News: ‘Golden Hour’: Flight medics speed trauma patients off battlefield
Story by Cpl. Paul Peterson
FOB DELARAM, Afghanistan - Helicopter 865 touched down outside the medical tent at Forward Operating Base Delaram II, Afghanistan, just shy of 8:50 a.m., Nov 14.
Afghan National Army medics had rushed an injured soldier into the base nearly twenty minutes earlier. They staunched the blood flow from the gunshot wound in the soldier’s lower abdomen and noted the exit wound perilously close his spinal column.
The nature of the wound posed a significant threat to the soldier’s life, so the medics requested to airlift him to a surgical facility.
Within minutes, officials cleared the casualty for the nearly 25-minute flight to Camp Bastion, where trauma care specialists awaited his arrival. The medevac was already on standby, rotors spinning and ready for flight.
Wind swelled beneath the blades of the UH-60 Black Hawk and washed over the litter crew as they dashed toward the open door on the left side of the bird. A final, powerful gust quivered the blue medical blanket over the patient as the team slid the wounded solder into the helicopter and closed the doors for takeoff.
“We have an hour to get that patient from the time they incurred their injury to a major hospital,” said Sgt. Jeffrey Jacobs, a flight medic with Charlie Company, 1-168th General Support Aviation Battalion. “A large amount of that time is transportation … A lot can happen in 20 to 25 minutes.”
Spc. Ryan Waller, the lead medic for the flight to Camp Bastion, secured the patient and prepped an intravenous line as the sudden, gut-sucking motion of liftoff filled the small cabin.
“That ‘Golden Hour’ takes into account the time of injury to surgery,” said Waller, an Aromas, Calif., native. “We have to assume the worst. We don’t know if we get there a minute too late if the patient is going to die.”
The hour mark already loomed over the injured soldier by the time Waller and Jacobs got their hands on him. Goosebumps bristled along his skin as the chill from blood loss and strain set into his body.
The two medics wrapped the ANA soldier in a green wool blanket and strapped an oxygen mask around his face.
“The fact that we are taking them up to altitude means they’re automatically going to be hypoxic,” said Waller. “The oxygen levels in the blood are not going to be as high as on the ground. The patient is already injured, so that’s one of the things we can always count on.”
Waller and Jacobs moved feverishly about the helicopter with an unspoken sense of purpose. Waller prepped a syringe, holding the needle out for his partner to see, as Jacobs tied off the patient’s right arm and coaxed a vein to the surface.
“We’ve gotten used to each other’s body language and the flow of events,” said Jacobs, a native of Elk Grove, Calif. “I can look at him, see what he’s doing, and prep for what’s next.”
Jacobs slid his needle into the soldiers arm near the bend in the right elbow. Waller was already doing the same on the other side.
“The trust factor is huge,” said Waller. “I know if he is off doing something it’s important for the patient. He knows the same for me.”
The two have handled roughly 30 trauma cases during their six months in Afghanistan. Since medevac, or DUSTOFF, flights are reserved for urgent patients only, they honed their skills on the razors edge of life and death for the patients in their care.
“Just the two medics in the back are performing the jobs of almost eight people in the hospital,” said Jacobs. “It’s humbling. At that point you know it’s just you. There’s no real reason to worry about it … it’s just you.”
The nature of the helicopter itself is a constant challenge for the team, admitted Waller.
The medics crawl around the fuselage on their knees, hooked to the helicopter frame by a safety strap. The weight of their gear and the cramped conditions make it difficult to conduct traditional assessments on patients. The sheering sound of the engines drowns out their ability to shout back and forth.
Unable to feel for a pulse or listen to the patient’s lungs, they rely on an array of sensors, medical equipment, and pure instinct to monitor the patient’s vital signs.
“The back [of the helicopter] really is where we shine,” said Waller.
By 9:11 a.m., Helicopter 865 touched down at Camp Bastion, where Waller and Jacobs turned the patient over to critical care personnel waiting by the flight line.