Staging Wounded Warriors key to successful transition

Published May 31, 2011
By Tech. Sgt. Stacia Zachary
AFCENT Combat Correspondent

CAMP BASTION, Afghanistan -- (Editor's note: This is the first in a three-part series on the contingency aeromedical staging facility.)

Patients come off the battlefield in all stage of recovery. Some are going home, some need specialized care while others desperately cling to life as medical teams scramble to stabilize them for a flight in order to be handed off to another team of medical experts. The goal is the same in every circumstance: preserve life.

Serving as a medical airport, the contingency aeromedical staging facility is responsible for helping patients transition from one medical center to the next.

"The patients are the passengers and we provide everything from security checks to in-flight meals to checking on them before their flight," said Lt. Col. Barbara Persons, 451st Contingency Aeromedical Staging Facility Detachment 1 commander.

The four main functions of the CASF is aeromedical clearance, nursing care, administrative processing and patient transportation.

When a patient comes in, it's our job to identify these needs regardless of where the patient is recovering at the clinic or receiving more extensive care at the Role 3 Hospital, the colonel said.

When a patient has been scheduled for departure on an aeromedical evacuation mission, the CASF team prepares their medical records, medication, equipment and baggage for transport to the aircraft on Bastion Airfield, commonly referred to by the British as "Little Heathrow."

The CASF team will then load up the patients in an ambulance or an ambus, a bus that's been refitted to function as an ambulance with the capability to carry multiple patients. While en route, the patients will constantly be monitored by a medic, nurse or a critical care aeromedical transfer team staff member. A typical transport mission will be aboard a C-130 Hercules. Once on the plane, the patients' care will transfer over to the aeromedical evacuation crewmembers specially trained to care for sick and wounded patients while in flight, according to the CASF in-processing guide.

"The most important service we provide is taking care of patients who are in transition and moving them from here or the hospital to the aircraft safely," Lt. Col. Persons said.

There can be several hurdles that make it difficult for the CASF staff to complete this task successfully but a well-orchestrated crew will be able to maneuver around them.

"My team is so talented," Lt. Col. Persons said. "There hasn't been a single thing yet that we haven't been able to overcome - it's required a lot of creativity but we've been able to do it."

One of the biggest collective challenges for the deployed medical community has been the type of injuries coming off the battlefield.

"The injuries we're seeing now, as opposed to other wars, is the amount of amputees and shrapnel victims," said Capt. Paul Boackle, 451st Expeditionary Aeromedical Evacuation Squadorn Detachment 1 Aeromedical Evacuation Operations Team flight nurse. "They're surviving because of the quick employment of medical assets to save their lives and it's working."

Another injury Service members are encountering more frequently is head injuries.

"When the guys survive the blasts, their heads still receive a hell of a blow and we're seeing a lot of [traumatic brain injuries] as a result," the captain said.

Since the Global War on Terror kicked off in 2001, the medical community has seen a constant rise in injuries resulting from the detonation of improvised explosive devices. For some, it foretold the trend of marring service members with dismembering but survivable injuries.

"Years ago, in 2003 while I was working at the CASF at Ramstein [Air Base, Germany], I told a visiting congresswoman that they need to prepare the VA for the most horrific injuries we've yet to see," Lt. Col. Persons said.

The accuracy of colonel's prediction that this war will bring with it a catastrophic rate of walking wounded still shocks her today.

"I hate to say that I was right.," Lt. Col. Persons said. "The injuries that our Service members are coming to us with are terrible."

Many of the wounded transiting through the CASF are testimony to the extraordinary measures that are being taken to save lives.

"You're seeing men and women, who only a few decades ago, wouldn't have made it out of the field," Capt. Boackle said. "Our doctors are doing extraordinary things and really staying ahead of things all to save a life."

Because of these improvements in lifesaving procedures, the men and women who are coming off the battlefield are badly banged up or maimed and many require reassembly in order to sustain life.

"We have doctors and nurses and [technicians] here who are doing impossible things to keep them alive," Colonel Persons said. "As a result, our [service members] are dealing with surviving something that they otherwise wouldn't have and having to learn how to live with their injuries."

Non-critical patients will be released from the hospital to either return to duty or await transport to another medical facility for additional care. The CASF has served as a halfway house that allows the wounded or recovering to relax and focus on getting better.

"The best thing about this place is when the Marines come here, they shed their tough skin for a little bit and just take it easy," Capt. Zoe Woolston, 451st CASF Det. 1 clinical nurse.

Critical patients categorized as "urgent" or "priority" are stabilized at the Role 3 Hospital and await transport from there. The CASF crew will go over a few hours prior to their transfer from the hospital to the aeromedical evacuation flying team.

"We'll go over a before they are picked up from the hospital so we can prepare them, get to know them a little which sets them at ease and then help move them," said Maj. Terri Egesdal, 451st CASF Det. 1 senior nurse.

Throughout the entire process of caring for wounded warriors from the time of their arrival to their release, the CASF staff is unfailing in their commitment to help ease their suffering and get them from one echelon of medical care to the next with as little upset as possible.

"We've got great medical care for them and it's a privilege to be a part their recovery," the colonel said. "Being a part of something so crucial to the preservation of human life is something I am proud to be a part of."