From wounded to well: Med techs at the CASF

Published Aug. 15, 2008
By Staff Sgt. Vincent Borden
386th Air Expeditionary Wing

SOUTHWEST ASIA -- Editor's note: This is the first of a three-part series titled "From wounded to well." The series takes a look at how the Contingency Aeromedical Staging Facility operates day to day, and how it contributes to the operations scheme of U.S. Central Command.

Two aircraft parked tail-to-tail is something that doesn't happen often on the flightline, and now Senior Airman Ronnie Tipton knows why. The day he saw it for the first time, three U.S. servicemembers had arrived in critical condition at the 386th Air Expeditionary Wing in a C-130, wrapped in bandages with burns and blood and IVs attached, surrounded by nurses and crew members rushing them from one aircraft to another. The two aircraft were parked that way to help facilitate the transfer.

Airman Tipton, a medical technician deployed from Wright-Patterson Air Force Base, Ohio, describes the scene as surreal, but he and a crew of medical technicians and nurses from the wing's Contingency Aeromedical Staging Facility shook off the shock and provided help where they could.

"The patients were on life support, and they had their critical care teams with them," said Airman 1st Class Thomas Waters, a medical technician who also arrived on the scene. "We figured out the logistics of how we were going to get them from one plane to the other as quickly as possible, but with the least amount of movement."

Within minutes, the aircraft was in the air, transporting the servicemembers to Landstuhl Regional Medical Center in Germany. The C-17 left behind more than 2,900 Airmen stationed at the base who never knew it was here, and 22 others who would never forget it came.

"I had never seen a tail-to-tail before," Airman Tipton said. "I worked in Balad in 2004 at the CASF, and we always got our patients out of the theater hospital there, loaded them on the bus and transported them to the aircraft. This was different."

Treating critical care patients is not something new to the technicians here; a few of them have experience working in Balad's CASF at some time in their careers. Airman Waters, who is deployed from Wright-Patterson AFB, performed medical technician duties on critical care patients at LRMC as early as last year. But for other technicians that had never been exposed to the sight of severe battlefield injury, the experience strengthened them all in acknowledging the purpose of why they're here.

"Here in this facility, we're seeing [patients] mostly after they've been seen, the bleeding's been stopped, patched up and bandaged," said Staff Sgt. Randy McKenzie, noncommissioned officer in charge of the CASF. "It isn't like being in Balad where injuries are coming in left and right, straight off the battlefield. So, that was something that we got to see firsthand, and it was a great [experience]."

Since then, Sergeant McKenzie and his team of 15 medical technicians have seen other critical care patients, as well as servicemembers with broken arms and legs and burns from improvised explosive device blasts. The range of injuries is staggering.
This is life at the CASF here, where the erratic schedule of aircraft flights pick up and drop off patients leaving and entering the base a majority of the time during the twilight hours of the day.

The medical staff at the CASF sees injured servicemembers almost every day in some capacity. In fact, the facility has seen more than 1,300 inbound and outbound patients since May.

Many of them stop for medical care on their way to a nearby Army camp, or on their way to fly to another base for treatment. Some stay as long as 72 hours, and others less than 72 minutes. In either case, the facilities' medical technicians provide an array of assistance to them all.

"We bring them in and make sure they're comfortable while they're here, and get them back out so they can receive further care," said Sergeant McKenzie.

The CASF is one of two staging facilities in the U.S. Central Command area of responsibility. It's one of the few places wounded servicemembers can come to get well.

The CASF is an idea the Air Force has been modifying since the early 1980s, when the service began to pre-position several large contingency hospitals in Europe and Asia, said Judith Taylor, 59th Medical Wing historian at Lackland Air Force Base, Texas.

Throughout the decades since, the Air Force has modernized the hospitals and given them strategic positioning due to the scarcity of airlift in deployments. That modernization included an expandable hospital capacity, as well as pre-positioned medical supplies and equipment.

The facility has a significant number of beds, which can be expanded to hold even more patients, said Maj. Bonnie Stiffler, a nurse at the CASF deployed from Wright-Patterson AFB. "We have an anti-hijacking room, where patients get checked to ensure they don't have any knives, razor blades or weapons in their possession, and their bags get scanned through an X-ray machine.

"Afterward we brief them on the different things we can offer at the facility and take them to their beds, where they'll talk to a nurse about their current condition and any problems they may be having with pain," Major Stiffler said.

Most of the time, the medical technicians are the first and last Airmen that patients see when they arrive and leave the base. Their duties have the technicians interacting with patients in a variety of ways throughout their stay at the facility.

For instance, the technicians carry the patients off the aircraft in litters and drive them by bus to the CASF, then prep them in the anti-hijacking room, where they check for weapons, take their vitals and ask them questions on any medications they may be taking.

After taking their bags to a holding room, the technicians escort the patients to their beds for the night, where they are met by the facilities' nurses for further assessment. Every 12 hours from the time they enter the hospital, the medical technicians must retake their vital signs and ensure they are feeling as well as possible. The technicians keep this up until it's time to load the patients' bags and drive them from the staging facility to the aircraft, where they'll carry the patients on their litters from the bus to the plane.

With the range of injuries suffered by servicemembers in the field, from lower-extremity breaks and fractures to burns and post traumatic stress disorder, the unpredictability of what can happen everyday is both daunting and enriching at times.

"We know that when the patients get here, you have to be ready to act and know what you're doing," said Sergeant McKenzie. "Here, you have to be ready for anything."