Sniper attacks are now a bigger threat to troops in Helmand province than home-made bombs, according to the man who runs the morgue at Camp Bastion.
Regimental Sergeant Major (RSM) Stephen Smith, 43, from Co Antrim, said the nature of injuries had changed dramatically over the past two years.
He said: "Our detection of IEDs (improvised explosive devices) is incredible. We have a lot of good kit out on the ground so guys are detecting them. Plus, the Afghan National Army (ANA) and Afghan National Security Forces (ANSF) are taking the lead and they are at the sharp point."
RSM Smith, who is serving with the Hydebank-based 204 Field Hospital, said while the tempo of battle had significantly slowed for British troops on the ground, he still had a difficult job to do.
"Some of the sights I have seen are pretty gruesome to be honest, and nothing prepares you for that," the father-of-two said. "The mortuary is the most difficult definitely. It can range from babies right the way to fully-grown adults. But, you have just got to be able to switch off - if you keep playing over and over then it will affect you more and more to be honest."
RSM Smith is also the first to meet casualties when they arrive at the Camp Bastion trauma unit, where the survival rate is 97%. Before being admitted, they are frisked for explosives such as grenades, weapons and knives.
He said: "You don't know what is in there till you open the back doors. You just go into autopilot. You just hope when you hear the MERT (medical emergency response team) coming in that the patient is stable enough to get them into the hospital.
"Once they are in the hospital, the probability of survival is massive. That all stems from the medics on the ground - the point of injury - they are fantastic what they are doing now.
"The kit as well is massively improved in the last five or 10 years. When they get to us, if they are still breathing and they still have a strong pulse, the stuff they can do in the hospital is like miracles. We are just geared up for every worst-case situation."
More than 30 medics from Northern Ireland are helping to run the field hospital at Camp Bastion. It is one of the best-equipped hospitals anywhere with an eight-bay emergency department, 12 intensive care beds, four operating theatres and a 40-bed ward, plus four side rooms and two isolation booths.