On a wing & a prayer - U.S. Army "Dustoff" Medevac Crews risk it all to save their battle buddies

US ARMY DUSTOFF MEDEVAC Flight saves a wounded Marine in Sangin....The pictures show Lance Cpl. Blas Trevino from 1st Battalion, 5th Marines whose ordeal is detailed below.

These men & women are the heroes who fly into a hail of bullets, risking all to save a wounded battle buddy in Afghanistan's most dangerous places. No words can praise them well enough.

Bravo Zulu !!

Lucky Charms and Bullet Holes -- Flying Medevac
June 17, 2011
Associated Press by Anja Niedringhaus

"We got another mission," the message from U.S. Army medic Sgt. Josef Campbell read.

I jotted back: "Where?"

"Sangin, hot landing zone, Marines under fire, one is injured."

Southern Afghanistan remains a stronghold of the Taliban, and Sangin is a hotly contested district. The spring fighting season is now under way. That means more soldiers wounded by gunfire and bombings. And more work for the medics of the "Dustoff" helicopters.

As we approached Sangin, I saw an Afghan woman hanging her laundry inside the yard of her house. The tranquility of the scene helped me relax.

That sense of calm lasted just a few moments.

Dust, mud and grass churned up in front of us as the Black Hawk landed.

Campbell, 35, of Juniper, Idaho, reached out to open the door. Then gunfire erupted.

I heard a metallic sound and realized the helicopter had been hit. The pilot, Chief Warrant Officer 3 Dan Fink, quickly pulled the helicopter's nose toward the sky. All I could see in front of us were trees and power lines.

"If we are going to crash. I don't want to see it," I thought. My eyes shut, I held onto my seat belt.

I opened my eyes. We hadn't crashed. Slowly, the helicopter gained altitude and rose to safety.

We cruised slowly as Fink, 40, of Spring Hills, Kansas, and another pilot, Chief Warrant Office 2 Niel Steward, 34, of Grand Rapids, Michigan, checked the helicopter to make sure it could still maneuver. It could.

Only one thing rushed through my mind: "Please, please, just let us get out of here until that firefight down on the ground ends." But of course I didn't say that out loud.

After 15 minutes, I realized we would return to the same spot. As I looked at Campbell, I noticed his extraordinary level of concentration. He adjusted his gloves, reached for his assault rifle and then peered out of his open window.

I kept trying to find my lucky charms in my pockets.

The helicopter touched down right where we took fire only minutes earlier. The big side door slid open. I reached for my camera, feeling better because I could concentrate on something else.

Campbell jumped out first. He looked around. Neither of us could see the Marines. Suddenly, a Marine jumped up from a ditch nearby, one hand on his stomach and the other holding rosary beads.

The Marine sprinted toward us, turning around to wave to the others that he could make it to the helicopter. Another Marine tried to catch up to help him, but the injured Marine, Lance Cpl. Blas Trevino from 1st Battalion, 5th Marines, ran so fast he made it to the helicopter first.

Trevino latched onto Campbell in a desperate hug.

"You have made it! You have made it!" Campbell shouted over the whine of the idling helicopter.

Trevino collapsed on a stretcher, exhausted. He lifted his head to scream: "Yes, I have made it!"

As the helicopter lifted off again, the medics began treating Trevino for a gunshot wound to his stomach. During the 10-minute flight, Trevino kept praying while clutching his rosary beads. He gave us thumbs-up signal. He would survive the wound.

We landed at Forward Operating Base Edi outside Sangin but still in Helmand province. Medics carried Trevino into a hospital tent.

Meanwhile, Fink and Stewart walked around the helicopter, looking for damage.

Gunfire had struck five times in the tail. One bullet passed barely a third of an inch (1 centimeter) from the hydraulic system powering the huge helicopter. Another went through the metal near the fuel tank.

The two men took off their bulletproof vests.

"That was pretty close," they agreed.

Nineteen soldiers make up the U.S. Army "Dustoff" unit. The unit, based out of Landstuhl, Germany, operates from a gravel runway in Helmand province. The soldiers use plastic bags for toilets.

Most of their supplies, like food and water bottles, is dropped by parachute every other day from a plane. Marines run out of the camp to collect them, taking care not to step on land mines.

After a year in Afghanistan, members of the unit will head home with their memories. Spc. Jenny Martinez's voice grew soft as she recounted treating a Marine who stepped on an explosive and lost both of his legs.

She held his hand all the way to the field hospital.

