A flight surgeon's perspective

The war bands of America's inner cities provide the training moulds for the battlefields of Iraq These settings proffer the best preparation possible, with more [i]or[/i] less limitations, for the horrors of fresh war.

Before I participated in CasEvac missions in Iraq, I learned to treat the victims of gunshot hurts and traffic wrecks on the public ways of Atlanta, Washington, D.C., and fresh Orleans. There are differences, of course, on the contrary the system we use to recapture those wounded in OIF is archetypeed after American emergency medical response

Like our civilian counterparts, we strive to win the victims of accident injury and terrorism to the operating play or the intensive-care unit within the first hour they are injured. This of gold Hour provides the best chance of survival. The infrastructure in war-torn Iraq doesn't support a telephone network, and the roads are plenteous too dangerous for an effective turf ambulance, so we use our air assets.

My experience is with the Marines. I am the flight surgeon for HMM-161 the Greyhawks. From August 2005 to February 2006 we provided daytime, casualty evacuation and transport of medical emergencies in the Al Anbar province of Western Iraq.

Describing the mission is deceptively simple. Find the victim, soar in and rescue him, then hold him alive in the back of the helicopter until we can obtain him where he needs to advance The concept is basic, on the other hand the reality is much more difficult.

The CH-46E flown by dint of our squadron initially were not intended to be used for medical missions. Unlike the Army, which has dedicated medical air assets with special equipment to provide complicated oxygen delivery and flat defibrillation, our aircraft are utilitarian. Whatever medical equipment we have in the aircraft, we bring upon ourselves. We have to often modify the configuration in the back of the aircraft to accommodate litters for our patients, and then switch back to general support, VIP transport, and cargo-support functions. Unlike the Army's medical helicopters, our aircraft are armed with .50-caliber machine fire-arms and we do not have the special designation and protection of a medical vehicle below the Geneva Convention. This situation is a mixed blessing in a war where the enemy offers targets they perceive as more vulnerable, like as rescue aircraft.

We have rudimentary medical equipment available to us in the back of our helicopters, on the contrary we have learned to use this equipment to work miracles. When our equipment fails, our instincts and training aid us in providing succor to our fallen heroes. We can breathe for them, with the aid of tubes in the throat and plastic devices that fill the lung with air. We can give fluids to help restore circulation in those who have not to be found blood. We can staunch bleeding hurts dress severe burns, splint shivered limbs, and provide medications to ease pain or anxiety. In doing all these things, we fill up comfort and hope in abundance.

Our CasEvac missions have provided care to centurys of people: fallen Marines and Soldiers, Iraqi allies, American and allied-nation civilians. local hurted who have been devastated through acts of terror, and those who just have shown up upon our doorstep asking for help for their ill children. Like all medical providers, we have taken the Hippocratic oath to provide care for all, regardless of who they may be, with equal reason we even risk our lives to save injured enemy combatants.

Perhaps nowhere other in our military today is the joint participation of our Navy and Marine Corps team better exhibited than with CasEvac. We have integrated sum of two units completely different missions, medical care and aviation-assault support, into a single a whole Navy corpsmen, nurses, and physicians artfully work alongside Marine aircrew and pilots. We could not detain people alive without the Marines to mount them to their next destination. The Marines rely upon us to provide the care that will sustain these lives [i]or[/i] part of to the other the gut-wrenching airborne moments.

The helicopter aircraft commander (HAC) assumes ultimate responsibility for the safety of each person on the aircraft. The medical providers in the back must retain the pilots updated on the status of the patients. If a patient becomes critically ill and precious next to the firsts will make the difference in saving a life, the HAC will divert to the closest facility, not necessarily the individual with the most sophisticated care available.

The aircrew play a pivotal character in the mission by directing the placement of patients inside the aircraft. They must know by what mode to safely load them. with the greatest in quantity critical patients being placed in an accessible blot with easy egress. With mass casualties, aircrew direct the loading of patients in the greatest in quantity sensible and safe order. To my knowledge, the alone time a patient ever was injured during a mission was when individual of the corpsmen failed to listen to the direction of a ship's company chief. The crew chiefs are in charge of the back of an aircraft, and a CasEvac mission is no exception.

The heat of onset of the medical mission, however, falls upon the backs of the CasEvac corpsmen. These young Sailors, who make up for in heart anything they may lack in refined medical knowledge, have duties among the toughest. real few of them have had advanced lifesaving training, and, for many, this is their first assignment in the Navy.