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File: 092396_aug96_decls14_0024.txt
Subject: PATIENT FILE
Box ID: BX000482
Document Number: 2
Folder Title: MEDSTAT - SITREPS DEC 90 4 OF 6
Folder Seq #: 8
Unit: ARCENT
Parent Organzation: CENTCOM
0'0:44.47 PATIEN- FILE 12/29"cD
A
PERSONAL DATA - PRTVACV A@,i- OF 11?74
5 U.S.C. 552 (b)(6)
A
16. AUTFDR,,Y #: 036OA009 2. SSAN: 3. PRECEDENCE: R
i. NAVIE@ IT
4. STAT: Al' 5. GRADE: E05 6. AGE- 'L2Y 7. SEX@ M 8. 14T-@ 180 9. READY DATE: 360
10, ISO: "OR: l@. SPEC
14. REAS REG: DS 15@ DATE L AT VIS!TI 16. CLASS: 2A
AS
17. A'@4,EP, PP.YST JFIRD 10. A.PPI/SURG DAT-'-- NO
20@ APPROV ALITH: '@l@ CANC/INC; '@2. VALID: f CWH Y4
2 . I'ITF O@IG: A5150 USA DISPENSARY DHAHRAN 24. TCAO ORIG-. DEDR
MT- DEST-. A5040 2@4D CEil H'GSP LANIDSTdr. 26. ICAO DESTI EBAR
DIAB 1: 8941 M.Ul@TIPLt- & UNC-PECIFIED OPEN! @OUND OF LOW-ER "IMB, CO@IPLICAIP-D
I MU' TIPIE & UNSPECIFIED CPEIN WOUND CF LOWER LI@MR, uLIM@FLIC,4TED
@9@ FRED SPEC 2: SODS 30. DIAS 2- B?41 1, i
31. i iED SPEC 3: SSE 32. DIAG 3: 8876 TRAUMATIC AMPUTATION OF ARM & HAND, BILATERAL, ANY LEVEL
32A. PROCEDURE;
3-1". SPEC DIET: N/ 34@ IV:
5. 02/LPri: N 36@ SLIP@T: N 37. NG TUBE: N. 38. RESPI N' 39. FOLEY: t4 40. STRYKERI t\l
T
41. Ii%'P@UB: N 42. TRACT@ N' 43. IVIED: N 44. CA@-i/LCC: N 4,5. TRACH@ N 46, riCN; @,i
71. PT BAB TYPE; NIB 72@ PT BAB TAG #-. 7'@. PT BAG WT:
47@ SUPO INFG- HHC 4/,@25TH INF; 82,@'@1.1 AIR@RORNE DIV; FT. BRAGS, NC REFORI-ED BY
173RD/O@@ EVAC
48, MAX ENRTE STOPS@ Y / 9 49@ MAX 0 RON-@-: Y 9 50. ALT REST/IIAX HT: N
53. INPATIENT: Y 54. SPEC PROG: VA DRUG ALCOHOL @IT N'ON'G X 55. VA COD':
c
'E. AD@t!N/BVERSEAS;
58. VITAL SIGNS(TEi'IP/PULSE/Rc@SP/BLOOD PRc@SS): 099.3 98 2L' / 120@ 1 64
N:
62@ (4BCz 63. SIIVSI: 64. MEDICATIONS: 13ENTAMY'lt4 SOMFj'S IV OBICLOS'@ 900qs
IV @8/P.NPYCILLIN 26NS IV 96/B@RONIC08nE .2CC/20C NFTL SALINE 06
65. HISTORY: TRAUMATIC AMPUTATION L. HAND AND L. LOWER ARM SUBTAIN'@t-D FROM A
L.A.W. ROUND EXPLOSION ON' 27@ DEC 90. OPEN Pla@14T SION FX L. LOWER LEG W/SIGNIFI
@u @
i'-ANT BONE AND TISSUE LOSS AND CRITICAL DEFECTS TO R. LEG. MULTIPLE ABRASIONS,
LACE5@ATIGt46, BURNS AND EXPLOSIONS TATOGING OVER FACE, -.@ST AND THIGHS. NEED
8 @RREE-FLAP COVERASE OF L. LEG A.S.A.P TO GAVE THE EXTREMITY; AS WELL AS FRED
UC,NIT DRESSIP46 CHANGES FOR THIS FREE-FLAP. Pi WI!_;_ NEED MTCRO-VASCULAP PLASTIC
SURGERY WHICH IS AVAILABLE NOT ONLY AT LAND6TUHI- BUT IN CON',JS 41- '@4RAMC.
66. ATT PHYS-. GAMBLE 67, PF@#: 000 000 0000 68. WARD#/PH#i 000 I 000 000 0000
69. REPORTED BY: DENTO@@' 70. P,4#: 000 0000
74. ATTENDANT NAME #II 75. STATUS: 76. GRADE;
77. AGE: 78. SEX: 78A. WT: 79. RELATIONSHIP TO PATIEN[I
80. BAB TYPE. 81. BIG TAG 82. -RAG V@T.
83. ATTENDANT NAM@@C #2@ 84. STATUS: 85@ GRADE:
86. ACE: 87. SEX: 87A. 88. RELA.TIONSHI0 TO PATIENT:
90. BAG TAG #i 91. BAG t@IT;
92. TRANS GRIG PHONE #t EXT:
93. TRANS DEST PHONE #: EXT:
94@ ETA N@RIG MTF(DATc@/TI.IE); 000 95. ETA DEST MTF@DAT@c/TIVE): OC)O
97. OTHER COMMENTS:
51, Mc-tl\i #: OOOC@/360 52. RON !-OC@
57. VALIDATED BYIREA.6 FOR HIGHER PRECEDENCE: 1
96. AIRCRAFT ITINERARY:
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Document 30 f:/Week-32/BX000482/MEDSTAT - SITREPS DEC 90 4 OF 6/patient file:09069614064231
Control Fields 17
File Room = aug96_declassified
File Cabinet = Week-32
Box ID = BX000482
Unit = ARCENT
Parent Organization = CENTCOM
Folder Title = MEDSTAT - SITREPS DEC 90 4 OF 6
Folder Seq # = 8
Subject = PATIENT FILE
Document Seq # = 31
Document Date =
Scan Date = 14-AUG-1996
Queued for Declassification = 01-JAN-1980
Short Term Referral = 01-JAN-1980
Long Term Referral = 01-JAN-1980
Permanent Referral = 01-JAN-1980
Non-Health Related Document = 01-JAN-1980
Declassified = 06-SEP-1996