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Friday, April 30

Medevac crews hop around the globe to get wounded soldiers home

By Army Times

RAMSTEIN AIR BASE, Germany - Against a strong, steady wind under a gray German sky, 28 sick and injured U.S. troops, fresh from the war zones of Iraq and Afghanistan, board aeromedical evacuation Flight 50226 bound for Andrews Air Force Base, Md.

Most walk up the ramp into the C-141 aircraft on their own, or with the help of crutches or a medic's arm. But about half a dozen are carried on stretchers.

Some troops have wounds from rocket-propelled grenades and improvised explosive devices. Others became sick or were injured away from combat.

The scene, a reminder of war's grim realities, repeats itself six days a week as medical and air crews on Air Force C-141s fly to Kuwait or Iraq to pick up sick or injured troops and evacuate them to Germany or the United States for treatment.

For the most part, the troops remain upbeat despite their situation.

"They come back with these horrific injuries and their attitude is incredible," said Air Force Capt. Carol Noriega, the medical crew director of this flight, over the noise of the aircraft. "It's something they've accepted as part of their duty."

One last mission

This is the 20th and final mission for Noriega's medical crew, members of the Air Force Reserve's 911th Aeromedical Evacuation Squadron out of Pittsburgh, which was activated soon after Thanksgiving.

"I actually think it's going to be difficult to go back to the civilian sector," said Noriega, an emergency-room nurse at the University of Pittsburgh Medical Center, Shadyside Campus.

It may have been the last mission for the medical team, but it was the first in which 28-year-old Capt. Tom Fuhrman commanded a flight into Iraq. "I never really expected I'd end up doing this," Fuhrman said. As a kid he wanted to be a fighter pilot, but by the time he was in college, the drawdown of military forces had left few openings in fighter cockpits. A recruiter called and told him he had openings for C-141 pilots, and in 1999 he went to officer training school.

Flying the medical evacuation missions gives him a feeling of contributing. "You see the direct effect you have," Fuhrman said.

Seven medical workers - three nurses and four technicians - are staffing this flight, standard for evacuations out of Ramstein to the states. If necessary, more staff from a critical-care, air-transport team could be added.

The medical crew flies with 800 pounds of equipment on every mission - litter straps, cardiac monitors, defibrillators, suction and intubation equipment, syringes, drugs, bandages and other gear.

Much of the medical equipment they carry is the same as what's used in their civilian hospital jobs. The big difference here is that they must use the gear and their skills while in the air.

Besides their usual medical knowledge, the medical crew must be schooled in flight stresses - for example, how air pressure at higher altitudes can affect head or eye injuries.

A swirl of motion

In flight, the crew members are in constant motion. Not only do they administer medicine and monitor patients' health, they also help them use the lavatory, heat up and serve their meals, and clean up afterward.

Air Force Capt. Randy Dickerson, a nurse, uses the natural light streaming through a porthole to illuminate an X-ray showing Marine Cpl. Robert Garza's multiple cervical vertebra fractures. The 22-year-old from Irving, Texas, was injured March 16 when his Humvee hit a mine near the Syrian-Iraqi border. He is in pain, lying on a litter with his neck in a hard brace, and doesn't want to talk much.

Dickerson and a technician want to see where the fractures are as they try to find a more comfortable position for Garza. They're able to offer padding and prop him up slightly.

About six hours into the trip across the Atlantic, the plane hits rough air, and Garza grimaces. A technician consults Noriega, then injects medicine to prevent blood clots. The ride quickly turns smooth again, and Garza doesn't need anything more for his pain.

C-141s: medevac workhorses

The C-141 aircrews regularly fly cargo missions. But for Operation Iraqi Freedom, C-141s out of Wright-Patterson Air Force Base, Ohio, and March Air Reserve Base, Calif., are the only regularly scheduled medevac flights out of Kuwait and Iraq, said Lt. Col. Brian Dominguez, commander of the 356th Airlift Squadron and a Delta Airlines pilot in civilian life.

The aircrews carry cargo and medical teams into the war zone. Cargo is off-loaded and the plane is then reconfigured for patients.

Less than three days before the flight to Andrews, Dominguez's crew carried 23,000 pounds of food and medical supplies and three aeromedical teams into Balad, Iraq. They flew out with 19 patients, one of whom was so badly injured he needed critical care while in transit.

Complex and far-reaching

The military medevac system for Iraq and Afghanistan uses an array of regularly scheduled and on-demand flights, both fixed-wing planes and helicopters.

According to military data, more than 12,000 patients have been flown out of the two war zones.

The medical crew said the evacuation system helps to save lives, getting patients to more advanced care when they need it within hours of their initial injury, and less than 30 minutes from their field surgeries.

"The type of care these patients are receiving in the 'golden hour' is actually increasing the survival rate like we've never seen before," Noriega said.

'Give them our best'

Flight 50226 is a long one - more than 10 hours, thanks to a 70 mph headwind - and the medical crew is looking forward to getting home now that its three-month deployment is up.

They'll spend the night in Maryland, then get picked up by their unit the next day for the final leg to Pittsburgh.

"One more night away from home," Dickerson said within an hour of landing.

Up front, in the dim glow of the flight deck, Fuhrman guided the plane down the East Coast over the lights of Philadelphia and Baltimore toward Andrews Air Force Base. About 10 p.m., the military control tower began to direct his final approach.

With the comfort of his sick and injured passengers in mind, Fuhrman asked for a slow descent. The controller obliged, slightly re-routing the aircraft.

"You got military patients?" the controller asked.

"Yes, we do," Fuhrman replied.

"Give them our best."