Air Force medics evacuating critically ill from Haiti

Maj. John Lynch, 88th Medical Group Critical Care Air Transport Team, prepares a 3-year-old earthquake victim for aeromedical evacuation from Port-au-Prince, Haiti to Fort Lauderdale, Fla. (U.S. Air Force photo by 2nd Lt. Anastasia Wasem/Released)

Maj. John Lynch, a physician and Critical Care Air Transport Team member, prepares a 3-year-old earthquake victim for aeromedical evacuation from Port-au-Prince, Haiti, to Fort Lauderdale, Fla. Major Lynch is with the 88th Medical Group from Wright-Patterson Air Force Base, Ohio. (U.S. Air Force photo/2nd Lt. Anastasia Wasem)

Senior Airman Brooke Lohr, 88th Medical Group Critical Care Air Transport Team, rides with a patient who will be aeromedically evacuated from Port-au-Prince, Haiti to Fort Lauderdale, Fla. (U.S. Air Force photo by 2nd Lt. Anastasia Wasem/Released)

Senior Airman Brooke Lohr, a cardiopulmonary technician and Critical Care Air Transport Team member, prepares a critical patient for aeromedical evacuation from Port-au-Prince, Haiti, to Fort Lauderdale, Fla. Senior Airman Lohr is deployed from the 88th Medical Group at Wright-Patterson Air Force Base, Ohio. (U.S. Air Force photo/2nd Lt. Anastasia Wasem)

Emergency medical technicians from Miami-Dade Fire Rescue work with Air Force critical care air transport team members to offload critical-care patients from an Air Force aeromedical evacuation flight to Miami International Airport Jan. 23, 2010. The CCATT accompanied the patients from Haiti, providing critical care while airborne. (U.S. Air Force photo/2nd Lt. Nicholas Mercurio)

Emergency medical technicians from Miami-Dade Fire Rescue work with Air Force critical care air transport team members to offload critical-care patients from an Air Force aeromedical evacuation flight to Miami International Airport Jan. 23, 2010. The CCATT accompanied the patients from Haiti, providing critical care while airborne. (U.S. Air Force photo/2nd Lt. Nicholas Mercurio)

WRIGHT-PATTERSON AIR FORCE BASE, Ohio -- A three-person medical team from the Wright-Patterson Medical Center here has deployed to provide aeromedical evacuation support to assist victims of the earthquake in Port-au-Prince, Haiti.

The Critical Care Air Transport, or CCAT team, is staging from MacDill Air Force Base, Fla. with the 45th Aeromedical Evacuation Squadron. From there, the team flies to Port-au-Prince, picks up critically injured patients and evacuates them to hospitals in south Florida.

The Wright-Patt CCAT team is led by Maj. John Lynch, a physician with the 88th Medical Group at Wright-Patt. Capt. Jeffery Marsh, an Intensive Care Unit nurse, and Senior Airman Brooke Lohr, a cardiopulmonary technician, round out the team.

"Ours was the first CCAT to arrive on the ground in Haiti," said Major Lynch.

The first CCAT mission in support of Operation Unified Response left Haiti for Fort Lauderdale, Fla., on Jan. 20.

To date, the Wright-Patt team has flown three missions evacuating a total of 10 critical care patients. Two were to Fort Lauderdale and one to Miami.
They planned to depart late Tuesday, Jan. 26, to fly to Port-au-Prince for their fourth medevac.

Two additional CCAT teams from Keesler Air Force Base, Miss., have joined the Wright-Patterson team to move patients. The Critical Care Air Transport Teams are highly specialized, rapidly deployable medical teams which set up and provide life-sustaining portable intensive care unit-level care aboard transport aircraft in flight. Most often they set up their equipment aboard Air Force C-130 Hercules or C-17 Globemaster III aicraft.

"We're transporting a lot of crush injuries, amputees, burns, and closed head trauma," Major Lynch said. "About half of our critical patients to date have been pediatric patients with all of those types of injuries."

Major Lynch said his team calls ahead to Miami-Dade Fire Rescue and Broward County Fire and EMS while airborne to identify the mix of patients onboard so they are ready to receive cases and transport to local trauma and pediatric medical centers.

"As soon as we open the back of the plane, they are there waiting to take the patients off," Major Lynch said.

The major said each CCAT typically oversees care for three critical patients in flight, but has provided ICU care for up to four patients on missions
flown to date from Haiti. Critical care patient capacity is maxed out on each aircraft.

According to Major Lynch, as of Tuesday, Jan. 26, the combined CCAT teams have moved a total of 20 patients.

On the ground in Haiti the air evacuations are directed by a combination of an Medical Air Staging Facility, which provides triage and stabilization for
patients and an Air Evacuation Liasion Team, which requests dedicated airlift by speaking directly to the Air Mobility Command's Tanker-Airlift Control Center at Scott Air Force Base, Ill.

Capt. Jeffery Marsh -- a critical care ICU nurse originally from Albuquerque, N.M. who now lives in Dayton -- said many of the patients the team has evacuated have been extremely ill, having had to endure burns and crushing injuries for seven days or more prior to transport.

"It's a different mission than we encounter in Afghanistan and Iraq, nonetheless its very rewarding to be part of this humanitarian effort," Captain Marsh said. "Taking care of these patients when you fly over the country of Haiti, you see that it is completely pancaked and utterly devastated.

"It's really hectic, really stressful because of the situation in country," Captain Marsh added. "You normally don't get this type of experience in a career, so I am very happy to be a part of it."

Both Captain Marsh and Major Lynch acknowledged the real heroes in the Air Force's medical response have been a group of special operations Airmen from Hurlburt Field, Fla. who were on the ground in Port au Prince early, helping to free those trapped in the rubble and provide quick surgical intervention. All of the critical patients moved by the Wright-Patt team to date were identified by the special ops team.

Captain Marsh called them "a mixed bag of pararescue jumpers, surgeons, nurses, who ask for no thanks, and somehow manage to keep a smile on, despite being dead tired."

As the CCAT team's only enlisted member, Senior Airman Brooke Lohr's job is to ensure patients have a good airway and are getting life sustaining oxygen, whether they can breathe on their own, need to be masked, or intubated and placed on a ventilator.

Airman Lohr, who is originally from Columbia, S.C., said she's "really learned a lot about teamwork."

"We each know a little bit about what the other does, but it really takes every person on the team to accomplish the mission and bring the patient
safely back to wherever they are going," Airman Lohr said.

One patient that stood out in her mind was a 9-month-old girl who was at Port-au-Prince airport experiencing a perfect storm of respiratory distress from malaria, pneuomonia and an apparent asthma attack.

"We were able to give two albuterol nebulizer treatments, and racemic epinephrine, which they didn't have available," Airman Lohr said.

"Had we not been there to give those medications they probably would have had to intubate to save the baby, and they really don't have a lot of pediatric stuff right now," she added. The baby was stabilized and was later transported by the Navy to the USNS Comfort.

Major Lynch, a Lexington, Ky., native, said all CCAT members get two weeks of specialized training with the U.S. Air Force School of Aerospace Medicine at Brooks City Base, Texas. His team also participated in a two-week trauma training course done in partnership with University Hospital Cincinnati. The training program is known as Centers for Sustainment of Trauma and Readiness Skills or C-STARS.