Nevada medical aviation unit speeds trauma patients off the battlefield
December 3, 2013
Editor's note: This unit now serving in Afghanistan includes guardsmen from the Fernley and Fallon area.
FORWARD OPERATING BASE DELARAM, Afghanistan — Twenty minutes after an injured Afghan soldier arrived here on Nov. 14, Helicopter 865 touched down outside the medical tent at about 8:50 a.m.
Afghan National Army medics had rushed the injured soldier to the base without delay. They staunched the blood flow from the gunshot wound in the Soldier's lower abdomen and noted the exit wound perilously close his spinal column.
The nature of the wound posed a significant threat to the soldier's life, so the medics requested to airlift him to a surgical facility. The airlift mission would be performed by Charlie Company, 1-168th General Support Aviation Battalion. The unit includes about 40 Nevada Army Guard soldiers as well as California and Washington Guardsmen. Charlie Company left Nevada on March 31 and is set to return in late winter.
Within minutes, medical personnel prepared the casualty for his 25-minute flight to Camp Bastion, where trauma care specialists awaited his arrival. The medical evacuation helicopter was ready, rotors spinning and set for takeoff.
Wind swelled beneath the blades of the UH-60 Black Hawk and washed over the litter crew as they dashed toward the open door on the left side of the bird. A final, powerful gust quivered the blue medical blanket over the patient as the team slid the wounded Soldier into the helicopter and closed the doors for takeoff.
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"We have an hour to get the patient to a major hospital from the time they incurred their injury," said Sgt. Jeffrey Jacobs, a flight medic with Charlie Company. "A majority of that time involves transportation. A lot can happen in 20-25 minutes."
Spc. Ryan Waller, the lead medic for the flight to Camp Bastion, secured the patient and prepped an intravenous line as the sudden, gut-sucking motion of liftoff filled the small cabin.
"The 'Golden Hour' takes into account the time of injury to surgery," said Waller, an Aromas, Calif., native. "We have to assume the worst. If we get there a minute too late, the patient may die."
The hour mark already loomed over the injured Soldier by the time Waller and Jacobs began their treatment. Goosebumps bristled on the victim's skin as the chill from blood loss and strain set into his body.
The two medics wrapped the ANA soldier in a green wool blanket and strapped an oxygen mask around his face.
"The fact we are taking them up in altitude means they're automatically going to be hypoxic," Waller said. "The oxygen levels in the blood are not going to be as high as on the ground. The patient is already injured, so that's one of the things we can always count on."
Waller and Jacobs moved feverishly about the helicopter in silent coordination. Waller prepped a syringe, holding the needle out for his partner to see, as Jacobs tied off the patient's right arm and coaxed a vein to the surface.
"We've gotten used to each other's body language and the flow of events," said Jacobs, a native of Elk Grove, Calif. "I can look at him, see what he's doing, and prep for what's next."
Jacobs slid a needle into the Soldier's arm near the bend in the right elbow. Waller did the same on the other arm.
"The trust factor is huge," Waller said. "I know if he is off doing something, it's important for the patient."
The two have handled about 30 trauma cases during their six months in Afghanistan.
"The two medics in the back are performing the jobs of almost eight people in the hospital," Jacobs said.
The nature of the helicopter itself is a constant challenge for the team, said Waller.
The medics crawl around the fuselage on their knees, attached to the helicopter frame by a safety strap. The weight of their gear and the cramped conditions make it difficult to conduct traditional assessments on patients. The sheering sound of the engines drowns out their ability to communicate verbally.
Unable to feel for a pulse or listen to the patient's lungs, they rely on an array of sensors, medical equipment and pure instinct to monitor the patient's vital signs.
"The back [of the helicopter] really is where we shine," Waller said.
By 9:11 a.m., Helicopter 865 touched down at Camp Bastion, where Waller and Jacobs turned the patient over to critical care personnel waiting by the flight line. The Golden Hour deadline was met.