other underwent an extensive series of re(.;onstrLlctive surgical departments were encouraged to help In operations, including bilateral tarsorraphy, bilateral the initial reception and clerking of patients. split skin grafts to upper and lower eyelids followed A total of 48 male patients. aged between 18 by Wolfe grafts to the same areas. and split skin and 41 , all injured on 8 June 1982, were admitted to grafts to other parts including the hands, arms and the Queen Elizabeth Military 'Hospital from 18 June scalp.