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Travis aircrew fly wounded Soldiers to Germany after insider attack

One of seven U.S. Army Soldiers who were wounded in a rocket propelled grenade attack is loaded into an MRAP ambulance at Mazar-i-Sharrif, Afghanistan June 17, 2017. The Soldiers were flown to Craig Joint Theater Hospital at Bagram Airfield, Afghanistan where they underwent 12 hours of trauma care. They were later flown to Germany by a C-17 Globemaster III from Travis Air Force Base, Calif. (Courtesy Photo) (This image was edited for patient privacy)

One of seven U.S. Army Soldiers who were wounded in a rocket propelled grenade attack is loaded into an MRAP ambulance at Mazar-i-Sharrif, Afghanistan June 17, 2017. The Soldiers were flown to Craig Joint Theater Hospital at Bagram Airfield, Afghanistan where they underwent 12 hours of trauma care. They were later flown to Germany by a C-17 Globemaster III from Travis Air Force Base, Calif. (Courtesy Photo) (This image was edited for patient privacy)

From left, U.S. Air Force Capt. Justen Fazekas, Staff Sgt. John Ledford and Capt. Michael Schwartz from the 21st Airlift Squadron, Travis Air Force Base, Calif., pose for a photo July 27, 2017. The aircrew flew five critically injured U.S. Army Soldiers in the C-17 Globemaster III pictured during an aeromedical evacuation mission from Bagram Airfield, Afghanistan to Ramstein Air Base, Germany on June 18, 2017. The Soldiers were injured during an insider attack at Camp Shaheen, in the northern city of Mazar-i-Sharif. Also part of the crew but not pictured are Capt. Linden Ballen, Tech. Sgt. Daryl Metheny, and Senior Airman Cole Pincin. (U.S. Air Force photo by Louis Briscese)

From left, U.S. Air Force Capt. Justen Fazekas, Staff Sgt. John Ledford and Capt. Michael Schwartz from the 21st Airlift Squadron, Travis Air Force Base, Calif., pose for a photo July 27, 2017. The aircrew flew five critically injured U.S. Army Soldiers in the C-17 Globemaster III pictured during an aeromedical evacuation mission from Bagram Airfield, Afghanistan to Ramstein Air Base, Germany on June 18, 2017. The Soldiers were injured during an insider attack at Camp Shaheen, in the northern city of Mazar-i-Sharif. Also part of the crew but not pictured are Capt. Linden Ballen, Tech. Sgt. Daryl Metheny, and Senior Airman Cole Pincin. (U.S. Air Force photo by Louis Briscese)

Members of the 455th Expeditionary Aeromedical Evacuation Squadron provide care for U.S. Army Soldiers who were wounded in a rocket propelled grenade attack in a C-130J Super Hercules during a flight to Bagram Airfield, Afghanistan June 17, 2017. The Soldiers underwent 12 hours of trauma care at Craig Joint Theater Hospital at Bagram before they were flown to Germany by a C-17 Globemaster III from Travis Air Force Base, Calif. (Courtesy Photo)

Members of the 455th Expeditionary Aeromedical Evacuation Squadron provide care for U.S. Army Soldiers who were wounded in a rocket propelled grenade attack in a C-130J Super Hercules during a flight to Bagram Airfield, Afghanistan June 17, 2017. The Soldiers underwent 12 hours of trauma care at Craig Joint Theater Hospital at Bagram before they were flown to Germany by a C-17 Globemaster III from Travis Air Force Base, Calif. (Courtesy Photo)

A C-17 Globemaster III from the 21st Airlift Squadron, sits on the tarmac at Travis Air Force Base, Calif., July 27, 2017. The aircraft was used to transport five critically injured U.S. Army Soldiers in an aeromedical evacuation mission from Bagram Airfield, Afghanistan to Ramstein Air Base, Germany on June 18, 2017. The Soldiers were injured during an insider attack at Camp Shaheen, in the northern city of Mazar-i-Sharif. (U.S. Air Force photo by Louis Briscese)

A C-17 Globemaster III from the 21st Airlift Squadron, sits on the tarmac at Travis Air Force Base, Calif., July 27, 2017. The aircraft was used to transport five critically injured U.S. Army Soldiers in an aeromedical evacuation mission from Bagram Airfield, Afghanistan to Ramstein Air Base, Germany on June 18, 2017. The Soldiers were injured during an insider attack at Camp Shaheen, in the northern city of Mazar-i-Sharif. (U.S. Air Force photo by Louis Briscese)

TRAVIS AIR FORCE BASE, Calif. – Six aircrew members from Travis Air Force Base, California, flew a C-17 Globemaster III into Bagram Airfield, Afghanistan June 18 to medevac five U.S. Army special operators who were wounded in an insider attack at Camp Shaheen, in the northern city of Mazar-i-Sharif.

The attack occurred when an Afghan commando, loyal to the Taliban, fired upon Soldiers with a rocket propelled grenade launcher, killing a member of the Afghan National Army and severely wounding seven U.S. Army Soldiers.

According to witness accounts of the attack, one of the Soldiers charged the attacker while firing his pistol, killing him and ending the assault. From there, the Soldiers received urgent medical care at a German military hospital, Craig Joint Theater Hospital at Bagram and later, the U.S. military Landstuhl Regional Medical Center in Germany for a variety of injuries including a collapsed lung, as well as blast and shrapnel injuries.

Capt. Michael Schwartz, 21st Airlift Squadron C-17 pilot and the aircraft commander on the mission that flew the Soldiers from Bagram to Ramstein Air Base, Germany, said everyone on the aircrew stepped up in every way possible to support the Soldiers.

“We made a checklist of everything that had to be accomplished to execute the mission safely and effectively,” he said. “We had to get new diplomatic clearances, updated tactical publications, a new intelligence brief, plan sleep cycles and retrieve enough food for our crew who were going to fly an extra 10-hour duty day.”

