JOINT BASE BALAD, Iraq – An aeromedical evacuation crew, consisting of two flight nurses and three medical technicians, completed a round-robin mission transporting patients from locations in Southwest Asia to critical care facilities May 13.
The 332nd Expeditionary Aeromedical Evacuation Flight's mission is to move patients by fixed-wing aircraft, under the supervision of aeromedical evacuation crews, to locations offering appropriate levels of care.
"There are echelons of care to support the wounded warriors within the theater of Operation Iraqi Freedom," said Master Sgt. Eric Jenkinson, chief aeromedical evacuation operations officer, deployed from the Air Force Reserve's 911th Airlift Wing, Pittsburgh, Pa.
The progression of care starts on the battlefield with self-aid and buddy care.
Once appropriate treatment is determined by a medic on the ground, the patient can be moved through a battalion aid station, which is usually located at forward operating bases. If more extensive care is needed, he or she can be transported to a theater medical hospital, then to a theater hospital in Germany, and finally, if crucial, the patient is transported to designated stateside hospitals.
Between the battalion aid station and the theater hospital, patient diagnosis is determined by the flight surgeon who dictates movement precedence - urgent, priority or routine.
Urgent precedence means transportation is required within 12 hours. Priority transportation is required within 24 hours and routine transportation is required within 72.
"We are able to get the sick and wounded to definitive care and then back into the fight quicker than ever before," said Tech. Sgt. Sean Kassebaum deployed from the Air Force Reserve's 908th Aeromedical Evacuation Squadron, Maxwell Air Force Base, Ala. "In addition to that, [for] the people who aren't returning to the fight, we're getting them to rehabilitation faster and to higher levels of rehabilitation faster than ever before, so they are able to lead more productive ways of life post injury."
The round-robin mission is a way of ensuring quick retrieval, quick medical attention and quick return.
"There are three scheduled round-robin missions a week and then there are in-system select missions," said Maj. Mick LuCore, 332nd EAEF mission operations officer and former U.S. Army Ranger medic deployed from the Air Force Reserve's 934th Aeromedical Evacuation Squadron, Minneapolis, Minn. "ISS happens when we have emergencies outside our scheduled missions."
While completing the round-robin mission, the C-130 aircrew deployed from Little Rock AFB, Ark., received word of an ISS. Due to this change in schedule, the crew returned to Joint Base Balad, dropped off patients, picked up a Critical Care Air Transport Team and proceeded to the requested location.
What started as an almost three-hour mission suddenly turned into a 15-hour day.
The AE crew didn't show signs of frustration or complain about the prospect of another long day. They simply discussed what needed to be done to get patients currently being treated to the next level of care while gathering information about the next patient load.
The AE team's flexibility and ability to adapt are crucial to the joint fight.
"We move stable or stabilized patients as quickly as possible to get them back in the fight," Jenkinson said. "Stable means their injuries aren't severe and vital signs are pretty much within normal limits. A stabilized patient would need different medications or equipment and is someone we would use a CCATT team for."
A CCATT team is composed of one trauma-certified physician, one critical-care nurse, and one cardio-pulmonary technician. The team provides essential critical care, in conjunction with AE crews, to evacuate critically-injured and ill patients, who require specific care during transportation.
"They're not allowed to fly without us because we are trained in egress and aircraft emergency," Jenkinson said.
Once patient status is designated, the AE teams work with the aircrew for appropriate cargo configuration. AE crews can fly on any fixed-wing aircraft, but the C-130 Hercules is the primary aircraft for tactical movement of a patient from a combat area.
The C-130 is adaptable for the purposes of an AE team because it has the capability to configure its cargo area with a maximum of 74 litters, 92 ambulatory patients or any combination of both.
"We're cargo transport," said Eau Claire, Wis., native Maj. LuCore who is in charge of an emergency room in his civilian life, "except we transport precious cargo."
This process may sound simple, but coordination to prepare the missions is very complex.
Tech. Sgt. Pamela Mulleck, 332nd EAEF duty control NCO, does a lot of behind-the-scenes coordination in order to ensure the AE teams are fully prepared before each mission.
"Duty controllers really make or break us," LuCore said. "If they don't have accurate and current information, we can be set up for failure. Mulleck does a great job."
Some of the information duty controllers are responsible for coordinating prior to each mission are: verifying missions and mission numbers, types of aircraft, tail numbers, parking spots and patient loads.
From the AE team and support staff to the base volunteers and aircrew members themselves, at the end of the day, it's teamwork that makes the mission successful.
"When you look at the volunteers who come out here to help, you see the spirit of the service, the heart and compassion for our wounded warriors," said Maj. Jim Palmisano, incoming director of operations. "It's very humbling to see the base come together."
"It's great to see the firemen and the others who volunteer to help with the missions," said Master Sgt. Lou Wolber, deployed from the 911th AES. "They want to support the troops. These guys have long days and they're really great about it and they love what they do."