Critical Care Transport Teams Keep Patients Stabilized During Transport

Air National Guard members will begin flying a newly assigned critical care air transport team mission from Ramstein Air Base, Germany, Jan. 10, the air surgeon said in an interview at Joint Base Andrews just outside Washington, DC on Jan. 4. The CCATTs, which consist of a physician specializing in critical care, pulmonology, anesthesiology or surgery, along with a critical care nurse and a respiratory technician, are designed to provide a higher level of care in the aeromedical evacuation system, said Col. Brett Wyrick.

(L-R) Master Sgt. Theresa Sheheen, Capt. Michelle Mulberry

"The Air Guard went from having absolutely no CCATTs six months ago to providing the trained and ready manpower for this air expeditionary force requirement for the next two years," he said.

The teams will deploy from here for tours that vary from 60 to 180 days. "A flexible tour length allows for maximum participation among these highly specialized caregivers who are in high demand in the civilian world as well as the military," Colonel Wyrick said. They will be based out of Ramstein AB, which is one of the Air Force's CCATT hubs. "The Air Guard will place at least one CCATT on each rotation flying out of Ramstein (AB) ... and we are looking to combine with the Air Force Reserve to field even more teams in the coming months," Colonel Wyrick said.

From Ramstein AB, they may be called on to fly missions into Iraq, Afghanistan or possibly Africa and bring patients back to Landstuhl Regional Medical Center, in Germany.

The role of the CCATT is to keep patients stabilized throughout the flight and deliver them in stable condition to a treatment center, Colonel Wyrick said. The CCATT evolved, because "there was a need to move patients with a higher level of injury, the more critically injured patients, from the forward areas of the battlefield back to the continental United States," Colonel Wyrick said.

He added that this mission is vitally important for the future of Air Guard medicine. "Because this is one of the primary missions that the Air Force does, and as a total force partner with the Air Force, we need to be involved in the missions they're involved with," Colonel Wyrick said. "If it's important enough for the Air Force to do it, then it's important enough for the Air National Guard to do it.

"This is a total force mission, in which you will find guardsmen working side-by-side with their active-duty counterparts, whether it be at the hospital, transportation of patients from the hospital to the aircraft or working on the patients on the aircraft," he said. The Air National Guard had CCATTs when the aeromedical program began, but over the years the Air Guard migrated away from the mission as it got more involved in domestic response teams, such as the Chemical, Biological, Radiological, Nuclear and High-yield Explosive Enhanced Response Force Package and the Homeland Response Force missions.

"Now ... there is a need out there and the active-duty (Air Force) CCATT teams are getting stretched thin because of the operations tempo, and therefore we were asked by the surgeon general of the Air Force if we could help out," Colonel Wyrick said. "This ANG effort is significant, because it will decrease the burden on the active-duty Air Force to field these high-demand and low-density teams."

In addition to their federal mission, CCATTs will also give state governors a surge capacity for homeland-response evacuations that otherwise would not exist. "They can be available in the event of any natural or man-made disaster with civilian casualties," Colonel Wyrick said.

During a disaster response, one of the problems is the ability to move patients from the area of devastation to hospitals outside of the affected area, he said. CCATTs will allow a more immediate response to a critically injured patient than a traditional aeromedical evacuation team. "The team, along with its special medical equipment, can turn almost any airframe (whether active duty, Guard, or in some cases civilian) into a flying intensive care unit within minutes," he said.

CCATT members are experienced in the care of critically ill or injured patients with multi-system trauma, shock, burns, respiratory failure, multiple organ failure, or other life-threatening complications. CCATT members are traditional guardsmen who have volunteered for the mission. They are taking time away from their civilian practices and occupations to fill the requirements, Colonel Wyrick said.

To become a member of a CCATT, medical professionals must endure an extensive selection and screening process. Once they are approved, they go to the Center for Sustainment of Trauma and Readiness Skills center in Cincinnati for specific CCATT training. Wyrick said the Air Guard needs more skilled medical professionals in its ranks.

"We always are looking for good physicians, nurses and medical personnel," Colonel Wyrick said. "Medical happens to be one of the most difficult areas to recruit in the Air National Guard, because even on the civilian side ... it's low-density, high-demand occupations that we're looking for."

FMI: www.ang.af.mil