CINCINNATI — The soldier on the military cargo plane struggles to breathe. He developed pneumonia while serving in Afghanistan and needs medicine now, but the pump to deliver it won't work properly. "I can't believe I'm still messing around with this pump," the nurse says, speaking on a headset because the three-person crew is surrounded by the constant roar of jet engines even as she struggles with the thin air at 30,000 feet. But those engines aren't real. The "plane" is a simulation center deep inside the University of Cincinnati Medical Center, the pump failure orchestrated from a control room next door. The patient is a mannequin. The whole thing, in fact, is a training exercise, with those in the control room recording every word and reaction. "There are communication issues for sure," said Air Force Maj. Daniel Cox after the training exercise is done. "(The doctor) has got to be more vocal." "The cadre," 17 Air Force trainers housed here at the University of Cincinnati, is charged with developing a new generation of war doctors, nurses and respiratory therapists. The university is one of three training sites for Air Force doctors, including those in the National Guard and Reserves, about to be deployed to Afghanistan or other active theater. The other training sites are in Baltimore and St. Louis. Once deployed, the doctors, nurses and respiratory therapists will treat injured service members being flown to other sites in theater or to an American military hospital in Germany. Most have backgrounds in critical care, but they often haven't seen the range of injuries common in America's 21st century wars: blast injuries, amputations, multi-trauma head injuries. "It can be a difficult transition," said Lt. Col. Elena Schlenker, deputy director of the training program, called C-Stars, or Center for Sustainment of Trauma and Readiness Skills. There are all kinds of rules for pilots. How often can they fly? How far can they fly? But there are no rules for the people in the back of the aircraft. Richard Branson, University of Cincinnati surgery professor. Even for doctors and nurses active in the military, the stress, confined space and oxygen-deprived conditions in transport planes can be overwhelming, said University of Cincinnati surgery professor Richard Branson. The experiments hone in on how altitude affects not only the patients, but the caregivers and their equipment as well. "There are all kinds of rules for pilots," he said. "How often can they fly? How far can they fly? But there are no rules for the people in the back of the aircraft."
BAGRAM AIRFIELD, Afghanistan — More than 70 years ago, the first flight nurse graduated from the flight nurse course on Bowman Field, Ky. These flight nurses trained to provide a higher level of care to patients while they traveled by aircraft to other medical facilities. Today, the flight nurses and technicians of the 455th Expeditionary Aeromedical Evacuation Squadron keep that level of care going in the skies above Afghanistan. The 455th EAES provides medical and nursing care in flight to ill or injured service members or Department of Defense civilians. They perform their mission on fixed wing aircraft, including the C-17 Globemaster III, C-130 Hercules and KC-135 Stratotanker, and can provide extensive critical care capability equal to the level of care that patients receive at the Craig Joint Theater Hospital here. “Our job is to move the sick and injured through the area of responsibility of Afghanistan,” said Col. Edward Farley, 455th EAES commander. “We obviously don’t want to be very busy, because that means that something bad has happened, and we have to move our service members or our coalition partners to a higher level of care.” Farley, deployed from Scott Air Force Base, Ill., leads 48 medical personnel with teams of four basic crews consisting of two flight nurses and three emergency medical technicians. All flight crewmembers received specialized altitude training to become universally qualified to move patients by aircraft. Tech. Sgt. Alejandro Rojas, 455th EAES medical technician, said the hardest part about his job is the uncertainty of the missions, but his team trains for the unexpected. “Each of our teams preps and configures all of our equipment the same way,” he said. “That way no matter what aircraft or patients we get, we are ready.” He also said that even though his unit doesn’t always stay extremely busy, primarily during the winter seasons, the necessity to have them is unquestionable. “We are like life insurance,” Rojas said.
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SOUTHWEST ASIA - Eight members from the 379th Expeditionary Aeromedical Evacuation Squadron transported a patient from a forward deployed location in Southwest Asia, to Landstuhl Regional Medical Center in Germany, Dec. 6, 2013, aboard a C-17 Globemaster III. The patient, a 54-year-old Army soldier, was suffering from respiratory failure when the aeromedical evacuation crew was notified to transport him to the nearest medical treatment facility. "When we landed near the patient's location, we immediately grabbed all of our medical gear and loaded in the back of a (Army medevac) Black Hawk to get to the pick-up site," said Maj. Matthew Pieper, a 379th EAES critical care air transport team physician deployed from Travis Air Force Base, Calif., and a St. Louis, Mo., native. "Riding in a helicopter was the quickest form of transportation to the patient." When the CCATT, also including Travis AFB airmen, Maj. Michele Suggs from Flint, Mich., and Tech. Sgt. Athena Sotak from Brownsville, Texas, arrived on scene with the patient, they quickly got him aboard the helicopter, began performing a medical assessment and started a medical ventilator, Pieper said. "Keeping a patient stable in the back of a helicopter is challenging," Pieper said. "There is less space to work, communication is difficult and we had to stay in our seats. We communicated directions with an Army medevac [technician] who was attached to a harness. He had a little more room to move and keep the patient stable." During the helicopter ride back to the C-17, the medical crew swapped out three oxygen tanks to keep the patient breathing through the ventilator. On the third oxygen tank, the patient's oxygen level began to dip as the helicopter was landing, Pieper said. "We ran the patient about 200 yards from the helicopter to the C-17," Pieper said. "The C-17 has more oxygen capacity than the helicopter so we needed to move him as quickly as possible." Capt. Rebecca Wastart, a 379th EAES flight nurse from Scott Air Force Base, Ill., helped set up the plane to receive the patient said,
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