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Andersen medical teams showcase disaster response support during Cope North 16

Royal New Zealand Air Force Leading Aircraftwoman Katherine Ruwhiu, a flight medic, comforts a patient with simulated injuries during a medical transfer training Feb. 17, 2016, at Andersen Air Force Base, Guam. Exercise Cope North 16 enhances humanitarian assistance and disaster relief crisis response capabilities between six nations and lays the foundation for regional cooperation expansion during real-world contingencies in the Indo-Asia-Pacific Region. (U.S. Air Force photo by Staff Sgt. Alexander W. Riedel/Released)

Royal New Zealand Air Force Leading Aircraftwoman Katherine Ruwhiu, a flight medic, comforts a patient with simulated injuries during a medical transfer training Feb. 17, 2016, at Andersen Air Force Base, Guam. Exercise Cope North 16 enhances humanitarian assistance and disaster relief crisis response capabilities between six nations and lays the foundation for regional cooperation expansion during real-world contingencies in the Indo-Asia-Pacific Region. (U.S. Air Force photo by Staff Sgt. Alexander W. Riedel/Released)

Staff Sgt. Matthew Flowers, an aeromedical evacuation technician with the 18th Aeromedical Evacuation Squadron, performs simulated CPR aboard a U.S. Air Force C-130 Hercules Feb. 15, 2016, during an expeditionary medical support exercise above the Pacific Ocean near Guam. Exercise Cope North 16 enhances humanitarian assistance and disaster relief crisis response capabilities between six nations and lays the foundation for regional cooperation during real-world contingencies in the Indo-Asia-Pacific region. (U.S. Air Force photo by Staff Sgt. Alexander W. Riedel/Released)

Staff Sgt. Matthew Flowers, an aeromedical evacuation technician with the 18th Aeromedical Evacuation Squadron, performs simulated CPR aboard a U.S. Air Force C-130 Hercules Feb. 15, 2016, during an expeditionary medical support exercise above the Pacific Ocean near Guam. Exercise Cope North 16 enhances humanitarian assistance and disaster relief crisis response capabilities between six nations and lays the foundation for regional cooperation during real-world contingencies in the Indo-Asia-Pacific region. (U.S. Air Force photo by Staff Sgt. Alexander W. Riedel/Released)

ANDERSEN AIR FORCE BASE, Guam -- When disaster strikes, U.S. Airmen are ready to respond decisively with expert search and rescue, air base opening and airfield management, infrastructure repair, and medical response teams within hours of notification.

Medical teams from the U.S. Air Force and Navy partnered with their counterparts of the Royal Australian Air Force, Japan Air Self-Defense Force, Republic of Korea Air Force, Royal New Zealand Air Force, and Philippine Air Force during exercise Cope North 16 from Feb. 11-18, in various locations throughout the Commonwealth of the Northern Mariana Islands.

According to the fictitious exercise scenario, a severe typhoon crossed between the islands of Rota and Tinian, causing severe damage. In response, international coalition members deployed with the Expeditionary Medical Support Health Response Team, EMEDS HRT, a rapidly deployable system comprised of five tents and 40 medics, designed to provide patient care in austere environments.

“It is very hard to describe the magnitude of what we can do with such small amount of personnel and equipment,” said 1st Lt Irene Mitchell, a Medical Service Corps Officer, and the EMEDS HRT administrator . “It is something you have to experience for yourself. It is truly extraordinary.”

The primary mission of EMEDS teams is to provide forward stabilization, resuscitative care, primary care, dental services and force health protection and prepare casualties for evacuation to the next level of care. The modular and scalable design allows the Air Force to deploy medical capabilities ranging from small teams, which provide highly skilled medical care for a limited number of casualties, to a large medical system that can provide specialized care for up to 500 patients per day.

On Rota, the team set up ER capabilities even faster than the concept of operations’ two-hour recommendation and was fully operational within 12-hours.

“Our ER doctor was already treating patients before we were completely set up,” said Capt Barrington Dykes, 36th Medical Group dentist, who is also the triage team chief for the EMEDS HRT. “That is one of the great advantages of this system, we can treat patients almost immediately upon arrival.”

Upon mobile hospital stand-up, the team worked through multiple patient scenarios and emergency situations, treating a variety of notional injuries from crush and penetrating injuries to gastro-intestinal conditions and vector transmitted diseases. Patients were treated on scene, transported to the EMEDS on Rota to be stabilized and eventually aero-medically evacuated to Guam for definitive care at U.S. Naval Hospital Guam.

“We can take care of any emergency surgical procedure on the neck, chest, abdomen, or extremities that’s to include vascular injuries,” said Maj. Angela Prescott, a general surgeon from the 374th Medical Group, Yokota Air Base, Japan. “We try to keep the procedures about one and a half hours to two hours or less.”

Ultimately, the EMEDS team worked through 53 urgent patients, preparing more than 45 for aeromedical evacuations, including seven critical, who required the care of a specialized team of providers called Critical Care Air Transport Team, in effect, a flying ICU.

“We can’t just put a patient on any aircraft and fly them to a hospital,” said Lt. Col. Tim Deater, 36th Medical Group administrator. “We must ensure our patients are stable and have been cleared to fly at altitude by a validating flight surgeon.”

Because of these requirements, the ground medical capability further enhances the aeromedical evacuation process and this year’s exercise proved that, Deater added.

To improve medical evacuation training, the exercise for the first time also incorporated the En-Route Patient Staging System, as well as an aeromedical evacuation liaison team from Kadena AB, Japan, which was instrumental in the coordination of intra-theater patient transportation.

Additionally, training cadre from Camp Bullis, Texas, oversaw simultaneous EMEDS ground training and awarded initial and refresher credit to all participants saving the Air Force an estimated $100K in training and travel costs.

The EMEDS HRT is a Role 2 mobile medical facility that can stabilize and hold four patients for 24 hours to support the early phases of Air Expeditionary Forces deployments during major combat, contingency, HA/DR and stability operations. It includes specialized personnel and equipment that can be added depending on the mission. Its primary goal is to stabilize patients and prepare them for movement to the next level of care.

Designed for rapid mobility and efficient setup, the team can deploy within 24 hours of notification, establish ER capability within 2 hours, operating room capability within 4 hours, and critical care capability within 6 hours. It can reach full operational capability within 12 hours of arrival.

For CN 16, a specialty care package was deployed, which included internal medicine, pediatrics, obstetrics/gynecology, an international health specialist, and pharmacy and radiology capabilities.

Role 2 facilities provide advanced trauma management and emergency medical treatment including continuation of resuscitation started in Role 1, which is the first medical care military personnel receive (also referred to as unit-level medical care). U.S. Naval Hospital Guam, where patients were eventually transferred to, is a Role 3 facility, where the patients are treated in a medical treatment facility that is staffed and equipped to provide care to all categories of patients, to include resuscitation, initial wound surgery, and post-operative treatment.

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