Combat Nurses: Certified Registered Nurse Anesthetists Published Jan. 30, 2008 By Tech. Sgt. D. Clare 332nd Air Expeditionary Wing Public Affairs BALAD AIR BASE, Iraq -- The human body alone isn't equipped to deal with the wounds of war. Trauma caused by an improvised explosive device, for instance, is literally and figuratively a jolt to the entire system. Blood changes and loss, temperature decreases, oxygen deprivation and shifts to the pH balance of bodily fluids spell disaster in the operating room. As important as a procedure may be to saving a patient's life, the troops' vital conditions must be constantly maintained for the body to survive. That's part of the reason why Capt. Charlie Johnson, a certified registered nurse anesthetist, looks like a one-man band in the operating room. Before an operation, the patient must be intubated to maintain the airway during surgery, given an appropriate amount of inhalation gasses to remain asleep, and narcotics to block pain. All those responsibilities fall to Captain Johnson. In surgery, he's checking the patient's haemodynamic status to see if he needs packed blood cells or platelets. He jokingly calls himself a "walking pharmacist" because he administers medication and has to know exactly what to give and how much to provide. At the same time, he's checking the patient's blood pressure and temperature. "While the surgeons are doing their job on their side to fix whatever is going on with the patient, we have to back up and look at the big picture to make sure that individual is doing well," says Captain Johnson, a native of Converse, La. "It's symbiotic, they have to do their part and we do ours to see that the patient gets through." Stateside, the majority of anesthesia is provided by anesthesiologists and CRNAs. In Iraq, the majority is provided by CRNAs alone, according to the captain. Their duties, he says, reflect the trust the Air Force puts in their abilities. In and out of the operating room, the captain maintains a full schedule. A self-described "gym rat," he's slimmed down during his tour by improving his diet and stepping up his workout regimen. He does cardio and lifts weights five days a week. He does 400 crunches a day. On his light day, he runs three to five miles and does pull ups. He says his stamina improves his work. Lives depend on the care he provides, and he tries his best to keep his edge. He also trains medics from other services on intubation and initial patient care in the combat zone. He has worked with Army and Air Force special forces' medics. Like many military nurses, Captain Johnson says he will take any training opportunity he can get. Already a veteran of Afghanistan, he earned his CRNA certification through David Grant Medical Center at Travis Air Force Base, Calif., and received additional training at the R. Adams Cowley Shock Trauma Center in Baltimore. "I wouldn't have been able to go back to school and further my education without the Air Force. I wouldn't have been able to maintain my lifestyle or get paid to be in school," he says. "Still, the greatest reward in my military career is knowing that I'm a part of something that's greater than what I am. I think most people you talk to in military medicine would say the same thing." Note: This is the third installment of a five part series by Tech. Sgt. D. Clare titled "Combat Nurses." The entire series is available online at www.balad.afnews.af.mil. USAF. (U.S. Air Force Graphic by Rosario "Charo" Gutierrez) Photo Details / Download Hi-Res USAF. (U.S. Air Force Graphic by Rosario "Charo" Gutierrez)