“The loadmasters helped the AE (aeromedical evacuation) team wherever they could; the crew chief serviced the engine and fueled the jet and the pilots prepared for departure, so we were ready the moment the patients were loaded and settled,” he said.

The mission, while challenging, was the greatest of his career, Schwartz added.

“It was an honor to lead a team of consummate professional aviators and medics to rescue special operators who, if the tables had been turned, would’ve been there to rescue us,” he said. “I was proud and grateful we were in the best position, being that we were already airborne, to execute the AE mission.

“The support we had from the Tanker Airlift Control Center and en-route facilities was second to none and everyone up and down the chain of command ensured we had premier support to expedite the five injured Soldiers to a higher echelon of care in Germany less than 24 hours after the attack,” said Schwartz.

The Travis C-17 was on a mission to deliver two UH-60M helicopters and about 70,000 pounds of cargo to undisclosed base in Southwest Asia in support of Operation Inherent Resolve when it received a call from TACC approximately two hours before arriving. The crew was instructed to quickly download their cargo and fly to Bagram as quickly as possible to evacuate the Soldiers. 

“We were able to help people who gave all they had to the fight,” said Staff Sgt. John Ledford, 60th Operations Support Squadron C-17 wing training manager, and one of two loadmasters who configured the aircraft into an airborne ambulance.

“As loadmasters we deliver people and goods and we often don’t see the impact of those actions,” he said. “I was proud to be a part of that mission. To be called upon at the very last minute to get those Soldiers the help they needed.”

Before making it to the C-17, the Soldiers received care at Camp Shaheen from German doctors. Later, AE and Critical Care Air Transport Teams from the 455th Expeditionary Aeromedical Evacuation Squadron flew them to Bagram in a C-130J Super Hercules providing additional care throughout the trip.

Maj. (Dr.) Drew Shiner, 455th EAES physician, was one of the doctors who cared for the Soldiers.

“Everything happened very quickly,” he said. “We received an initial report that there were Americans wounded at Mazar-i-Sharif, and our Aeromedical Evacuation Operations Team immediately got to work on configuring a C-130 for the mission. Right before the ramp went up I was handed a piece of paper that told me the number of patients to expect and a cursory overview of their injuries.  My team and I spent the trip up there running through scenarios in our heads and came up with our plan of action.” 

Upon landing, the CCATT teams loaded their equipment and litters in a van then sped off to the hospital. 

“I can’t thank our German partners enough for the excellent job they did stabilizing our Soldiers and providing critical care interventions until we arrived,” said Shiner.  

However, receiving the Soldiers from a foreign facility presented some challenges.

“Since they used syringe pumps for intravenous medications, all of the infusions they were giving were incompatible with our equipment,” said Shiner.  “Luckily, my CCATT nurse, Capt. Kara Granroth, (455th EAES) had extensive experience flying CCATT missions in the Pacific theater and was used to having to mix up new drips on the fly. She efficiently transitioned the patient to our pumps and we continued to prepare the Soldiers for the flight.” 

After overcoming numerous other challenges, including incompatible oxygen bottles, the Soldiers were loaded into an MRAP ambulance and transported to the C-130.

Along the way one Soldier began to retain too much carbon dioxide, which is a serious concern for anyone suffering from a traumatic brain injury, said Shiner. The crew worked to optimize the Soldier’s oxygen intake by using a ventilator while providing care for the others over the course of the short flight.

Upon arriving at Bagram, the wounded warriors underwent trauma care for 12 hours at Craig Joint Theater Hospital. Maj. (Dr.) Eric Ball, 455th EAES CCATT physician, helped care for the Soldiers at CJTH. He also flew on the AE/CCATT mission that transported them to Germany.

“One Soldier, I’ll call him Patient 1, had a severe TBI with an intracranial metal fragment,” he said. “He required multiple medications to reduce his brain pressure and control sedation. After a CT scan, we discovered multiple areas of bleeding in his brain. Later that night he (underwent) a craniotomy (a procedure that removes part of the skull to release pressure). He also lost a lot of blood which required transfusions.”

“Another Soldier, Patient 2, received treatment for a severe brain injury, as well as a collapsed lung and hemothorax (a collection of blood in the space between the chest wall and the lung),” said Ball. “He received chest tube care overnight and was placed on a ventilator. Patient 3 suffered a blast injury to his face which broke a bone in his right cheek and injured his right eye. Patients 4 and 5 were treated for shrapnel wounds, while patients 6 and 7 were treated for mild concussions.”

After receiving care through the night of June 17, the Soldiers were prepped to fly on the C-17 to Ramstein AB. The Travis aircrew and the CJTH En Route Patient Staging System crew assisted the 455th EAES AE/CCATT team with the loading of each patient and more than 600 pounds of medical equipment into the aircraft. ERPSS personnel are responsible for all patient movement from the hospital to the aircraft and also provide patient loading assistance.  

During the flight, CCATT and AE members continued to care for the Soldiers.

“One patient required constant attention due to brain swelling,” said Ball. “He required multiple medications as well as transfusions of blood in flight due to so much blood loss.”

This also required Schwartz to fly the C-17 no higher than 32,000 feet to prevent increases to any of the patients’ brain pressure.  

Ball said he’s proud of everyone who supported the AE/CCATT mission.

“We are able to take Soldiers wounded in a remote area of Afghanistan and transport them from point of injury, to a forward operating base, to a Role 3 (hospital) (and finally) to Germany in less than 24 hours,” he said. “Along the way they receive ICU level care and multiple damage control surgeries without a drop in the level of care. They can be back to the United States within 48 hours.  Never in our history have we been able to provide this level of definitive care.”