CINCINNATI —
The soldier on the military cargo plane struggles to breathe. He developed pneumonia while serving in Afghanistan and needs medicine now, but the pump to deliver it won't work properly. "I can't believe I'm still messing around with this pump," the nurse says, speaking on a headset because the three-person crew is surrounded by the constant roar of jet engines even as she struggles with the thin air at 30,000 feet. But those engines aren't real. The "plane" is a simulation center deep inside the University of Cincinnati Medical Center, the pump failure orchestrated from a control room next door. The patient is a mannequin. The whole thing, in fact, is a training exercise, with those in the control room recording every word and reaction. "There are communication issues for sure," said Air Force Maj. Daniel Cox after the training exercise is done. "(The doctor) has got to be more vocal." "The cadre," 17 Air Force trainers housed here at the University of Cincinnati, is charged with developing a new generation of war doctors, nurses and respiratory therapists. The university is one of three training sites for Air Force doctors, including those in the National Guard and Reserves, about to be deployed to Afghanistan or other active theater. The other training sites are in Baltimore and St. Louis. Once deployed, the doctors, nurses and respiratory therapists will treat injured service members being flown to other sites in theater or to an American military hospital in Germany. Most have backgrounds in critical care, but they often haven't seen the range of injuries common in America's 21st century wars: blast injuries, amputations, multi-trauma head injuries. "It can be a difficult transition," said Lt. Col. Elena Schlenker, deputy director of the training program, called C-Stars, or Center for Sustainment of Trauma and Readiness SkillsThere are all kinds of rules for pilots. How often can they fly? How far can they fly? But there are no rules for the people in the back of the aircraft. Richard Branson, University of Cincinnati surgery professor. Even for doctors and nurses active in the military, the stress, confined space and oxygen-deprived conditions in transport planes can be overwhelming, said University of Cincinnati surgery professor Richard Branson. The experiments hone in on how altitude affects not only the patients, but the caregivers and their equipment as well. "There are all kinds of rules for pilots," he said. "How often can they fly? How far can they fly? But there are no rules for the people in the back of the aircraft."

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Master Sgt. Jennifer Higgs, 455th Expeditionary Aeromedical Evacuation Squadron technician, conducts an equipment function check inside a C-130 Hercules Feb. 21, 2013, on Bagram Airfield, Afghanistan. The 455th EAES performs its missions on fixed wing aircraft, including the C-17 Globemaster III, C-130 Hercules and KC-135 Stratotanker, and can provide extensive critical care capability with the Critical Care Air Transport Teams.
BAGRAM AIRFIELD, Afghanistan — More than 70 years ago, the first flight nurse graduated from the flight nurse course on Bowman Field, Ky. These flight nurses trained to provide a higher level of care to patients while they traveled by aircraft to other medical facilities.  Today, the flight nurses and technicians of the 455th Expeditionary Aeromedical Evacuation Squadron keep that level of care going in the skies above Afghanistan.  The 455th EAES provides medical and nursing care in flight to ill or injured service members or Department of Defense civilians. They perform their mission on fixed wing aircraft, including the C-17 Globemaster III, C-130 Hercules and KC-135 Stratotanker, and can provide extensive critical care capability equal to the level of care that patients receive at the Craig Joint Theater Hospital here.  “Our job is to move the sick and injured through the area of responsibility of Afghanistan,” said Col. Edward Farley, 455th EAES commander. “We obviously don’t want to be very busy, because that means that something bad has happened, and we have to move our service members or our coalition partners to a higher level of care.”  Farley, deployed from Scott Air Force Base, Ill., leads 48 medical personnel with teams of four basic crews consisting of two flight nurses and three emergency medical technicians. All flight crewmembers received specialized altitude training to become universally qualified to move patients by aircraft. 
Tech. Sgt. Alejandro Rojas, 455th EAES medical technician, said the hardest part about his job is the uncertainty of the missions, but his team trains for the unexpected. “Each of our teams preps and configures all of our equipment the same way,” he said. “That way no matter what aircraft or patients we get, we are ready.”  He also said that even though his unit doesn’t always stay extremely busy, primarily during the winter seasons, the necessity to have them is unquestionable.  “We are like life insurance,” Rojas said.

