HC-130P King - First Afghanistan Medevac Flight

The first all-Air Force Critical Care Air Transport and Aero-medical Evacuation Team to fly with the only fixed wing aircraft dedicated to the medical evacuation mission in Afghanistan completed its first successful mission Jan. 13 and continues saving lives.

The CCAT/AE team flies with the 76th Expeditionary Rescue Squadron, who provide medical or casualty evacuation for U.S. and coalition forces, Afghan National Security Forces and local nationals in all of the Regional Commands in Afghanistan. They can reach almost any airfield in Afghanistan in an hour and a half from their home base in Helmand Province.

The HC-130P King aircraft assigned to the 76th EQRS are equipped with an air-to-land command and control system, which allows the crew to communicate in real-time with their operations center. This gives them the option to re-task a mission while still in the air, reducing response time. This speed of response combined with the higher level of in-flight care provided by the CCAT team brings a much-needed MEDEVAC capability to the fight.

"When we first started flying these types of missions, we flew with an Air Force pararescue team, who are trained paramedics and very good at trauma care," said Lt. Col. Peter Dominicis, 76th ERQS commander. "As we flew more, we started seeing patients that were more critical and needed more attention."

To further meet the needs of their patients, flight doctors and Army en-route critical care nurses were added to each mission. Although this was an improvement, some of the patients still required care that exceeded the scope of the team. The need was addressed and two months later, the first specialized CCAT team, comprised of a critical care physician, nurse and respiratory technician, and AE team, comprised of a nurse and two medical technicians, arrived to the 76th ERQS.

The CCAT teams are validated through a 14-day course meant to familiarize them with the three components of the team and how to work together in the back of the aircraft. The AE team is comprised of medical professionals that fly as aircrew. The AE Airmen are familiar with aircraft emergency procedures, where the CCAT team is not.
Staff Sgt. Erin Hyder, CCAT respiratory therapist, says the CCAT team's skill set is for the more critical patients.

"We're there to help with patients that can't maintain their own airway, or have multiple injuries and require different types of treatment at the same time," she said.

Hyder said that although the bulk of the missions flown with the EQRS are to transfer stable patients from field-type medical facilities to major hospitals, the CCAT team is there for the missions that require extra care.

"We are here for that 10 percent of the missions where the patients may still be in the operating room when we get the alert," she said. "Here, the patients that are critical are pretty bad. It's important that we're here to get them from point A to point B to save their lives."

One of those missions came on Jan. 18, when the squadron responded to a mass casualty event in Kajaki, Afghanistan. Dominicis said that although the CCAT team wasn't on alert that day, they sprang into action.

"We had one patient, a U.S. Marine, with burns to over 80 percent of his body. The plane was running, the CCAT team hopped on and waited for the patient to arrive by helicopter," he said. "They took the Marine to Kandahar with the CCAT and AE team providing care en-route. I don't think he would've survived if it hadn't been for the teams."

The ERQS is still evolving to better meet the needs of its patients. Dominicis said the goal is for the squadron to receive a Tactical Critical Care Evacuation Team with even more specialized training in critical care later this year. But in the interim, the CCAT/AE team is in the fight. After 20 missions and 11 saves of life, limb and eyesight, Hyder says she's glad she can contribute to the successful missions of the EQRS.

"It's very gratifying to know that we are able to help the guys on the ground that are out here fighting for us," she said. "It's a great feeling to be able to return the favor."