Critical Care Air Transport Teams: 'Prepared for anything'

Published Aug. 18, 2009
By Bekah Clark
Air Mobility Command Public Affairs

SCOTT AIR FORCE BASE, Ill. -- In the aeromedical evacuation world, "you have to be prepared for anything," said Capt. Michelle Lambert, a critical care nurse with the 932nd Medical Squadron.

This statement accurately describes the world that Critical Care Air Transport Team, or CCATT, members operate in. "Every patient and every mission represents a unique circumstance with unique challenges," she said.

Throughout the world, CCATTs are saving lives as part of Air Mobility Command's aeromedical evacuation mission, said Lt. Col. Don Tweedel, Director of the Air Force CCATT Program. The CCATT's mission is to operate an intensive care unit in an aircraft during flight, helping enable America to follow through on its promise to the critically wounded warrior.

The teams are made up of three members, a critical care physician and nurse, and a respiratory therapist, and can care for up to three critically injured, monitored patients, or up to six less severely injured patients, for 72 hours. The teams are called in to care for the most critically injured patients, who may have extensive burns, lost limbs in a blast, or suffer from another serious injury or illness.

The CCATTs are responsible for ensuring that these severely injured servicemembers receive the intensive care they need aboard aircraft that are transporting them to a hospital capable of escalated levels of care.

Once they are alerted, the CCATT members gather medical equipment, said Maj. Sonja Opolka, also a critical care nurse with the 932nd, as well as their individual "go" bags which include any personal items a team member may need for a mission.

"It's all about being prepared," Major Opolka said.

Once alerted and after the necessary equipment is in place, the team receives an operational security briefing that explains the mission, where they're going, and necessary security measures. They then report to the command center before departure, said Maj. Roberta Heldenbrand, another of the critical care nurses.

"The patient will be stabilized and prepared for evacuation by the time the team is on the way," Major Heldenbrand said. The CCATT loads patients onto the aircraft, and then prepares the patients and equipment for the flight by securing the patient, setting up all the necessary medical equipment, and ensuring that all medical equipment is facing the team so they can see warning and status lights since the in-flight noise hinders the team's ability to hear alarms.

Major Opolka noted that during these critical care flights, CCATTs are charged with the responsibility of caring for the critically wounded and handling any challenges that come their way, whether flight-related or medical.

"It's a constantly changing environment, especially when you're deployed and working with critical care team members who you haven't worked with before," Major Opolka said.

When working with unfamiliar people, the first mission is one of the biggest hurdles, Major Heldenbrand said. "After the first mission, when the strengths and capabilities of the individual team members are identified, it gets easier to work as a team."

Teamwork is especially important since these medical professionals are in a flying environment -- an added challenge that most medical practitioners don't have to deal with. Each of the nurses said the unexpected happens often, to include combat flying procedures and things like weather and turbulence.

Captain Lambert knows what it's like to be "prepared for anything" after an experience in 2005, when she was the lone critical care provider to escort and care for a critically injured servicemember from a forward operating base in Iraq, to Balad Air Base, Iraq, aboard an Army Blackhawk helicopter. That patient is now healthy and back at work, she said.

"You'll do anything to get to anyone who needs help. It doesn't matter," she said.

Captain Lambert and Majors Heldenbrand and Opolka have seen aircrews go through extraordinary measures to get severely injured troops to better levels of care.

"I've seen an aircrew break down an entire aircraft to get a patient on board," said Captain Lambert. "Aircrews will move mountains and go above and beyond."

Whether they're closely monitoring a patient's vitals, or ensuring the patient's pain is under control and as limited as possible, the top priority is to ensure the patients get back to their families. Additionally, each of the nurses agreed that regardless of the outcome, it's an honor to care for and serve injured servicemembers.

"It's a privilege to serve the wounded, whether it's in death or survival," Captain Lambert said.

"We're thankful that we can be there for them and their families," said Major Opolka. "We'll keep standing by to meet the alert call when it comes in. We're prepared for anything."

AMC is solely responsible for the AE mission from beginning to end. AMC supplies the aircraft, the flight crews, the staging facilities, and the medical and critical care teams for safely transporting wounded service members, treating them en route, and quickly delivering them to a higher level of care. Since 9-11, AMC has completed more than 27,659 Aeromedical Evacuation sorties and nearly 135,000 patient movements.