"He didn't want to let me go," said Martinez, 24, of Colorado Springs, Colorado. But "I had to leave because we had another mission

455th Expeditionary Aeromedical Evacuation, Bagram - “Ultimately, what we do is about those soldiers, sailors, airmen, Marines...is for the warrior"

The mission to save those wounded in battle is imperative here in Afghanistan. The care & dedication shown by our medical corps and those who fly the medivac flights brings great credit and distinction to the US Military. They respond 24/7/365 to any and all persons in need of their services.

BRAVO ZULU to those working the mission in Evaci-stan...

Aeromedical Evacuation Saves Lives in Afghanistan
By Donna Miles
American Forces Press Service

BAGRAM AIRFIELD, Afghanistan, May 6, 2011 – An aeromedical evacuation capacity unrivaled anywhere in the world is saving the lives of wounded warriors in Afghanistan, said the officer here who oversees the effort at the combat theater’s busiest aeromedical evacuation point.

Air Force Lt. Col. Kathleen Flarity, commander of the 455th Expeditionary Aeromedical Evacuation Flight’s operations at Bagram Airfield, Afghanistan, said better equipment and processes are improving the way the military moves wounded warriors to increasingly more advanced levels of care.

Equipment and procedures are being improved continually to move wounded warriors to progressively more sophisticated levels of care in Afghanistan and ultimately, in the United States, said Air Force Lt. Col. Kathleen Flarity, commander of the 455th Expeditionary Aeromedical Evacuation Flight’s operations here.

During the Vietnam War, it typically took more than a month to move wounded troops to advanced treatment facilities in the United States, she said. Today, it’s down to as little as three days.

“That’s not the goal, to get them home,” she said at her office in her unit’s compound, known as “Evac-istan.”

The goal is “to get them what they need, when they need it,” said Flarity, an Air Force Reserve nurse practitioner deployed from Peterson Air Force Base, Colo. “That is huge, and that has changed a lot.”

Flarity attributed much of that change to initiatives adopted since 9/11: the use of multiple air platforms to move wounded warriors; state-of-the-art medical equipment able to operate in demanding conditions and high altitudes; and critical care air transport teams specially qualified to transport even the most critically wounded warriors, among them.

Air Force HH-60G Pave Hawk helicopters, operated by elite Air Force expeditionary rescue squadrons, have joined Army “Dustoff” helicopter crews -- nicknamed for their motto, “Dedicated, Unhesitating Service to Our Fighting Forces” -- to evacuate wounded warriors from remote forward operating bases and combat outposts.

And gone are the days when aeromedical evacuation crews had to wait for a specific air platform to fly patients for care at Landstuhl Regional Medical Center in Germany and then on to facilities in the United States. Now, they can use a variety of aircraft: the C-17 Globemaster III, C-130 Hercules and KC-135 Stratotanker.

“We are universally qualified” on the different platforms, Flarity said. “So essentially, any time there is an aircraft available, we can take our teams and our equipment and jump onto any aircraft. … This opens up a lot more aircraft availability.”

The C-17, with its large cargo bay and ability to move the most patients, is a favorite among aeromedical evacuation crews. Specifically designed to include aeromedical evacuation in its mission set, “it’s big, bright and spacious,” Flarity said, with many built-in amenities such as medical-grade oxygen and buttons patients can push to call for assistance.

Although built for air-to-air refueling, KC-135s have become aeromedical evacuation workhorses in Afghanistan. They don’t provide the temperature control of C-17s and require crews to carry aboard green boxes of liquid oxygen that converts to gaseous oxygen, Flarity said, but the KC-135s offer much-welcomed and much-needed capacity.

New medical equipment has improved the process. A pump introduced during the initial stages of the Iraq war enables patients to administer their own pain medication, within prescribed limits, and locally administered anesthesia is provided through strategically placed catheters.

A new liquid oxygen system is among new technologies being explored to give aeromedical evacuation crews additional capability.

In these and other improvements, Flarity said, the emphasis has been on common systems across the services that don’t need to be changed as patients move through different levels of care. “That way, I can take your pump and give you back mine, instead of changing out all the tubing and pieces and parts,” she explained.

The presidentially mandated electronic health record system is another development making steady progress across the aeromedical evacuation system. The transition has been relatively smooth for long missions to Ramstein Air Base in Germany and Joint Base Andrews in Maryland, Flarity said. But during 20-minute flights between forward operating bases in Afghanistan flown under low-light conditions, she acknowledged, it poses more challenges.

