Team effort saves NCO

  • Published
  • By Tech. Sgt. Gene Lappe
  • 506th Air Expeditionary Group Public Affairs
Kirkuk Air Base, Iraq --  From asleep to awake in seconds ... a pair of sharp stings from a scorpion known as the "death stalker" jolted a member of the 506th Expeditionary Medical Squadron awake in the early morning hours of Nov. 18.

Staff Sgt. Monique Munro-Harris, 506th EMEDS biomedical equipment technician deployed from RAF Lakenheath, was asleep when she felt something on her ear, and when she brushed it away, she was stung for the first time on the ring finger of her left hand.

The object landed on her side and stung her again. This sting woke her right up, and she started looking for the source of the pain.

"At first I thought it was a camel spider," said Sergeant Munro-Harris. "I got undressed, checked my clothes and looked through my sheets trying to find what had bitten or stung me."

Initially, she didn't see anything, but as she was getting dressed she saw the culprit - a small scorpion, already dead. She showed it to her roommate, and the two agreed that Sergeant Munro-Harris needed to go the emergency room.

She had the foresight to take the scorpion with her to the ER, which may ultimately have saved her life.

She said she felt fine when she got the E.R. Capt. (Dr.) Amy Gammill, 506th EMEDS internal medicine physician also deployed from the 48th Medical Group at RAF Lakenheath, examined her.

"When she first came in, she didn't have any symptoms except for a little redness and swelling on her finger," said Captain Gammill. "We sat her down, put ice on the sting sites and started working her history. The (wounds) looked like and felt like bee stings."

The ER staff also began actively monitoring her vital signs. After Captain Gammill started initial treatment to limit the effects of the toxin, she did some research and contacted Maj. Juan Leon, Public Health officer in charge another 48th MDG deployed member, for help with identifying the type of scorpion.

When he arrived at the ER, he immediately knew what it was: Lieurus Quinquestriatus, the "death stalker."

"We knew at that point that we needed to be very aggressive with our treatment," said Captain Gammill. She contacted the Air Force Theater Hospital at Balad Air Base to ensure antivenin was available if necessary and to find out if the staff had any experience with such cases. She also called Col. (Dr.) Pat Storms, 506th EMEDS deputy commander deployed from RAF Lakenheath, to discuss treatment options.

According to most data about stings by this type of scorpion, 97 percent of the victims have only a local reaction, and only 3 percent have severe reactions, Captain Gammill said. Based on these odds, the 506th staff decided to treat Sergeant Munro-Harris on site rather than transfer her to Balad.

Initially, the patient was fine. Then, about two-and-a-half hours after being stung, her condition started to deteriorate. In a matter of minutes, she felt as if she were having trouble breathing. She felt pressure in her chest and became visibly anxious. She may have been experiencing what Captain Gammill called "a systemic reaction to the sting" since the symptoms were appearing so rapidly.

A systemic reaction can involve the entire body, with symptoms ranging from red, warm skin and itching to swelling and tightness in the throat, chest, lips, or tongue, an abnormal heartbeat, a drop in blood pressure and shock that can lead to death.

After consultation with Colonel Storms, the staff made the decision to insert a breathing tube into the patient's windpipe - a process known as intubation - and transfer her to Balad to receive the antivenin.

"The last thing you want to do is deal with an airway problem in flight," said Colonel Storms. "It is challenging to work on a patient because there isn't enough room to work around them to insert a tube. We discussed this with the internist and the anesthesiologist and elected to do the procedure before we transported her."

A flight surgeon, Colonel Storms accompanied Sergeant Munro-Harris on the flight. The intubation had gone smoothly, and she did well for most of the trip to Balad, the colonel said.

"Then, 15 minutes before we landed, everything bad happened at once," he said. "She lost her blood pressure and pulse. She was also started having abnormal cardiac rhythms." These symptoms were brought on as a result of the venom coursing through her system.

Colonel Storms started administering medications to try to stabilize her. His efforts were successful, and her blood pressure and pulse returned. She continued to improve through the remainder of the flight.

By the time the helicopter landed at Balad, she had a steady pulse and good blood pressure.

She was rushed into the ER and given the antivenin. Once it started to counter the effects of the toxins, her condition improved rapidly and airway support was discontinued. She was later transferred to Landstuhl Regional Medical Center, Germany.

Four days later, her condition had improved so much that she was released from the hospital. She will remain in the area for a few days and have her heart checked regularly to ensure she has no lingering effects from the toxin.

"Sergeant Munro-Harris benefited from some pretty terrific teamwork," said Colonel Storms. "The ER-crew did a fantastic job getting her squared away and ready to transport. The anesthesiologist did a brilliant intubation. The Army medical evacuation personnel were fantastic, and the receiving team at Balad Air Base knew exactly what to do," he said. "A large group of people working as a team ... you can't get any better than that."