Courtesy photo 1st Lt. Edward Pisarsky, nurse with the 328th combat support hospital, checks patient data in the Intermediate Care Ward using an MC4 laptop.

In the emergency room of a combat support hospital in Afghanistan, a multi-disciplinary team assesses a Soldier’s wounds before being transferred to the operating room. In an intermediate care ward in Iraq, nurses keep a watchful eye on a Soldier prior to his evacuation to Landstuhl, Germany. Meanwhile, a team of nurses treat severe dehydration at a forward deployed outpatient clinic in Kuwait.

Throughout Southwest Asia nurses remain at the hub of activity in medical treatment facilities. They shoulder the heavy load of treating sick and injured patients, mobilizing Soldiers from litters to beds, running down lab results and shuffling orders from one end of a hospital to another.

Next to administering care, nurses are charged with capturing critical pieces of information. Given this responsibility, any nurse will admit that charting patient care is far from their favorite duty. Few will disagree how important it is that the patient’s information be recorded and shared.

‘‘One of the downsides to medical care is that no one likes to chart patient care since it takes away from the time we could spend helping other patients,” said Capt. Kara Beattie, an emergency room nurse previously deployed to Baghdad with the 10th CSH. ‘‘But having this information allows others to know what treatments have been given. This can also provide insight of what care still needs to be done.”

Today’s standard for recording patient information is electronic, where medical teams can access data easily and immediately, where results are delivered without flight of foot, and where supervisors can mine legible data and output reports to pinpoint trends. This standard has already spread to tented hospitals, aid stations and mobile clinics overseas — more than 200 facilities to be exact.

Army-issued laptops, handhelds, servers and printers reside in every level three facility and outlying Army and Air Force treatment facilities in SWA. These systems, called Medical Communication for Combat Casualty Care (MC4), provide the deployed medical workforce with a means of digitally recording patient information in communications-challenged environments.

When connectivity is present, they transfer patient information to a worldwide accessible database, providing commanders with a medical situational awareness capability they never had before. But the success of the system relies solely on the users, placing nurses directly in the cross hairs.

Their efforts using MC4 have contributed to the collection of nearly three million medical records. Also having the ability to check patient data electronically to administer timely care has proven to be a benefit over paper-based methods.

‘‘We had a patient admitted to the ICW for gastroenteritis and the doctor ordered some routine labs, including a complete blood count (CBC),” said 1st Lt. Mary Miller, nurse with the 325th CSH in Al Asad, Iraq.

‘‘I was able to quickly access the electronic lab results and noticed this patient had a very low hemoglobin and hematocrit. The patient was able to receive care for anemia in a timely manner. Had I waited for a printout of the results, the treatment could have been delayed.”

Having the ability to view a patient’s deployed medical history enables every member of the medical team to make the best informed decision.

‘‘One patient had a bruise on his back and we noted this in the record,” Beattie said. ‘‘It turned out to be a bruised kidney. Having this information in the EMR allowed other providers to watch the situation and test for additional injuries.”

The use of EMRs also helps eliminate records being lost in transit, thus eliminating the chance for redundant or unnecessary procedures.

‘‘I think that it’s our job as a health care team to ensure that that information travels with that patient where ever they may go,” Beattie said. ‘‘EMRs allow nurses and physicians in a multi-disciplinary team to make clear decisions on the care being administered to our Soldiers as they go through the various health care facilities before they get back home.”

While the collection of EMRs adds to the workload, nurses understand the importance of taking the time to electronically capture all of the patient data, especially on the battlefield.

‘‘We’re the advocate for the Soldier,” Beattie said. ‘‘We’re the ones making sure that a Soldier’s injuries and treatments are documented accurately so that the additional healthcare they receive is appropriate and accurate based upon the medical history. EMRs have allowed us to do that in such a way that is unbelievable. We have that opportunity to impact a Soldier’s life, not only on the battlefield but all the way into retirement or medical retirement. And if we don’t do that, we’re not doing our jobs as healthcare providers.”