Challenges are nothing new to aeromedical evacuation crews, Flarity noted. Operating in conditions that include noise, vibration, air-pressure fluctuations, turbulence, and sometimes enemy fire, today’s crews are the most experienced and battle-tested the Air Force has ever seen, she said.

Flarity called these “rainbow crews” -- a mix of active-duty, Air Force Reserve and Air National Guard members -- the backbone of the system committed to doing what it takes to get wounded warriors home safely.

“Ultimately, what we do is about those soldiers, sailors, airmen, Marines [and] Coast Guardsmen … is for the warrior at the battlefront,” she said. “And because we are here, it allows them to focus on their mission, … knowing we have their backs.”

Air Force Tech. Sgt. Latresia Pugh, the mission management technician on a recent aeromedical evacuation flight to Andrews, said she feels honored to be able to provide that support. “These are our brothers and sisters, and we want to take care of them,” she said.

“These guys are risking their lives for us, and we have to get them back to their families safely,” agreed Air Force Staff Sgt. Napolean Gifford, a critical care air transport respiratory therapist from Douglas, Ga. “That is the very least we can do for them.”

Air Force Maj. Gerry Martinez, a flight nurse deployed to Ramstein from Lackland Air Force Base, Texas, said he’s often touched to hear his patients express appreciation to the aeromedical evacuation crews.

“They are so grateful that we are here taking care of them,” he said. “But what I say to them is, ‘Thank YOU.’ These guys are the ones making the ultimate sacrifices.”

Air Force 1st Lt. Donna Olson, a Mississippi Air National Guardsman who served as medical crew director during a recent mission transporting 24 patients from Ramstein Air Base, acknowledged that transporting wounded warriors, many younger than her own children, can sometimes be emotionally tough.

“But I love this job, and wouldn’t trade it for anything in the world,” she said. “I have the gratification of helping them through all this and returning them home so they have the opportunity to live full lives.”

"If you arrive alive, you will survive." - Canadian Surgeons at KAF are among "the best of the best"

Many will write about those who fight in AFGHANISTAN, I like to feature stories about those who provide healing to all who are wounded there....

The Canadians have shared a major portion of that load in Afghanistan....I didn't always appreciate COMKAF (Command Kandahar Airfield) because the Canadian Command didn't always make good decisions BUT I will tell you, if you needed care, you really weren't concerned about the nationality of the medical team putting you back together...Here is a good story about a dedicated Canadian doctor and his experiences in the War Zone....




He who wishes to be a surgeon should go to war"
Canadian MDs risk life and limb in Afghanistan

By Graham Lanktree - The National Review of Medicine

Major Sandra West stepped out of the plane onto the dusty tarmac. This was Kandahar air base. Mere moments later word came down: 11 casualties, all of them Afghan National Army soldiers who had just been caught in a firefight, were headed her way.

Welcome to Afghanistan.

That was Maj West's brusque introduction to the country when she arrived last August. A senior military physician from Ottawa, she had been put in charge of all medical cases that were brought into the NATO air base hospital.

She found herself remembering Hippocrates' millennia-old aphorism: "He who wishes to be a surgeon should go to war."

"I knew more about gunshot wounds in my first week working in Kandahar than my entire career," says Maj West. "If you ever want to do trauma, after going through something like this nothing is going to faze you."

PREPARING FOR WAR
Maj West had little time to prepare for Afghanistan after being added on short notice to a rotation that would last from August through to the end of February this year. Just days before flying to Kandahar from Canada she finished a 12-week trauma course given by the military at Montreal General Hospital. "At the hospital, though, they get trauma cases in ones and twos — not eight or ten like we do in Kandahar," she says.

Or even more, sometimes. The worst situation she saw there brought 21 new Afghan patients into the hospital when 15 of the unit's 16 primary care beds were already occupied. For situations like that, military trauma physicians have developed their own triage shorthand: Alpha, for life threatening cases; Bravo, for serious wounds; and Charlie, for broken bones, cuts and bruises.

"You need lots of flexibility as a leader," observes Maj West. Not only to manage the number of staff working around you, but also to deal with whatever event is just around the corner. "Often we would get a call from a medic where they're under fire or they've been in a situation where there's an explosion," she reports. "They're trying to make an assessment and casualties could change in transit, or they don't know how bad the wounds are." She would have to prepare herself and the trauma team of at least nine other doctors for anything.

