MARCH AIR RESERVE BASE, CALIF. -- If the U.S. Armed Forces are to remain the leaders of global engagement, they must maintain a force that stands ready to deploy at a moment's notice. This type of commitment involves the selfless acts of those whose calling is to serve their country without question or mental reservation. Hardest hit are forces assigned to combat duty. Casualties are high, yet their spirits are higher because they know that if injured, the most proficient and efficient team of medical personnel will be there to see them from injury to recovery.
The 452d Aeromedical Staging Squadron, at March Air Reserve Base, makes up a small component of the men and women who enter the combat zone armed with scalpels, bandages and the logistical know-how, to move injured warriors from the battlefield to the hospital and back home for complete recovery.
"When tasked by higher headquarters [AFRC] to facilitate the transfer of patients from the area of responsibility back to a state side hospital, we get a flood of volunteers," said Senior Master Sgt. Briarly Saavedra, 452d ASTS. "To my knowledge, we have never had to force anyone to deploy. We spin up our people using checklists and briefings; ensure they have updated wills, family care plans and powers of attorney; and then manifest them on an air carrier destined for Germany."
When medical personnel reach Ramstein Air Base, Germany, they are billeted in designated rooms on base. After which, they are taken to the contingency aeromedical staging facility, or CASF, to meet up with their deployed flight commander and co-workers --usually consisting of permanent party and other deployed personnel. The first days involve getting familiar with operations, but after that, everyone is expected to perform as trained.
By assignment, this mission is an active duty role, with reservists serving as augmentees. On occasion, the Reserve has been called in to assume role as lead unit in the CASF, with active duty Airmen and sister-service personnel as augmentees.
"Deployed medics are positioned down range in areas of responsibility -- they are the first responders to injured warriors," said Master Sgt. Javier Retamoza, 452d ASTS. "Their primary mission is to stabilize the wounded for transport to Ramstein AB, the central hub for regional CASF operations."
Communication is key to mission success. Prior to transferring a patient, CASF personnel process patients into TRAC2ES (pronounced tray-sez), the single global patient movement automated information system for DOD. It is the primary single web-based systems interface that tracks patient movement from start to finish. The information contained in this system streamlines the logistical aspect of which location to transport patients. Using time and severity of patients as determining factors, the system determines which medical facility is best suited for the patient
"As an administrative technician deployed to Ramstein AB, we would coordinate the movement of patients through the Theater Patient Movement Requirement Center, or TPMRC, in cooperation with the doctors and nurses down range," said Saavedra. "They would pass on the patient case-load to ensure we were capable of continuing stabilization of the patient for eventual transport to the US."
On occasion, allied forces would transit through the CASF and remain until a liaison officer from their country arrived to retrieve them.
"We have supported wounded North Atlantic Treaty Organization, or NATO, personnel from Britain, Canada, Belgium and Australia," said Saavedra. "During our morning briefings, we notify allied forces liaisons when their wounded will be arriving and to have someone present to receive them."
We do not have a "specific" treatment agreement with our allies, but if someone comes on our aircraft, we tend to them until their own personnel can pick them up, explained Retamoza.
"On rare occasions, we have taken care of enemy combatants," said Retamoza. "There was an instance in Iraq when we were notified that there were wounded U.S. Forces who were struck by a road-side bomb, just outside of the perimeter. When they arrived, we discovered there were also injured enemy forces present. We treated our wounded in the CASF, while the enemy combatants received treatment at our Mobile Army Surgical Hospital, or M.A.S.H unit -- yes we were opposing forces, but also humanitarians."
Upon notification of inbound patients, support personnel are readied to meet the aircraft when it pulls in the chalks. Doctors, nurses, medics, chaplains and liaison officers make up the greeting party of the incoming wounded. From the time the aircraft door swings open to having the patient placed in the ambulance is usually 20 minutes -- timing is crucial, especially for critically injured patients.
"Oftentimes, augmented ground personnel were augmented by volunteers who happen to get word that assistance was needed for moving patients," said Retamoza. "Patients can weigh up to 300 pounds, requiring more muscle to safely move them to the CASF -- we had off-duty active duty personnel volunteering for recovery efforts."
Saavedra explained that patients who arrive at the Ramstein CASF in critical condition and require additional follow-on care, are transferred to upper echelon medical care at Landstuhl Regional Medical Center. However, those arriving in stable condition are considered through-regulated patients and processed for flights back to the states or if foreign, to their respective country.
"The most rewarding experience during my deployment was the hands-on experience," said Saavedra. "Back home, I process pay orders and other administrative training, but when I am there, I am one of the personnel out at the aircraft, physically lifting patients on and off the planes, but in all trueness, they were lifting me up! The highlight of my career was when one of the injured returned, after being treated, to give thanks for what we did for him -- it was amazing that he even remembered my face because he came to us in pretty bad shape."
"The deployment was extremely stressful, yet rewarding at the same time," said Senior Master Sgt. Teresa Higgins, 452d ASTS. "Just being out there on the flightline, giving my all to ensure the continued safety of our wounded made me proud to be part of the Team!"