 

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SOUTHWEST ASIA - Eight members from the 379th Expeditionary Aeromedical Evacuation Squadron transported a patient from a forward deployed location in Southwest Asia, to Landstuhl Regional Medical Center in Germany, Dec. 6, 2013, aboard a C-17 Globemaster III.  The patient, a 54-year-old Army soldier, was suffering from respiratory failure when the aeromedical evacuation crew was notified to transport him to the nearest medical treatment facility. "When we landed near the patient's location, we immediately grabbed all of our medical gear and loaded in the back of a (Army medevac) Black Hawk to get to the pick-up site," said Maj. Matthew Pieper, a 379th EAES critical care air transport team physician deployed from Travis Air Force Base, Calif., and a St. Louis, Mo., native. "Riding in a helicopter was the quickest form of transportation to the patient."
When the CCATT, also including Travis AFB airmen, Maj. Michele Suggs from Flint, Mich., and Tech. Sgt. Athena Sotak from Brownsville, Texas, arrived on scene with the patient, they quickly got him aboard the helicopter, began performing a medical assessment and started a medical ventilator, Pieper said. "Keeping a patient stable in the back of a helicopter is challenging," Pieper said. "There is less space to work, communication is difficult and we had to stay in our seats. We communicated directions with an Army medevac [technician] who was attached to a harness. He had a little more room to move and keep the patient stable." During the helicopter ride back to the C-17, the medical crew swapped out three oxygen tanks to keep the patient breathing through the ventilator. On the third oxygen tank, the patient's oxygen level began to dip as the helicopter was landing, Pieper said. "We ran the patient about 200 yards from the helicopter to the C-17," Pieper said. "The C-17 has more oxygen capacity than the helicopter so we needed to move him as quickly as possible."  Capt. Rebecca Wastart, a 379th EAES flight nurse from Scott Air Force Base, Ill., helped set up the plane to receive the patient said,

 

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These nurses span 13 areas of expertise, 40 years of medical advancements, and all walks of life. Here are their inspiring stories of science and service.  Our 2013 Outstanding Nurses award winners span 13 areas of expertise, 40 years of medical advancements, and all walks of life.  Here are their inspiring—and surprising—stories of science and service.  Mpls.St.Paul Magazine's Outstanding Nurses Awards are given to the top nurses in the Twin Cities metro area. Nurses are nominated by peers, patients, and the general public, and finalists and winners are chosen by an independent panel of judges and Mpls.St.Paul editorial staff.  Along with editorial staff, finalists and winners of the 2013 awards were chosen by two judges with a combined 50 years of experience: Sue Sendelbach, director of nursing research at Abbott Northwestern Hospital, and Michael Petty, cardiothoracic clinical nurse specialist at the University of Minnesota Medical Center.  Nurses are chosen based on professionalism, bedside manner, patient interaction, credentials and experience, impact on an organization, and leadership. Additional weight is given to those who received multiple nominations from multiple sources and to those nominated by their patients.  To nominate a nurse, check back in February 2014, when nominations will open again.    “My leadership with the military, and my age and maturity, transfers into the ER, and my ER experiences transfer into the military. I can’t do one without the other.”  Extra Corporeal Membrane Oxygenation. It’s a mouthful, but it’s one of the incredible advancements Donald Brock has seen as a critical care nurse in the Air Force Reserves.  “While deployed to Germany last year, I witnessed the use of ECMO in a chest wound patient who was shot in Afghanistan,” 
Brock says. A machine oxygenated the soldier’s blood when his heart and lungs didn’t. It took a while, but “several weeks later this young man was sitting up in bed talking to his family as I prepared him for the flight back to the United States.”   Brock was so amazed by the soldier’s recovery that he immediately signed up for the military’s ECMO certification program. Then he shared the procedure with the folks at Regions Hospital (where he also works), who saw potential uses in the emergency room.  It’s all in a day’s work for Brock, who juggles two trauma-related jobs. “As a member of the United States Air Force, I have had the privilege of seeing firsthand how some of the many advances in medicine have saved lives,” he says. Lucky for us, he brings what he learns home.

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Dr. Bill Beninati is a critical care physician and a 25 year veteran of the US Air Force.  During his AF career he helped develop the Critical Care Air Transport (CCATT) program and served as a key medical leader in that program for 13 years.  His combat experience includes transports in Bosnia, Afghanistan, and Iraq where he also participated in rotary wing MEDEVAC.  Dr. Beninati now works for the not-for-profit Intermountain Healthcare System, conducts research, teaches medical students as an adjunct faculty member of the University of Utah School of Medicine, and provides leadership as chairman of the team overseeing critical care across the 22 hospital system.

