Aerovac

The name of the game in wartime medicine is air evacuation, otherwise known at aerovac. This is what allows us to keep people alive and to manage the constant flow of wounded warriors. In the year 2010, this is a rather elaborate process that has been perfected in many ways. Approximately 98% of soldiers injured in combat can be saved if they make it to a forward medical facility in a timely manner. We are a tertiary care facility at Bagram. The patients from all over Afghanistan are funneled here before leaving the country. If the patient has a surgical problem, chances are a surgery has been done at a forward surgical hospital to stabilize the injury. They come here and have more surgery. We have a lot of capabilities here, but also many limitations. For this reason, we must move our coaliton patients quickly out of our facility to Landstuhl Regional Medical Center in Germany.

A week ago the volcano in Iceland erupted and the aerovac system was thrown into chaos. Little did any of us know that mother nature above the arctic circle would affect us here in Afghanistan. Suddenly our well oiled machine was brought to grinding halt. No flights were allowed in or out of Germany. What on earth would we do with our coalition patients? The already high stress levels within the walls of our hospital soared to a new level. We were forced to set up cots in between the beds in order to make room for all the patients. There was literally about 3 feet from one patient to the next. Keeping them all straight in my mind was a challenge. I pride myself on knowing my patient's names and their stories. The numbers forced me to remember them simply as a diagnosis such as "right pneumothorax and axillary soft tissue injury" or "traumatic brain injury with L5 compression fracture". We have all been doing the best we can, but the tension has been rising. I have to admit that this does not bring out the best in me. Others are in the same boat.

I know very little about aviation or the operational air force. But, I am familiar with the phrase, "Flexibility is the key to Air Power." This has become rather apparent to us all in the last week. As people all over Europe were struggling to get from point A to point B, our aerovac system needed to find new routes as well. We had to think long and hard before putting certain patients on planes not knowing exactly how long it would be before they could have surgery again. Our most critical patients simply had to stay with us. Each day new ideas were coming forth on how we should handle this crisis. How about flights all the way to San Antonio? What about a stop over in Kuwait? Could the plane just stop to refuel in southern Europe before going all the way to DC? I am sure many hours were spent by higher headquarters wrestling with these questions.

To the relief of our entire medical staff, a workable solution has been found. There happens to be another theater of operations directly on the way back to the states. We still have many assets and a rather large foot print in Iraq. Why not utilize our medical facilities there? That is exactly what is happening. So, one of my patients caught wind of all this. He absolutely could not believe that after being blown up in Afghanistan, the next time he would see the light of day he would be back in Iraq! It is kind of insane, but for the time being it is the best that we can do. I'm just happy that we can all get a little more sleep now. More importanly, aerovac will be getting our patients home in 48-72 hours despite volcanic activity in Iceland.