Flying ICUs save lives

RAMSTEIN AIR FORCE BASE, Germany — The Air Force has converted a group of C-17s, which fly weekly medical evacuation missions from here to the battlefields of Afghanistan and Iraq, into flying ICUs that provide the same technology on an aircraft that is available in any hospital intensive care unit.

That includes heart monitors and respiratory ventilators configured and certified for use in the air, plugged into the plane’s onboard electrical and oxygen systems, said Air Force Col. Sharyn Roettger, commander of the 791st Expeditionary Aeromedical Evacuation Squadron. When evacuees are moved to ambulances, the systems operate on battery power during the 10-mile trip to the Army Landstuhl Regional Medical Center (LRMC).

Upon arrival, evacuees are hooked to hospital ICU gear, Roettger said.

Technology also aids medics on the battlefields, who use ultrasound devices as small as a handheld computer to locate shards of shrapnel in the bodies of wounded soldiers.

Altogether, today’s troops have the lowest fatality rates of any war because of technologies that were not available to earlier generations of medics, according to Col. Doug Robb, command surgeon for the U.S. Central Command, which has overall command of U.S. forces in Afghanistan and Iraq.

Robb, speaking at the Military Health System conference in February, said a wounded soldier can be medevaced via helicopter to a field hospital in less than 20 minutes, be on a C-17 en route to Ramstein in 24 hours or less, and be transported to a U.S. hospital, such as the Walter Reed Army Medical Center in Washington, D.C., within two days.

Army Lt. Col. Claude Hines, program manager for the MHS Theater Medical Information Program, said last month at a health care information technology conference in San Diego that field medics can use handheld computers to record battle wounds and then upload that information into a soldier’s medical record contained in the clinical data repository of the Armed Forces Health Longitudinal Technology Application.

Once the soldiers are ready to be moved, the military wants to get them off the battlefield and into fully functioning health facilities. Technology plays a role in this as well.

Army Col. John Sweeney, director of the Deployed Warrior Medical Management Center (DWMMC) at LRMC, said he coordinates the flow of patients using two management systems — the Joint Patient Tracking Application and the U.S. Transportation Command Regulating and Command & Control Evacuation System (TRAC2ES).

Sweeney is an internal medicine specialist at the Veterans Affairs Hospital in Philadelphia when not on active duty. He said the systems allow the DWMMC to help build patient manifests for medevac flights and configure inbound aircraft, down to the number of intravenous tube poles needed for a mission and their locations on the aircraft.

Capt. Donnie Kotulan, operations officer of the Air Force’s Theater Patient Movement Requirements Center-Europe (TPMRC-E), said the systems allow his unit to electronically triage evacuees, including their ultimate stateside hospital destination.

Patients suffering from burns are transported to Brooke Army Medical Center in San Antonio, Texas, which specializes in treatment of burn wounds. The TPMRC-E uses JPTA and TRAC2ES to alert Brooke, which then dispatches a burn treatment team here to meet incoming C-17s with patients on board.

Sweeney said the two systems allow DWMMC to tightly choreograph patient movement, which is crucial to a continuum of care — beginning at field hospitals in Afghanistan and Iraq, to the carriers and to U.S. medical centers such as Brooke or Walter Reed.