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3/16/2012 - Minneapolis St. Paul Air Reserve Station -- Five critical care nurses from the 934th Airlift Wing's Critical Care Air Transport Team, participated in a training flight over northern Minnesota, Feb. 5.  Capt. Don Brock, the mission clinical and operations coordinator for CCATT, organized the training flight for a crew staffed by Lt. Col. Ed Galvez, Maj. Mark Testerman, Maj. Michael Mackovich, and Lt. Eric Stroup. The quarterly training flight is required for the CCATT team to practice trauma nursing skills to prepare them for deployment.  "CCATT belongs to the Aeromedical Staging Squadron when in garrison or stateside. When deployed and for simulated training missions, we fall under the Aeromedical Evacuation Squadron system," explained Brock.  During the training Feb 4, the CCATT team paired with the 934th AES which provided ground support for the CCATT. AES coordinated transport, arranging for necessary equipment such as x-ray machines, and providing food, said Brock. AES provides care for non-critical patients, when no physician is needed. AES is focused on prepping the plane, while CCATT is focused on critical patient care.  "CCATT is different," Brock said. "On the Reserve side, this is our primary duty. Our primary job is to train to go to war. So when we come to UTA, it's all business. We do a lot of flight training, and we try to make this as realistic as possible."  While deployed, CCATT provides critical care for all service members, foreign nationals, and coalition forces, and sometimes even K-9 dogs, who can suffer hearing trauma while deployed, he said.  Neurotrauma is common in their work, and they also provide treatment to patients who experience severe trauma through Improvised Explosive Device blasts, sometimes resulting in double and triple amputations, said Lt. Col. Ed Galvez, a CCATT trauma nurse specialist, a traditional reservist, and trauma nurse in Chicago.  The training day began with extracting a $67,000 manikin, a Gourmand S-3000 HAL, from the VA Medical Center's simulation lab in St. Paul, Minn. HAL is a male manikin-simulator, used for training purposes.  "It provides the most realistic medical response training that we can get as far as critical care transport providers," Brock said.

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Front Page Alerts

Item Update: New Maintenance Label Update

Please help us get the word out to all AE forces that there will be a new DD Form 2163 which will be replacing the old DD Form 2163 and the AF Form 4368 through attrition. I would like to immediately begin phasing in the new DD 2163 sticker and through attrition replace all the old 4368's. Can you put the word out to the AE community that the new 2163 is acceptable and will eventually replace...

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Recall Notice: Carefusion SmartSite Needlefree Connector

Recall Notice: Carefusion SmartSite Nedlefree Connector Model 2000E

REASON: The affected SmartSite connector lots may unintentionally disconnect from a female luer, may be difficult to disconnect from a female luer, or may fail to disconnect from a female luer once attached. Leakage may also be observed if the connector disconnects from the female luer durig infusion. An inability...

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Recall: Dobutamine Injection, USP, 250mg, 20mL Vial

Hospira Dobutamine 250mg/20mL Vial Recall

ALL,
Please see attached recall notification issued by Hospira, Inc. for Dobutamine 12.5, NDC 00409-2344-02, NSN 6505014917667.  This item is used in the below listed Allowance Standards.

NDC: 00409-2344-02

Expiration Date: 1 Mar 2015

LOT #: 27-352-DK* (*Note: the lot number may be followed by 01)

887A...

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Recall Notice: Atrium ATS Drains

Atrium ATS Drains QA MFR Recall 

REASON: ATS connection can leak or detach. Atrium Medical has become aware that the force required to detach the tubing from the drain may be lower than our product specifications.

ALL,

Please have your units check their operational AE and CCATT kits for the

below listed item, Lot numbers affected are listed...

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Advisory: Phillips HeartStart MRx Device Correction

Phillips HeartStart MRx Manufacturer Advisory 

This is to inform you of a product correction initiated by Philips Healthcare due to an issue that occurs when the Philips HeartStart MRx Monitor/Defibrillator is used for synchronized cardioversion.

This Field Safety Notice is intended to inform you about:

  • what the issue is and under what conditions...
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ABG Interpretation Worksheet (CCATT Sustainment Training)
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Training Module: IVAC IV Pump (CCATT Sustainment Training)
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Aerovac World

Aerovac World

Welcome to AE World, your #1 stop for all things related to AE. This group is dedicated to thosethat worked, are working or will work in any area of AE. This is a place to share pictures, stories, and network with one another. We use this page to link all related stories to AE and share the incredible missions we have accomplished throughout AE's rich history. So sit back, relax and enjoy the pictures, articles and stories on this group.

Aviator Gear Salutes CCATT

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Aviator Gear salutes these brave men and women who willingly put themselves in harm’s way to provide critical medical aid to our troops in combat. Showing our support by providing great quality products at 50% off discounts is our way of showing our appreciation for their stalwart service and dedication to duty.