{"id":31213,"date":"2014-03-13T11:36:56","date_gmt":"2014-03-13T10:36:56","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=31213"},"modified":"2014-03-13T11:36:56","modified_gmt":"2014-03-13T10:36:56","slug":"the-bmj-today-surgery-in-a-war-zone","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2014\/03\/13\/the-bmj-today-surgery-in-a-war-zone\/","title":{"rendered":"The BMJ Today: Surgery in a war zone"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" alt=\"Deborah Cohen\" src=\"http:\/\/www.bmj.com\/site\/blog\/icons\/debs.jpg\" width=\"160\" height=\"160\" align=\"left\" \/>\u201c<a href=\"http:\/\/www.bmj.com\/content\/348\/bmj.g2016\">Nothing else comes close to the enjoyment of being able to help people in a war zone<\/a>,\u201d says London based vascular surgeon David Nott in BMJ Confidential.<\/p>\n<p>For two decades he has taken around six weeks, unpaid leave almost every year to provide help and to train doctors in war zones, starting in Sarajevo in 1993 and most recently in Syria. <!--more--><\/p>\n<p>Last year, while stationed in Aleppo, Nott released an x-ray image that became global front page news. It showed an unborn baby with a bullet lodged in its skull\u2014the result of pregnant women being targeted by snipers.<\/p>\n<p>It\u2019s not the first time that the <em>BMJ<\/em> has interviewed Nott. Back in 2008, while on a ward round working for M\u00e9decins Sans Fronti\u00e8res in the Democratic Republic of Congo, he came across a 16 year old boy who needed an emergency forequarter amputation. Never having done one before\u2014but realising the boy would die without one\u2014he contacted his colleague, Professor Meirion Thomas, at the Royal Marsden Hospital, whom Nott believed to have the \u201cgreatest experience with forequarter amputation in the UK.\u201d<\/p>\n<p>Through a series of detailed text messages from Thomas, and hours of planning the procedure on pieces of paper, Nott carried out the procedure successfully. Read the <a href=\"http:\/\/www.bmj.com\/content\/337\/bmj.a2958\">full text exchange here<\/a>.<\/p>\n<p>In BMJ Confidential, Nott says that what has made the biggest difference in his specialty is his understanding of the physiology of trauma. \u201cIt allows me to do what is right for the patient in any environment I find myself,\u201d he says.<br \/>\nHe is putting that knowledge to good use. With funds from the Department for International Development, he is training doctors who have expressed an interest in doing humanitarian medical work via the<a href=\"http:\/\/www.uk-med.org\/trauma.html\"> UK International Emergency Trauma Register<\/a> in surgical practice in warzones.<\/p>\n<p>For those interested in learning more about emergency surgery, <a href=\"http:\/\/www.bmj.com\/content\/348\/bmj.g1140\">Munawar Al-Mudhaffar and Philip Hormbrey describe the basics of assessing abdominal trauma<\/a>. \u201cTo avoid missing significant injuries, one must assume that every major trauma patient has suffered an abdominal injury unless the patient is awake, has no abdominal pain or distracting injuries, and has normal vital signs,\u201d they say.<\/p>\n<p><em><strong>Deborah Cohen<\/strong> is investigations editor, The BMJ.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>\u201cNothing else comes close to the enjoyment of being able to help people in a war zone,\u201d says London based vascular surgeon David Nott in BMJ Confidential. For two decades [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2014\/03\/13\/the-bmj-today-surgery-in-a-war-zone\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[447,5750,1357],"tags":[],"class_list":["post-31213","post","type-post","status-publish","format-standard","hentry","category-india","category-the-bmj-today","category-us-health-care"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>The BMJ Today: Surgery in a war zone - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2014\/03\/13\/the-bmj-today-surgery-in-a-war-zone\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"The BMJ Today: Surgery in a war zone - The BMJ\" \/>\n<meta property=\"og:description\" content=\"\u201cNothing else comes close to the enjoyment of being able to help people in a war zone,\u201d says London based vascular surgeon David Nott in BMJ Confidential. For two decades [...]More...\" \/>\n<meta property=\"og:url\" content=\"https:\/\/blogs.bmj.com\/bmj\/2014\/03\/13\/the-bmj-today-surgery-in-a-war-zone\/\" \/>\n<meta property=\"og:site_name\" content=\"The BMJ\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/bmjdotcom\/\" \/>\n<meta property=\"article:published_time\" content=\"2014-03-13T10:36:56+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/www.bmj.com\/site\/blog\/icons\/debs.jpg\" \/>\n<meta name=\"author\" content=\"BMJ\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@bmj_latest\" \/>\n<meta name=\"twitter:site\" content=\"@bmj_latest\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"BMJ\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"2 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2014\\\/03\\\/13\\\/the-bmj-today-surgery-in-a-war-zone\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2014\\\/03\\\/13\\\/the-bmj-today-surgery-in-a-war-zone\\\/\"},\"author\":{\"name\":\"BMJ\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/#\\\/schema\\\/person\\\/ba3da426ed20e8f1d933ca367d8216fe\"},\"headline\":\"The BMJ Today: Surgery in a war zone\",\"datePublished\":\"2014-03-13T10:36:56+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2014\\\/03\\\/13\\\/the-bmj-today-surgery-in-a-war-zone\\\/\"},\"wordCount\":370,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2014\\\/03\\\/13\\\/the-bmj-today-surgery-in-a-war-zone\\\/#primaryimage\"},\"thumbnailUrl\":\"http:\\\/\\\/www.bmj.com\\\/site\\\/blog\\\/icons\\\/debs.jpg\",\"articleSection\":[\"South Asia\",\"The BMJ today\",\"US healthcare\"],\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2014\\\/03\\\/13\\\/the-bmj-today-surgery-in-a-war-zone\\\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2014\\\/03\\\/13\\\/the-bmj-today-surgery-in-a-war-zone\\\/\",\"url\":\"https:\\\/\\\/blogs.bmj.com\\\/bmj\\\/2014\\\/03\\\/13\\\/the-bmj-today-surgery-in-a-war-zone\\\/\",\"name\":\"The BMJ Today: Surgery in a war zone - 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