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News | Aug. 24, 2020

JTF-Bravo aeromedical evacuation teams save three lives in four weeks

By Capt Madeline Krpan Joint Task Force - Bravo

SOTO CANO AIR BASE, Honduras – Pilots and crew from Joint Task Force – Bravo’s 1st Battalion, 228th Aviation Regiment, Air Ambulance Detachment recently performed three life-saving aeromedical evacuations in the course of four weeks, from Jun. 22 to Jul. 14, 2020.

Based out of Soto Cano Air Base, Honduras, the U.S. Army 1-228 Charlie Company stands at the ready 24 hours a day, seven days a week, 365 days a year to respond to emergencies and perform aeromedical evacuations of civilians and military members throughout Central America. The company, made up of just 20 members, is the only aeromedical evacuation unit in the U.S. Southern Command area of responsibility, which spans 31 countries and 16 dependencies and areas of special sovereignty.

The company, whose motto is “Always Ready,” prides itself on their quick response capability and ability to carry out missions while navigating difficult weather conditions. However, during recent missions, the soldiers faced more than lightning strikes and low cloud ceilings; the COVID-19 pandemic added an additional dynamic to mission execution.

When the team received a call on Jun. 22 to move a service member who was diagnosed with appendicitis, their options for getting rapid treatment in the local community were limited due to the COVID-19 pandemic. In close coordination with Joint Task Force-Bravo (JTF-B)’s Army Forces Battalion Combat Support Hospital Detachment, a team including a pilot, copilot, a crew chief, and a flight medic transported a patient that had been experiencing severe pain for 12 hours to receive emergency surgery at a hospital in the Honduran capital of Tegucigalpa before the patient’s health deteriorated further.

While the mission was straightforward and flying conditions were clear, the mission represented one of the first times the pilots and crew departed the base using N-95 masks to protect themselves and others from the coronavirus. The crew took other special precautions developed to protect patients and personnel in the event they are exposed to a COVID-19 positive individual.

“Our medics got together to try to figure out how to tackle [handling] a COVID patient if necessary,” said U.S. Army Sgt. Patrick Baidal, UH-60 crew chief. “In order to facilitate that, we wanted to make sure we had implemented the appropriate measures to care for them.” These measures included prepositioning “COVID kits” comprised of masks, gloves, sanitizing gel, and extra pairs of clothes to change into should the crew be exposed to the virus on the aircraft.

The second aeromedical evacuation took place just two days later, on Jun. 25, when the on-duty crew received word that a civilian contractor assigned to Soto Cano had collapsed and was experiencing rapid health deterioration.

The crews launched less than fifteen minutes from initial notification for both events, which U.S. Army Chief Warrant Officer 2 Kristopher Pinson, co-pilot for the mission, said is standard practice for the aeromedical evacuation community, and one that the unit prides themselves on upholding.

“There was a lot going on. [We performed] a present position departure from the airfield, and touched down on the helipad by the [combat support hospital],” said Pinson, describing a technique helicopter pilots use to rapidly depart a location by ascending vertically directly from where they are parked, rather than taxiing to a different part of the airfield before takeoff. 

The third request came around 7:00 p.m. on Jul. 13. In close coordination with Honduran authorities, the first crew departed Soto Cano in less than 15 minutes after receiving a brief that a civilian, severely injured with a gunshot wound to the neck, required immediate aeromedical evacuation from the island of Roatan, off the northern coast of Honduras, to a hospital in the city of San Pedro Sula.

Thunderstorms, low visibility and low cloud ceilings created dangerous flying conditions as the first crew attempted to make the approximately hour and a half long flight to Roatan, and they returned to base until weather conditions improved. Several hours later, another crew launched in near total darkness, making it 45 miles from the air base before experiencing similar damaging and unsafe conditions.

“We are in a [geographic] bowl [surrounded by mountains], and we’re in Central America, so right now it could be sunny, and then in half an hour, torrential downpour, and in an hour from there, it’s sunny again. Weather is always that x factor, instead of being able to take weather into account like in other locations, because of the mountainous terrain, the humidity, and all the factors that create the perfect cesspool for storms to form,” said Baidal. An additional complexity is that the staff weather officers assigned to the 1-228 forecast using only satellite data, rather than the forecasting sensors found in many stateside locations.

On Jul. 14, after two unsuccessful attempts to reach the patient, a third crew with a pilot, copilot, crew chief, and three critical care flight paramedics departed Soto Cano and navigated around inclement weather, making it to Roatan.

While the patient had received initial surgery on the wound, they required further intensive medical care and a ventilator. Fortunately, despite repeated obstacles, the aeromedical evacuation team was able to stabilize the patient and safely transport them to a higher level of care.

During the mission, the team leveraged unique skills such as U.S. Army Capt. Richard Jackson, the flight doctor, being fluent in Spanish, easing communication with Honduran medical professionals during the patient transfer process.

The 1-228 Charlie Company commander, U.S. Army Maj. Cody Sneed, said this particular mission was inspiring because of the team’s consistency, commitment, and lack of hesitation.

“It’s tough when you know that the person you are launching to get is having the worst day of their life…there’s that sense of urgency that if you don’t get there, they could die,” said Sneed. “The fact that the crews turned around twice, I know that they pushed their comfort level, before they made the decision to turn around. That’s the medevac mission. You don’t have a lot of time to plan, and from the minute you receive the initial nine line, it’s already expired information.”

U.S. Army 1st Lt. Ian Gidcomb, who co-piloted the third attempt to reach the patient on Jul.14, described the aeromedical evacuation, which was his first operational mission, as a success.

“I have to say listening to [the flight doctor] and medics in the back stabilizing the patient, and all the intensive care they had to do, was very impressive,” he said. “We’re down here for a humanitarian mission, so it’s not just helping Americans, it’s helping out the entire region and trying to project a positive influence in Central and South America. That’s kind of the reward you look for and why you join the military; it’s these types of missions you really feel good about.”

The 1-228 commander, U.S. Army Lt. Col. Adam Bock, underscored the importance of the unit’s mission and ability to respond rapidly and coordinate multiple attempts in varying conditions.

“The recent success of our team demonstrates the Winged Warriors’ important contributions to the mission of JTF-B and our partners throughout Central America. We have highly trained aircrews, capable of providing rapid response medical support in one of the most challenging aviation environments in the world,” Bock said.

“Life-saving aeromedical evacuation is truly a collaborative effort.  Every member of our team is committed to the cause and I am extremely proud of their dedication to this mission.”