Face of Defense: Flight Nurse Provides Care in the Air

By Air Force Senior Airman Erik Cardenas
Special to American Forces Press Service

April 20, 2009 - While troops on the ground risk their lives fighting terrorism, Air Force Capt. Susan McCormick provides emergency care to wounded troops so they can return to the fight or return to their families back home. "I couldn't picture myself doing anything but this -- giving someone the chance to survive when they risk their lives every day for us," the flight nurse assigned to the 455th Expeditionary Aeromedical Evacuation Flight here said.

The 33-year-old captain enlisted as a reserve medical technician in the aeromedical evacuation career field in 1994. As a technical sergeant in 2003, she received her commission to become a licensed flight nurse.

As she serves here in her third deployment, McCormick's six years as a nurse in the operating and emergency rooms at St. Vincent's Hospital in Worcester, Mass., are coming full circle. She is deployed from the 439th Aeromedical Evacuation Flight at Westover Air Reserve Base, Mass.

"Each deployment has helped me better myself and my training," she said. "The skills we use in flight need to be practiced daily. My experience in the OR and ER has helped me become a better nurse."

Members of the 455th EAEF are on call 24 hours a day, seven days a week, covering Afghanistan and Kyrgyzstan. The unit has three types of missions: an Alpha alert, with a one-hour response time for critically injured patients; a Bravo alert, with a two-hour response time for patients who do not need immediate evacuation; and a scheduled flight twice a week for patients who need care or treatment that cannot be provided at their deployed location.

Each alert, depending on the situation, requires a different number of personnel. An Alpha alert requires a nurse and two medical technicians. A Bravo alert has either a three- or five-member medical crew, depending on the number of patients and their acuity. A five-member medical crew of two nurses and three medical technicians flies on the scheduled missions.

Before each mission, McCormick prepares by arranging equipment and configuring the aircraft. She said she also mentally prepares by visualizing the patient's condition and how it could progress during the flight, relying on reports from the ground medical team at a forward operating base and her training on how the stresses of flight could affect the patient's condition at altitude.

"I try to think about the worst, but really we have no idea what the patient will look like when [he or she arrives]," McCormick said. "With all the years I have been doing this, nothing can really prepare you to see a child who has devastating blast injuries."

In flight, patient conditions are subject to change. The altitude, cabin pressure and weather are concerns of the crew, and the lack of light and a noisy environment challenges their assessment skills. And sometimes, McCormick said, limited access to medical equipment leads the forward operating base's medical staff to an incomplete or inaccurate diagnosis.

"My crew had one patient who was ... stable until they took off," she said. "At altitude, the patient's oxygen level decreased drastically, and ... they didn't understand what was happening with the patient." The medical crew treated the condition and kept the patient stable until he was re-evaluated at Bagram and diagnosed with a hemo-pneumo thorax, which wasn't found at the forward operating base, she said.

The captain has treated 40 patients in the three months she has been deployed here. As each day gets warmer, she said,she expects to treat more patients, as insurgent activity traditionally rises during the spring and summer. But the seasoned nurse said she's more than ready to go when she gets the call.

"I'll fly anywhere on any plane in order to evacuate our men and women who are sick or injured and make sure they get the care they need," she said.

(Senior Airman Erik Cardenas serves with the 455th Air Expeditionary Wing.)