OUTSIDE THE WIRE
What the medics do on the front lines, however, is what really saves lives, says Maj West. There's a saying on the Kandahar airbase: "If you arrive alive, you will survive."

Captain Ray Wiss, an emergency physician from Sudbury, Ontario, treated soldiers in the critical moments after their injuries as the lead medic of an armoured ambulance crew. "One day when I was out there, one of our vehicles hit a mine," he recalls. "Trying to go from one injured guy to the other, to the other one, and making sure my team was doing this task, that task and managing everything — it was unforgettable. I was working at the most intense level I ever have. Your goal is to stabilize those people immediately. You're intubating them and starting multiple IVs and knowing that the chopper is 30 minutes away. It's stressful. You want to make all the right decisions."

AN UNUSUAL PATH
Capt Wiss's experience is unique; physicians rarely travel outside the wire, beyond the limits of the Kandahar base. But some paramedics had been killed, he says, and the military needed help out in the field. "When these gaps appeared people on the ground knew I had combat training as an infantry officer. So they asked me to take a front line position. I had to have a long conversation about it with my wife."

After only a couple of weeks in Kandahar working with Maj West as a trauma team leader, Capt Wiss set off for an outpost along the border of Pakistan on the edge of the Red Desert. It wasn't the first time he'd done something like this. He had trained in the Canadian infantry, working as a medic in South Africa in 1994 during the run-up to elections marking the end of apartheid, and Nicaragua in the mid-80s. He still carries a souvenir from Nicaragua: shards of an AK-47 bullet, lodged in his left knee.

When he responded to calls from Canadians, Capt Wiss would steel himself to treat severe injuries. "When Canadians come in it's always IEDs," he says. "The explosion comes from underneath so you're dealing with lots of leg wounds and other things from the waist on up. You can survive getting your legs ripped off. But if something happens to your chest and abdomen then the chances aren't as good." Luckily, in a pinch his skilled hands can perform needle thoracocentesis on collapsed lungs under some of the most extreme conditions.

CARING FOR THE TALIBAN
But Capt Wiss didn't only treat Canadians; many Taliban fighters who had just seen combat against Canada's forces would be brought in with gunshot wounds.

Captured Taliban fighters are terrified that at some point they're going to be tortured, he says. They're surprised when their wounds receive the same attention that a Canadian soldier's would.

Over at the Kandahar airbase the same prisoners treated outside the wire by Capt Wiss would be brought to see Maj West's team wearing blacked-out goggles and earmuffs to block any defining sights or sounds. They're then taken to a closed-off area where an interpreter, who translates between the medical staff and their patient, stands behind a screen hiding their identity. Maj West would also remove her nametag and rank. Just to be safe.

Some of her soldier colleagues learned to protect their identities the hard way. A number of soldiers purchased Afghan cell phones and used them to call back home. Resourceful Taliban fighters tapped into the calls and would later call those numbers back, terrorizing their families back in Canada by identifying themselves and saying "We've got your relative and you're never going to see them again."

Yet Maj West also felt for many of the Taliban fighters she treated. "Often they were young kids, 16 to 18 years old, who had been recruited to plant roadside bombs with the promise of money, or threats to their family's safety."

GAINING EXPERIENCE
Just a few weeks ago a Taliban rocket landed so close to the airbase medical building that it shook. Even on the heavily fortified NATO base rocket attacks aren't infrequent. So why would physicians — especially civilian physicians — put themselves in danger's way?

Dr Steven Wheeler, who finished his second tour in Afghanistan as a civilian at the end of February, says that he's a much better anesthetist for having gone. "I learned tons. In Canada I don't regularly take care of that many patients all at once. We would see four, seven patients arrive all together. If we ever had a mass casualty event in Calgary, now I'd be prepared."

Living with the military surgical staff taught him a lot. "My roommate was a surgeon from Vancouver. Over dinner we'd talk about abdominal compartment syndrome. I'd ask, 'What can I do to reduce this?' That constant sharing of ideas was excellent for my practice."

He learned to prioritize cases by their urgency as they arrived and was awed by the innovations that came from staff on all sides. (For more on the military's advances in emergency medicine, read our article in next month's issue).

FIGHTING SHORTAGES
About this time last year the Canadian military put out a desperate call for physicians to work in Afghanistan. They only had half the number of doctors they needed and military officials predicted it could be three to four years for the number to rise, staunching the gaps.

