Uniformed Services benefit from flight nurse course

Published March 28, 2006
By Rudy Purificato
311th Human Systems Wing Public Affairs

BROOKS CITY BASE, Texas -- They represent the changing face of military training, medical professionals such as U.S. Public Health Service officer Charles McGee and Navy Lieutenant Shawn Passons, who have come here as part of a U.S. Air Force School of Aerospace Medicine initiative.

Together with classmates from the Air Force and an Army nurse assigned to the White House, they learn within a joint training environment the skills and knowledge required of flight nurses and aeromedical evacuation technicians. They’re at Brooks City-Base because they know that this training course is not only considered by many as being the best in the nation, it’s also one-of-a-kind.

“The Navy doesn’t have a course like this for flight nurses. Flight surgeons (only) receive flight medicine training at the Naval Air Station in Pensacola, Fla.,” said Navy Lieutenant Chris Cesa, a flight nurse from Cherry Hill, N.J. The expanding role of Navy medicine since the Sept. 11, 2001, terrorist attacks has prompted participation in the USAFSAM course, he said.

“Prior to 9-11, the Navy was creating its own (flight nurse) course, but after 9-11 there was no funding for it. That’s why we’re here,” said USPHS Lieutenant Commander Steve Morin, a 30-year-old flight nurse from Auburn, Maine.

USPHS’s expanding role in aeromedical evacuation supporting hurricane and tsunami humanitarian relief operations has led to an increasing number of its flight nurses participating in Air Force medical evacuation training here.

“About 280 students per year come through this course, which is 21 duty days. They learn about the stresses of flight and its impact on patients,” said Capt. Jared Mort, USAFSAM flight nurse and aeromedical evacuation course instructor.

Besides altitude physiology, Captain Mort said, course participants also learn about fixed wing aircraft capabilities with respect to aeromedical evacuation. This includes knowing about various airframes and aircraft systems such as oxygen and electrical power supply.

“They learn to configure litters for C-130s and learn to operate aeromedical evacuation equipment. It’s practical hands-on training,” Captain Mort said.

So practical is this course, originally designed in the 1940s for U.S. Army Air Corps nurses, that non-Air Force flight nurses and aeromedical evacuation personnel are adapting the training to fulfill specific service-related requirements.

“The Navy has only three active-duty flight nurses,” said Navy Lieutenant Passons, who is attending the course to prepare her for an assignment on the Indian Ocean island of Diego Garcia. “There are two (Navy) flight nurses assigned there,” she said of the British owned territory that the U.S. government leases as a staging area for military forces in the region.

“The closest medical facility is in Singapore, which is a five-hour flight from Diego Garcia,” said Lieutenant Passons, a former Army explosive ordnance specialist who grew up on the Eastern Shoshone reservation at Fort Washakie, Wyo.

Lieutenant Cesa says the USAFSAM course is important in that it’s helping advance a trend within the Department of Defense toward aeromedical evacuation standardization. “We’re learning to talk the same lingo and practicing the same (aeromedical) procedures using the same equipment,” Lieutenant Cesa said.

This is especially important to the Navy where few medical professionals have been trained in aeromedical evacuation. Historically, flight surgeons and ship’s nurses have been used as ‘medical attendants’ aboard medevac (medical evacuation) flights that transport primarily non-combat casualty patients.

Lieutenant Cesa said the course here is critically important to everyone involved in aeromedical evacuation during the post 9/11 era. He’s attending it in preparation for his assignment at the Global Patient Movement Requirements Center at Scott AFB, Ill.

The USPHS flight nurses are attending the course to support mission requirements of the 6,000-plus member service that comes under the auspices of U.S. Surgeon General Richard Carmona. This uniformed service was originally created by President John Adams on July 16, 1798 to handle public health issues associated with immigration.

“The Bureau of Immigration Custom Enforcement, formerly the Immigration & Naturalization Service, charters flights for non-native residents who are being deported,” Lieutenant Commander Morin said. He explained that a USPHS flight nurse is required on these flights to administer medications.

“They are ambulatory patients,” said Lieutenant McGee, a Rochester, N.Y., native who previously served in the Air Force. The detainees who he and Commander Morin process always require flight nurse escorts, especially those that suffer from psychosis.

“We escort them on flights to ensure their safe passage without incident,” says Commander Morin, referring to what USPHS calls non-scheduled flights to places other than Mexico, such as Pakistan, Cambodia and China.

The USPHS Division of Immigration Health Service operates about a dozen detention centers stateside. From there, many detainees are deported via charter flight. “We average about 200 people per flight,” said Commander Morin, noting that the detention center at Florence, Ariz. where he is assigned processed 20,000 illegal immigrants in 2005. The influx of alien immigration has brought with it a variety of communicable diseases.

“We’ve seen a huge increase in tuberculosis cases among the detainees,” Commander Morin said, noting that other medical emergencies run the gamut from diabetes and cardiac problems to detainee injuries sustained in beatings from smugglers.