Medics provide intensive care from above

  • Published
  • By James Bowman
  • 18th Wing Public Affairs
KADENA AIR BASE, Japan --  People may have seen the aftermath of a horrific car wreck and thought about what happened to the passengers inside, but Capt. Tina Hall, a critical care nurse, knows all too well what happens after the blaring sirens and flashing lights streak out of sight.

"One of my most challenging missions involved a pediatric patient with severe abdominal trauma as a result of a motor vehicle crash," explained Hall, who is a team member of the Pacific Air Forces West Critical Care Air Transport Team based at Kadena. "Within 12 hours of the crash, [the patient] was taken to surgery to control the bleeding and on an aircraft headed to an advanced medical facility for medical care."

To say the mission was a challenge would be an understatement. The captain said evacuation flights are delicate because of the effects that altitude has on the body. To make things worse, the young girl's vital signs and blood count were weak.

"Blood was administered immediately and I'm happy to say the child made it to the final destination safely," Hall said. "The next week I paid her a visit after transferring another patient to the same facility. It made my day to see her sitting up in the bed watching TV and playing with her toys. When I told her who I was, she looked at me and simply said thank you in a sweet little voice. It's the difference I make in the lives of patients and families that lets me know I've done what I've been called to do."

The CCATT has a unique peacetime mission of transporting critical patients to more advanced medical care facilities. The team is on 24-hour stand-by and prepared to respond to any medical mission in the Asia-Pacific region. They are also augmented by the 18th Medical Group and U.S. Naval Hospital Okinawa Joint Medical Attendant Transport Teams.

By augmenting the Kadena's 18th Aeromedical Evacuation Squadron, CCATT has the ability to create and operate a flying intensive care unit that acts as an aeromedical bridge between medical facilities.

PACAF officially stood up the team in 2010. CCATT West consists of a specialized, three-person medical team consisting of a physician, critical care nurse, and a respiratory therapist. The team provides care to critically ill or injured patients with multi-system trauma, shock, burns, respiratory failure, multiple organ failure, or other life-threatening complications.

The team can care for three critically injured, monitored patients at a time, or six lower acuity stabilized patients during a 16-hour duty day of patient care. CCATT West is equipped to provide sustaining medical care until the patient is transported to an advanced treatment center.

Although CCATT West primarily provides peacetime missions, they are also designed to assist with humanitarian relief operations as well as during natural disasters. The team can create and operate a portable intensive care unit on board any commercial or military transport aircraft during flight. The most common aircraft used within the Pacific are the KC-135 Stratotanker, C-130 Hercules, and the C-17 Globemaster III.

"We have a truly unique mission here. Very few people have the opportunity to do peace time CCATT. There are only two teams in the world currently doing this full-time," said Maj. Mehdi Shelhamer, pulmonary and critical care physician. "The Pacific is composed of many islands with limited medical resources for service members, their dependents, and the retiree population. We are the means to moving these critical patients to advanced medical care facilities."

Once alerted, CCATT West has three hours to join the 18th AES for patient transport.

"Prior to meeting the 18th AES team, we must pre-flight all equipment, gather all medical supplies and obtain as much history as possible about the patient. This time period is critical for planning as we must anticipate the needs of our patient," explained Hall.

Upon meeting the patient, CCATT assesses the patient, retrieves medical records, connects the patient to the portable equipment to include IV pumps, monitors and a ventilator, and transports the patient to the aircraft.

While in flight, the 18th AES mission crew director keeps CCATT in contact with the receiving facility. If the patient becomes unstable or deteriorates in flight, CCATT via the 18th AES can notify the receiving facility and request additional supplies or equipment upon arrival prior to ground transport.

"As a CCATT member, you are definitely saving lives. Being able to utilize my critical care skills and expertise to save the lives of Airmen, Marines, Sailors and Soldiers is definitely the most rewarding thing I do," said Hall. "I love critical care and CCATT allows me to use my skills to make sure these individuals receive the care they deserve and need to bring them back to the fight."

The CCATT members receive 10 days of training at the U.S. Air Force School of Aeromedicine, in Wright-Patterson AFB, Ohio, followed by two weeks of training at the Air Force's Center for Sustainment of Trauma and Readiness Skills for the CCATT Advanced Course at University Hospital in Cincinnati, Ohio, every two years. During this training they perform clinical rotations in a level one trauma center, test their knowledge using advanced human and aircraft simulators, and practice new skills on a live aeromedical evacuation mission.

"Even after CCATT Advance course, our team still continues to train, ensuring we stay current on critical care skills and equipment," said Tech. Sgt. Michael Hermon, the team's respiratory therapist. "When you're flying a portable ICU at 37,000 feet with a critical care patient, there's no room for error."