However, the response was quick. One year later, the military has the physicians it needs. Generous cash incentives for enlisting may have played a part. Physicians receive a signing bonus of $225,000 plus an annual salary of up to $165,000 for a four-year enlistment in the Canadian Forces, and medical students close to graduation get a signing bonus of $180,000 — enough to pay off looming debt. And civilian physicians are compensated handsomely; they make $3,000 to $5,000 per day for one-month tours. That totals up to $155,000 for just a month in Kandahar.

"For many, the money enables them to go to Afghanistan," Maj West says. "You're asking people to put their lives at risk. There's no guarantee you're going home alive or able to continue practising medicine." But she believes many of those who go aren't in it for the money.

Despite the risks, Dr. Wheeler says it was worth it to work with the Canadian medical team in Kandahar. "I would be very happy to go back to a situation like Afghanistan. It would be very difficult to find people doing that level of medicine anywhere. They truly are the best of the best."

Angel of the Air - a Canadian Nurse in Afghanistan shares Quilts of Valour, donated from across Canada with wounded Soldiers

Words from a " Canadian Angel", a nurse who helps those who have shed their blood in battle...her words are far better than mine at describing the wonderful work that she does. She provides care and shares Quilts of Valour, donated from across Canada

God Bless her, the Canadian Quilters and all like her.


Angel of the air
November 14, 2010
The Hamilton Spectator, Hamilton, Ontario, Canada

There is a quiet moment just before the Challenger jet begins its final descent, when an “Angel of the Air” nurse slips in beside the wounded Canadian soldier and hands him or her a handmade quilt.

The injured soldier’s journey from battlefield to back home has already been long. And, for most, the real journey is just beginning. But, in that private moment, simple handcrafted pieces of cloth become a profound symbol of gratitude.

“There aren’t a lot of words spoken,” said Captain Joelle Beaudoin, an aeromedical evacuation flight nurse. “But, oh, what you can see in their eyes.”

A new batch of the Quilts of Valour, donated from across Canada, were draped throughout St. John’s Anglican Church in Winona yesterday for a “blessing” service, and Beaudoin was there to tell her story.

Born in Montreal, the 27-year-old found herself intrigued by news coverage of nurses working in combat zones, and by Hollywood depictions of nurses tending to the wounded.

Six years ago, she decided to become a military nurse and joined the Canadian Forces. In 2009, she was deployed to Afghanistan. Nothing, she said, could have prepared her what she would experience.

“It is hard to explain the feeling when you see a Canadian soldier coming to your trauma bay, because he or she has been seriously injured by an improvised explosive device,” she told the St. John’s parishioners.

“At times, it could be an extremely emotional and distressing experience … knowing a soldier’s life has been changed forever.

“In those moments, there is an overwhelming desire to help the soldier and to heal him.”

The bulk of medical work was treating Afghan soldiers, police and civilians who were injured in conflict or ill from living in poor health conditions. “There were a lot of amputations, burns and fractures.”

One patient in particular changed her life with his smile, she said.

He was only 12 years old and was the sole provider for his family. The boy was selling juice to the locals outside Kandahar Air Field when he was injured by a landmine. Both his legs had to be amputated.

“The next day when I started my shift, I was greeted by his smile. I was reminded how precious life can be, and was overcome with admiration for this young boy. Here his life was changed forever, and he was still smiling.

“I will always remember his courage and strength and carry his spirit with me forever.”

Sometimes when wounded Canadian soldiers were brought back to the Kandahar Air Field hospital, there was not enough blood available and the doctors had to activate emergency blood clinics.

“When the announcement went out over the intercom requesting help, we were overwhelmed with recipients who were willing to donate,” she said. “Imagine holding in your hand a small bag of fresh whole blood that is still warm.”

After her Afghanistan tour, Beaudoin was posted to the Aeromedical Evacuation Flight unit stationed at Trenton airbase, and became an “Angel of the Air” responsible for repatriating wounded soldiers from Landstuhl Regional Medical Center in Germany, where U.S. and Canadian casualties are sent from the battlefield.

Elaborate preparation goes into flying the wounded soldier home, and the “angels” do everything they can to provide a “bubble of dignity and respect” around the soldiers to make their journey back as stress-free as possible.

Beaudoin has made the trip seven times.

“I realize that I am not able to create a world without violence, but what I can do is try to make the life of a wounded solder a little bit easier.”

The quilt, so emblematic of home, means so much to the soldiers, she said.

“It’s a hug and a thank-you,” she said. “From all of Canada.”

pmorse@thespec.com