SCOTT AIR FORCE BASE, Ill. -- When a 34-year-old Navy sailor suffered multiple traumatic injuries during a mission in Syria, a Total Force team of medical professionals and Mobility Airmen sprung into action, intent on saving the life of a fellow service member.
The sailor suffered injuries while performing improvised explosive device clearing operations. The severity of his injuries reduced his survival rate to two percent, requiring urgent transport from Syria to Texas.
“The severity of injuries sustained by the patient were massive,” said Maj. Joshua Hamilton, Critical Care Air Transport Team physician “Many of us were shocked he survived the initial injury.”
The sailor’s injuries included a torn trachea, cervical spine injury, tibia/fibula fracture and an open eye injury. Doctors performed an emergency thoracotomy to manually massage the sailor’s heart before aeromedical teams arrived.
Hamilton, who is deployed from the 88th Air Base Wing, Wright-Patterson Air Force Base, Ohio, stated Critical Care Teams are strategically located to allow for quicker response to critically battle injured troops.
“Our team receives specialty training to allow us to provide critical care delivery to patients in austere environments,” Hamilton explained. “We are able to arrive at a location and assemble ICU level support, as well as provide intensive care in the air throughout the flight, and deliver the patient to other facilities for ongoing care.”
With time of the essence, the 618th Air Operations Center rerouted a C-17 preparing to depart from Joint Base Andrews, Maryland. That C-17 and its crew, under the command of Maj. Andrew Vandertoorn from the 452nd Air Mobility Wing, March Air Reserve Base, California, were reassigned to perform the air evacuation mission.
“At the time, we were preparing for a contingency mission to Al Udeid Air Base,” Vandertoorn said. “When the crew got the call, we sprung right into action. We knew how serious this mission was and started making the right decisions to make this mission a success.”
Vandertoorn added that though he and his crew are trained to accomplish the dynamic and unexpected challenges aeromedical missions present, this particular mission was different due to the severity of the patient’s injuries.
“We were restricted to a cabin altitude of 5,000 feet, meaning we had to maintain an altitude of 28,000 feet,” he said. “This meant we burnt more fuel, were subjected to different routings and encountered more adverse weather.”
To ensure resources and personnel were not overtasked, the 618th AOC leveraged the floater crew at Ramstein Air Base to coordinate flights between Germany and Baghdad.
“My responsibilities as aircraft commander were to ensure the safe transportation of the team and patient in and out of the combat zone,” Capt. Tim McCammon said. “In addition to operating the aircraft, I worked with the medical crew director to ensure the crew heading back to the States had what they needed to be able to accomplish their mission.”
McCammon, who was deployed to Ramstein from the 62nd Airlift Wing, Joint Base Lewis-McChord, Washington, said altitude and adverse weather were not the only challenges the team faced during the transport.
“The biggest hurdle was getting through Turkish airspace,” he said. “There was some discrepancy between our actual diplomatic clearance number for overfly and the one given to the Turkish authorities.”
The crew was instructed to circle around the Black Sea to avoid entering Turkish airspace, while 618th AOC flight managers coordinated with Turkish authorities.
“This was a frustrating ordeal because we knew this mission was extremely time-sensitive and could literally mean the difference between life and death of a service member.”
While the aircrew was handling the diplomatic obstacles, the medical crews were designing a configuration for the C-17 that would accommodate the additional personnel and equipment needed to get the patient back to Texas.
Given the patient’s injuries, a highly-specialized 10-member Extra Corporeal Membrane Oxygenation team from the San Antonio Military Medical Center, joined the AE and CCATT teams. The ECMO is a pump designed to circulate blood through an artificial lung back into the bloodstream.
“ECMO provides support to the body and compensates for lungs that are not adequate to bring oxygen into the body or take away the carbon dioxide the body produces,” Hamilton explained. “Even with the restricted cabin altitude of 5,000 feet, without ECMO, the patient would not have survived the trip.”
Although this mission was not their first aeromedical evacuation mission, every member involved stated this tops their lists in terms of magnitude.
“This was not the first urgent or critical patient in my career but it was the first with the ECMO mode of intervention, and unusually high number of caregivers,” said Capt. John. Soule, 145th Airlift Wing, North Carolina Air National Guard. “I believe my experience as a civilian paramedic and later as a nurse in a Neuro/Trauma intensive care unit prepared me for almost any mission from a technical aspect. I knew the assembled team was highly credentialed and skilled enough to give this sailor the best possible chance at survival, which is as comforting as anything else could be to my mind.”
Hamilton added accomplishing missions such as these is one of the reason why he joined the Air Force.
“To bring the skills of a critical care team to the bedside of an injured soldier at a time of need, and transport that patient to a higher level facility safely and quickly is something that can happen in no other military force on the planet,” he said. “This mission embodies the hopes we all have as we chose military medicine over civilian practice. To serve those injured protecting our country is the highest calling.”
McCammon echoed Hamilton’s sentiment, adding there are times when a mission re-cages an Airman’s view of their occupation.
“It is easy to get discouraged with long days and tough conditions, but it's a mission like that this that reminds you why you do what you do.”