Realities of War: Learning About Transport

Critical care transport requires the utmost in communication, planning, and, from what I learned today, total flexibility.

At Ramstein Air Force base, the medical evacuation crew described the ebbs and flows of patient transports.

Consider the following statistics: Since March 2003, the 435 Aerospace Medicine Squadron has coordinated 73,003 patient transports from "downrange," out of Iraq and Afghanistan and back to Ramstein before they went elsewhere for additional care or back to the states.

Of those, only 22 percent were actual battle injuries. The remaining injuries were classified non-battle, which could mean someone became ill due to poor sanitation or was facing a mental illness.

In a single day, the aeromedical evacuation squadron can bring back about 20-30 patients per flight. Today, the Contingency Aeromedical Staging Facility (see pictures from Balad Air Base, Iraq) crew, who is responsible for unloading patients from the plane, onto "ambuses" or ambulance-buses, had three flights scheduled to arrive and unload. Their job from that point is to take them to either Landstuhl Regional Medical Center or back to the CASF staging quarters if they are non-critical. There they wait about 48 hours for the next flight back to the states.

Their cohorts, the critical care transport team, demonstrated nothing short of enthusiasm and pride for their profession. Three captains I spoke with all got their start as civilian nurses in the states. Their backgrounds combine critical care, emergency and trauma nursing. But when they met with an Air Force nurse recruiter at their respective hospitals, were thrilled with the opportunity. Now, after going through weeks of intense critical care transport training, they may have about an hour notice before they are head to Iraq. How many patients they are picking up is unknown. They make sure they care for themselves during the 5 hours down, using the time to nap and keep hydrated. Because once they land, it is an entirely different story. One captain's greatest load was 56 patients.

Nearly everyone we spoke with today was eager to tell us what they do, how they do it and why they chose this line of work. Quick-thinking, adrenaline rush, handling the pressure might be part of the job. But they wouldn't show up if they didn't believe in what they do.

Here are some photos of my day. (photos by Jeffrey Leeser)