Civilian Surgeon Flies With Air Force Medevac Team

By Air Force Capt. Justin Brockhoff
Special to American Forces Press Service

Sept. 3, 2009 - Air Force medical evacuation airmen had the benefit of flying with a leading U.S. trauma surgeon during a recent mission to Iraq as part of a program to link military and civilian medical professionals. Thomas Scalea, physician in chief at the R. Adams Cowley Shock Trauma Center in Baltimore, flew aboard a C-17 Globemaster III transport jet on an Aug. 19 and 20 aeromedical evacuation mission to help to shape future training for military medical teams worldwide, Air Mobility Command officials said.

Scalea served as a lead contributor to the Air Force's Center for Sustainment of Trauma and Readiness Skills, or C-STARS, a medical service training program that links military medical personnel with select civilian trauma care centers across the country to prepare them for the types of cases they'll see while caring for warfighters.

"The goal of this trip was for Doctor Scalea to observe the often difficult conditions Air Force teams are faced with while aeromedically evacuating our troops from the theater," said Air Force Col. (Dr.) Lawrence Riddles, U.S. Transportation Command surgeon, who served as Scalea's escort.

"He's already an advocate for our programs and is deeply involved in our military health-care training, Riddles said. "Our operations tempo is the highest I've seen in my career, and with that, our training has to be the best. Giving our C-STARS partners the chance to see these missions will make our training programs more effective."

Results of the training speak for themselves. Since April 1, 2003, Air Force aeromedical evacuation personnel have flown more than 136,000 patient movements worldwide, including more than 8,700 this year. During operations in Vietnam, it took an average of 45 days to return an injured troop to U.S. soil. Today, it takes an average of three days.

Additionally, wounded troops have a 95 percent chance of survival when they make it to into the hands of the military's aeromedical evacuation experts, who are deployed all over the world. Command officials attribute those successes to the joint en route care system and to C-STARS, and similar training programs.

"This trip was very eye-opening, and I was honored to be included," Scalea said upon his return to the United States at Andrews Air Force Base, Md.

"In trauma centers, we are often working in good conditions with the lighting we need and enough space to move around," he said. "In the back of an airplane, the [aeromedical evacuation] crews work with flashlights strapped to their bodies and have to maneuver in and out of cramped spaces to care for multiple trauma patients at a time. But that does not impact the results. Each patient was cared for with the highest standards, and the care was top-notch."

And that care isn't only reserved for U.S. troops. In late July, Air Force aeromedical teams evacuated a British soldier out of Afghanistan to life-saving care after being shot in the upper abdomen and chest. The move took two airplanes to get the right medical equipment and personnel in place, and a third plane to fly the patient to further care.

"Because of C-STARS, our medical experts get hands-on experience with gunshot wounds, stab wounds, internal injuries and much more, and they experience those situations with world-renowned experts such as Doctor Scalea as an instructor," Riddles said. "That prepares our teams for a lot of what they'll see in the theater of operations, and it enables them to make those often fast-paced, life-saving decisions."

Many aeromedical evacuation personnel have more than a couple stories to back up the importance of programs like C-STARS.

"After attending C-STARS, I was deployed to launch and recover aeromedical evacuation missions as part of the aeromedical evacuation operations team in Southwest Asia," said Air Force Maj. Suzie Dietz, chief of aeromedical evacuation operations at the 618th Tanker Airlift Control Center here, and a flight nurse with more than 15 years of experience.

"I can definitely say that C-STARS helped prepare us for the types of situations we faced in the area of responsibility, and you can't put a price tag on the life-saving results you see every day," Dietz said.

It takes an average of 6.6 hours for the most severely injured patients to be flown out of Iraq and Afghanistan, according to command records. The 618th is responsible for planning the missions and staying in close contact with aircrews to accomplish the worldwide aeromedical evacuation mission.

All planning is closely coordinated with U.S. Transportation Command through the Global Patient Movement Requirements Center, which provides worldwide oversight and synchronization of patient movement, integrating medical regulating, evacuation service, and centralized command and control.

"Doctor Scalea is in internationally recognized expert in the field of trauma care and his expertise is an amazing resource for the training of our [aeromedical evacuation] personnel," said Steve Dugger, deputy chief of the 618th's aeromedical evacuation branch.

"Our role is to plan and execute all of AMC's aeromedical evacuation missions worldwide, and we have a number of people on our staff who've attended C-STARS," he said. "By having this first-hand training experience, and knowing what our teams will face in the field, we're better prepared in our role to coordinate aeromedical evacuation movements around the world."

C-STARS was created to help prepare Air Force medics to care for critically injured military members and safely evacuate them for follow-on care. The program is well worth the time and effort, participants say.

"Seeing what these people do to care for others is amazing, and the fact that they're doing it in the back of an airplane at 35,000 feet paints the picture of what the U.S. is willing to do to save lives," Scalea said. "I'd be honored to work with these teams any day of the week, and look forward to applying what I've experienced to support the C-STARS program."

(Air Force Capt. Justin Brockhoff serves with the 618th Tanker Airlift Control Center public affairs office.)