Air Force professionalism, teamwork save U.N. lives

Capt. William M.G. Manley
447th Aerospace Expeditionary Group Public Affairs

BAGHDAD, Iraq -- Airmen from several Air Force units at Baghdad International Airport rescued seven United Nations employees injured when a terrorist bomb exploded outside their Baghdad headquarters Aug. 19.

Shortly after the attack, the 301^st Expeditionary Rescue Squadron was told to stand by. Approximately 90 minutes later, the squadron dispatched two combat search and rescue teams. Each CSAR team included one pilot and three pararescuemen.  They were joined moments later by a third CSAR team.

“PJs bring more capability to an accident scene than most people are aware of,” said Hank, the 301st PJ team leader.  “We’re fully certified trauma paramedics who can perform minor field surgeries, amputations, tracheotomies and Venus cut downs (deep intravenous drips for burn patients).”

PJs can also operate specialized rescue equipment like the “Jaws of Life” and rope pulleys.  These skills were put to use Tuesday night. Their first task involved setting up, then using a rope pulley to retrieve a bombing victim. The victim was trapped in the rubble about 15 feet below the closest access point. The PJs made the rescue because other rescue personnel didn’t know how to set up and use a pulley system.

“This guy was in bad shape,” said Rich, another 301st PJ.  “He’d been pinned upside down for more than two hours.  Both his legs were crushed, his right hand was pretty much destroyed, and he’d lost about 40 percent of his blood as well.” 

It took about 40 minutes to retrieve and fly him to the Baghdad airport hospital, where he underwent the four-hour surgery that saved him. He was one of three patients the PJs rescued Tuesday.

“This is where training really pays off,” said Col. Brian Morr, 447^th Expeditionary Medical Squadron commander.  The 447^th EMEDS includes 31 medical professionals from 10 bases. 

“As medical personnel, we follow the same training plan worldwide, which makes us an effective team despite having never worked together before,” Morr said.

The 477^th EMEDS treated seven patients Tuesday evening.  Four were released within 24 hours. Three others were flown to medical facilities outside Iraq. One of those was the first person rescued by the PJs.

Fortunately the Air Force had the needed medical care. “Our Mobile Field Surgical Team, embedded in EMEDS, has the capability to perform emergency surgery to stabilize patients with life threatening injuries,” said Lt. Col. (Dr.) Craig Ruder, 477^th EMEDS orthopedic surgeon. “We treated his crush injuries, controlled ongoing bleeding and provided fluid resuscitation that stabilized his condition in preparation for transport.”

Eleven hours after the first PJ team responded, the final leg of the Baghdad airport medical marathon began at the 379^th Aeromedical Evacuation Squadron.  The squadron’s Mobile Aeromedical Staging Facility, or MASF, prepared the injured trio for aeromedical evacuation. The MASF also provided flight nurses and medical technicians to care for the patients. 

“The MASF is basically a hub for all the area’s medical evacuations,” said Lt. Col. Andy Wolkstein, its commander.  “We take patients from the surrounding camps and prepare them for transport.  (That night) we already had 61 patients scheduled for transportation to Germany, so we added that first critical patient and a Critical Care Air Transport Team at the last minute.”

Morr noted CCATT is one of the lessons learned from Operation Desert Storm more than a decade ago.  During that conflict, U.S. military learned it needed a way to transport critically injured patients quickly to better-equipped medical facilities.

While the capability had been a theory for a while, it became a reality during Operation Enduring Freedom and Operation Iraqi Freedom, said Master Sgt. Mike Jones, a respiratory therapist assigned to the CCATT.

“We used to only be able to transport stable patients,” said Jones.  “Now we’re able to transport patients who have been stabilized and are under intensive care.  That’s a major difference.”

The three-person teams include a critical care physician, critical care nurse, and respiratory therapist. The teams basically set up an intensive care unit in the airplane.  Each team can care for up to three critical patients who require ventilators or up to six who don’t.

It’s this multi-national, joint-service team that made sure the patients brought to Baghdad airport were safely airlifted to more advanced care outside Iraq. “This was a total team effort,” said Morr.  “Our team consisted of physicians from the Air Force and Navy; Air Force nurses; and Air Force, Navy, and Australian forces technicians.”