Care across the continents

by Tech. Sgt. Shawn David McCowan
455th Air Expeditionary Wing Public Affairs

10/16/2012 - BAGRAM AIRFIELD, Afghanistan (AFNS) -- Consistent quality is always a priority when it comes to medical care. Successful innovations and greater efficiency can send a hospital's credibility and patient reviews to new heights.

Medical emergencies in the military community can be more complicated than a civilian emergency due to the nature of the patient's injuries, but the Air Force has met the challenge and organized a patient care and transport system that truly flies miles above any other.

Service members injured on the battlefield don't have the luxury of easy access to emergency services. Careful and efficient coordination is often vital to a wounded warrior's survival and recovery. Once an injury occurs, on-scene medical technicians alert the state-of-the-art Craig Joint Theater Hospital here. That contact begins a chain of events designed to ensure the wounded warrior gets the care needed at the facility best equipped to provide it. CJTH is widely recognized as the premier medical facility in Afghanistan, but it isn't large enough to keep all incoming patients. In some cases, that means a patient must begin a journey on the road to recovery that begins in the mountains of Afghanistan and leads to a hospital back in America.

Patients are transported by medical evacuation helicopter to CJTH. Once there, volunteers deliver them to either the emergency room or the contingency aeromedical staging facility. The medical technicians hand over any charts, notes and insight on the patient's current condition. For patients who can't be treated solely at CJTH, an Air Force medical evacuation aircraft will transport them to Ramstein Air Base, Germany. In the meantime, medical technicians at the CASF constantly make sure patients have required medications and remain stabilized until the flight. Other support team members track and coordinate the next leg of the medical evacuation flight.

Some people might think caring for patients injured in a war zone may be highly stressful, but 1st Lt. Rachel Hinson, a registered nurse at the Bagram Airfield CASF, said she loves working right where she is.

"There's nowhere else I'd rather be working," she said. "It's so rewarding to work here because we're taking care of people who have pulled through and are about to start a flight back to the U.S.," Hinson said.

Getting patients from Afghanistan to Germany and America requires a special team of men and women assembled aboard a C-17 Globemaster II or C-130 Hercules. A medical team consisting of  a flight doctor, a critical care nurse, a respiratory specialist and several medical technicians travel with patients during the flight. The team assembles at the aircraft, where nurses like Hinson turn patient information over to the in-transit team, making certain that care remains constant and seamless.

Aboard the aircraft a medical crew director receives patients, medical equipment and any information necessary to make sure they remain stable during the from Bagram Airfield to Ramstein Air Base, Germany. He and the team of airborne medical specialists become the sole source of care for as many as 30 patients during the eight-hour flight to Germany.

When the aircraft arrives at Ramstein AB, patients are either transported to Landstuhl Regional Medical Center for further treatment or sent to Ramstein AB's CASF. There, Maj. Maria Coppola, a director at the CASF, makes sure those in her temporary care are kept as comfortable as possible until their journey to the United States. As Coppola watched patients arrive with various degrees of injury, she reflected on the perspective her team has toward all who enter their care.

"Whether someone has lost limbs, taken a head injury, or come in with a cast or stitches, each person is equally important here," she said. "While they are here, they really are like family because we're the only people they have to care for them right now. We do all we can to make sure they know how much we care."

One of the patients, Army Sgt. 1st Class Russell Allen, was traveling in a Stryker near Kandahar, Afghanistan, when the hatch he wsa under slipped from its catch, slamming onto his head. He sustained a head injury and nerve damage. He was hesitant to accept medical care, but his experience at Ramstein's CASF caused a change of heart.

"I saw a lot worse injuries out in the field, especially (roadside bomb) amputees," he said. "I thought I wouldn't be important enough to worry about, but I was blown away by the care here. I didn't expect this kind of reception or care. Everyone here is treated the same way, like we're all important."

As another day passed, and a new flight arrived to take patients on the final leg of their journey home, Coppola helped coordinate yet another transition for patient care. This time, her team turned over all patient information to another crew of in-flight caregivers. After the CASF team members completed the transition to the aircraft medical team, Coppola said through each treatment, transition, and flight, one constant brought a great sense of pride to her and her team.

"It's so fulfilling to know that, even though this process take patients halfway around the world, through at least three medical facilities, and on at least three flights, the standard of care never changes," she said. "These men and women are getting the best care medicine can offer every step of the way. That really says something about what we accomplish."

Even though the next day would likely bring another several dozen injured military members in need of constant care, the CASF team left the flightline with smiles, knowing their efforts meant a safer, efficient and more comfortable journey for wounded warriors on their way home.