BAGRAM AIRFIELD, Afghanistan - When Service members and Coalition forces around Afghanistan get injured or fall ill, they sometimes require air transport to a higher level of medical care than is available at their location.
That's when they rely on the men and women of the 455th Expeditionary Aeromedical Evacuation Squadron out of Bagram Airfield to transport them.
"We're here when they get hurt, we offer a smiling face, we provide them comfort, we get them safely to a higher level of care and ultimately get them home," said U.S. Air Force 1st Lt. Erica Hanshew, an Intensive Care nurse deployed from the West Virginia Air National Guard's 167th Aeromedical Evacuation Squadron at the 130th Airlift Wing. Hanshew began her military career as an Army medic before becoming a nurse and transferring to the Air Force.
A typical AE team consists of five personnel: two nurses and three medical technicians. The medical technicians are certified to provide care up to an intensive Care level. The nurses assess vitals and consult with the medical personnel that provided initial care, establishing baselines while on the ground, and then monitor for changes during the flight, adjusting care and administering medications as needed for routine, urgent and priority patients that need to be transported in a certain amount of time.
Oftentimes this means that missions are changed at the last minute to divert to a patient needing more immediate transport.
"Sometimes the mission doesn't go the way we originally expected, so we make adjustments and do what we need to do to take care of our patients," said Maj. Jacob Lin, a Critical Care Air Transport Team physician deployed from Eglin Air Force Base, Fla.
To transport the patients, the team loads airworthy medical equipment and configures a C-130J Super Hercules aircraft. They outfit it with a system to support patient litters, and then load frequency converters, oxygen, respirators, monitors, medications, bandages and patient comfort items allowing them to perform a wide range of critical intervention in-flight.
"Basically, if you can ask 'What if?', we bring something to cover it so that we can interdict that problem in flight," said Capt. Jason Melvin, a Critical Care Air Transport Team nurse deployed from Eglin Air Force Base, Fla.
The CCATT works in concert with the Aeromedical Evacuation team, supporting the more critically injured patients. Many times those patients are intubated or on respirators, requiring the skills of a specialized respiratory therapist, who manages the respirator and monitors blood gas levels. The CCATT team members undergo rigorous training, followed by a training period at the University of Cincinnati hospital where they undergo intensive and simulated scenarios to validate their skills and are judged by their peers. They also undergo recertification every two years or before every deployment.
"They ultimately decide if you're good enough to go out on missions and treat our heroes," said Melvin.
Lt. Col. Barb Marshall is a flight nurse who heads an AE team. She came into the Air Force as a nurse, and then returned to school to become a nurse practitioner. She is currently working at the Veterans Administration hospital in Huntington, W. Va., when not actively engaged with the West Virginia Air Guard.
"Taking care of the ill and wounded warriors is priority number one here. These guys and gals are so concerned about their buddies; they don't want to give up the fight. It's all about perspective; they're out in the battles together," said Marshall.
The teams spend a lot of time preparing and training, knowing that every mission can be critical to saving lives. If the AE team can get to a patient and transport them back to Craig Joint Theater Hospital at Bagram, those patients have a 99.5 percent survival rate.
"When you're sick or hurt, all you want to do is get home. The men and women on the ground know that we can get them out, and that helps a lot," said Tech. Sgt. Troy Baker, a medical technician from the 167th AES on his fourth deployment.
In addition to service members, the AE teams are sometimes called upon to provide transport to others as well. They recently evacuated a media reporter, in Afghanistan to cover their national elections, who was shot by an Afghan police officer. They were able to return her to a higher level care hospital, then ultimately to Germany where she was able to be returned to her home country for continuing care.
They also were able to coordinate with the 379th Blood Support Detachment and the 774th EAS for transport to provide emergency blood supplies to Forward Operating Base Shank on Election Day. Shank had exhausted their supply, so called on the AE team to provide relief in the form of a much needed blood supply, which directly resulted in saving the lives of three Afghan civilians who were critically wounded in an attack while voting.