Air Force Team Cares for Haiti Victims in Flight

By Derek Kaufman
Special to American Forces Press Service

Jan. 27, 2010 - A three-person medical team from the Wright-Patterson Medical Center here is providing aeromedical evacuation support for victims of the earthquake in Port-au-Prince, Haiti. The critical care air transport, or CCAT, team is staging from MacDill Air Force Base, Fla., with the 45th Aeromedical Staging Squadron. From there, the team flies to Port-au-Prince, picks up critically injured patients and takes them to hospitals in southern Florida.

CCAT teams are highly specialized, rapidly deployable medical teams that set up and provide intensive-care-unit-level care for patients aboard transport aircraft in flight. Most often, they set up their equipment aboard Air Force C-130 Hercules or C-17 Globemaster III aircraft.

Air Force Maj. (Dr.) John Lynch, a physician with the 88th Medical Group here, leads the Wright-Patterson team. Air Force Capt. Jeffery Marsh, an intensive-care unit nurse, and Air Force Senior Airman Brooke Lohr, a cardiopulmonary technician, round out the team.

"Ours was the first CCAT to arrive on the ground in Haiti," Lynch said. The first CCAT mission supporting Operation Unified Response left Haiti for Fort Lauderdale, Fla., Jan. 20.

To date, the Wright-Patterson team has flown three missions, evacuating 10 critical-care patients. Two were flown to Fort Lauderdale and one to Miami. The team planned to leave late yesterday to fly to Port-au-Prince for its fourth medevac mission.

"We're transporting a lot of crush injuries, amputees, burns, and closed-head trauma," Lynch said. "About half of our critical patients to date have been pediatric patients with all of those types of injuries."

Lynch said his team calls ahead to emergency personnel in Miami-Dade and Broward counties while airborne to identify the mix of patients onboard so they are ready to receive and transport them to local medical centers.

"As soon as we open the back of the plane, they are there waiting to take the patients off," Lynch said.

Lynch said each CCAT team typically oversees care for three critical patients in flight, but has provided intensive care for up to four patients on missions flown from Haiti so far. Critical care patient capacity is maxed out on each aircraft, he said.

Two additional CCAT teams from Keesler Air Force Base, Miss., have joined the Wright-Patterson team to move patients. As of yesterday, Lynch said, the combined CCAT teams had moved 20 patients.

On the ground in Haiti, the air evacuations are directed by a combination of a medical air staging facility, which provides triage and stabilization, and an air evacuation liaison team, which arranges airlift with Air Mobility Command's Tanker-Airlift Control Center at Scott Air Force Base, Ill.

Air Force Capt. Jeffery Marsh -- a critical care nurse originally from Albuquerque, N.M., who now lives in Dayton, Ohio, -- said many of the patients the team has evacuated have been extremely ill, having had to endure burns and crushing injuries for seven days or more prior to transport.

"It's a different mission than we encounter in Afghanistan and Iraq," he said. "Nonetheless, it's very rewarding to be part of this humanitarian effort. ... It's really hectic, really stressful, because of the situation in country. You normally don't get this type of experience in a career, so I am very happy to be a part of it."

Marsh and Lynch said the real heroes in the Air Force's medical response have been a group of special operations airmen from Hurlburt Field, Fla., who were on the ground in Port-au-Prince early, helping to free those trapped in the rubble and providing quick surgical intervention. All of the critical patients moved by the Wright-Patterson team to date were identified by the special operations team.

Marsh called the special operations airmen "a mixed bag of pararescue jumpers, surgeons [and] nurses who ask for no thanks and somehow manage to keep a smile on, despite being dead tired."

Lohr, the CCAT team's only enlisted member, ensures patients have a good airway and are getting enough oxygen. The Columbia, S.C., native said she's "really learned a lot about teamwork."

"We each know a little bit about what the other does," she said, "but it really takes every person on the team to accomplish the mission and bring the patient safely back to wherever they are going."

One patient who stands out in her mind is a 9-month-old girl who was experiencing a perfect storm of respiratory distress from malaria, pneumonia and an apparent asthma attack.

"We were able to give two albuterol nebulizer treatments, and racemic epinephrine, which they didn't have available," Lohr said. "Had we not been there to give those medications, they probably would have had to intubate to save the baby, and they really don't have a lot of pediatric stuff right now."

The baby was stabilized and later was transported to the Navy hospital ship USNS Comfort.

Lynch, a Lexington, Ky. native, said all CCAT team members get two weeks of specialized training with the U.S. Air Force School of Aerospace Medicine at Brooks City Base, Texas. His team also participated in a two-week trauma training course in partnership with University Hospital Cincinnati.

(Derek Kaufman works in the 88th Air Base Wing public affairs office.)