Posts Tagged ‘medevac’

Vantage Point: The Challenges of Small-Unit Patrolling in Afghanistan

C.J. Cheevers from the New York Times has been a go-to 24/7 resource for the SFTT news project; CJ also recently published the definitive history of the Avtomat Kalashnikov this past year in “The Gun.”  Available now on his NYT blog is a new entry that he will update periodically that the SFTT news team directs your attention to.

The first video blog provides an upfront and personal look at an aero-medevac of a wounded Marine in Marja.

As these video blogs become available, the SFTT news team will re-post them.

U.S. moves to strengthen local Afghan officials

In an attempt to improve legitimacy and capacity, the cornerstones to good governance, Regional Command South has created “security bubbles” that allow local residents and government officials to interact and “govern”, while “200-300” Taliban fighters remain around Kandahar.

Let’s do some math.  The population of Afghanistan is approximately 30 million.  The population of Kandarhar city proper is approximately 500,000.  Who knows the what the number of government officials and employees are required to make the trains run on time.

Oh, and the most recent  estimate of insurgents in Afghanistan is 25,000, but now we are supposed to believe that there are “200-300” Taliban fighters “around” Kandahar.   Do the math.

Rush for results in Afghanistan may undermine aid goals

In 2008, the USG approved a $75 million rule of law reform initiative for Afghanistan that neither reformed nor proved to be much of an initiative.  Unless you can accept that $15 million was spent to hire consultants that hosted kite-flying competitions.

Great way to spend US tax dollars.

Casualties

Five US/NATO troops were killed in action on January 12, 2011 in Afghanistan.

The grind continues.

Report: Growing mental health problems in military

Never knew that the Department of Defense publishes a Medical Surveillance report , but even without the findings everyone knows that mental health problems are the number one health issue facing our troops.  That’s a no-brainer. The November report highlighted in this story by CNN points out the fact that mental health issues send male troops to the hospital than any other cause, and are the second highest for hospitalization amongst women troopers. “The Army was relatively most affected (based on lost duty time) by mental disorder-related hospitalizations overall; and in 2009, the loss of manpower to the Army was more than twice that to the Marine Corps and more than three times that to the other Services,” the report says. “The Army has had many more deployers to Afghanistan and Iraq and many more combat-specific casualties; it is not surprising, therefore, that the Army has endured more mental disorder-related casualties and larger manpower losses than the other services.”

 With some patience you can navigate to the MS Report site and review a decades worth of reports – rather startling data.  Consider that there is data that tracks the numbers of deaths (and by cause) within two years after service in Iraq and Afghanistan.  Since 9/11, 88 women and 1947 male servicemembers have died within two years of serving in either Iraq or Afghanistan – that’s over 2,000 within 24 months since redeployment!  Almost 1,000 in some type of transportation accident (i.e. automobile/motorcycle), over 400 suicides, over 100 homicides, and 76 due to some type of neoplasm (i.e. Cancer).

 Insecurity and Violence Spreads to Northern Afghanistan

Whack-a-mole.  Surge in the south, leave open the north.  Whack-a-mole. Reposition in the north, enemy withdraws south.  Whack-a-mole. NATO has called this “an extreme escalation” of militant activity.  Actually, it’s a simple supply and demand problem and an economy of force issue.  What was once a gunfight that only involved the Afghan provinces in the east to the south in Afghanistan is now a 360 degree fight, where all areas  require more US/NATO forces are evident to the threat and being exploited.  Coupled with criminality and a lackluster Afghan government, the northern (and western) provinces in Afghanistan have become a vacuum for the enemy to operate in with impunity.  Limiting their operations outside of major urban centers the Taliban and their confederates have been able to provide an alternative to the local populace for services, justice, and security, which “allows the instability to spread.”

 Sad to say that the only real option without any operational or strategic effect is to “whack-a-mole”.  In other words hit the enemy wherever and whenever they emerge – problem is, it’s apparent that there are insufficient US/NATO troops to cover and respond to the threat, and Afghan National Security Forces lack the capability to respond in kind as well.

 Following Up: When A Crew Chief Fights With His Rifle

 Warms your heart when you get to read about courage amidst the carnage, especially when these humble acts are by combat medic crew chiefs.

The award recommendation is below:

SGT Grayson Colby, United States Army, distinguished himself by extraordinary courage and dedication to the MEDEVAC mission on 01 June 2010, in support of Regional Combat Team 7 in Regional Command Southwest during Operation Enduring Freedom 10.

While performing MEDEVAC duty at Camp Dwyer, the crew of DUSTOFF 56 (Pilot in Command CW2 Deric Sempsrott, Pilot CPT Matthew Stewart, Crew Chief SGT Colby, and Flight Medic SGT Ian Bugh) conducted MEDEVAC mission 06-01R in central Marjeh. A dismounted patrol of Marines had come under fire, and one Marine was shot in the upper thigh. Within minutes DO56 launched from Camp Dwyer, knowing they were headed for a high threat area. No escort was available due to the multiple troops-in-contact ongoing across Helmand. The Marine would surely die if not evacuated quickly, so the crews acknowledged the risk and were authorized to launch.

As DO56 approached the point of injury, a firefight erupted on three sides of the aircraft. With no aircraft providing cover, the crew continued to the ground without hesitation, determined not to abandon the wounded. Seeing the location from which the friendly forces were engaging the enemy, SGT Bugh and SGT Colby exited the aircraft from the right door where the largest contingent of the Marine patrol was engaging the enemy.

As the two crewmembers egressed from the aircraft, a Marine came out of the tree line in front of them and signaled for them to stay low. SGT Bugh and SGT Colby sprinted 50 meters across the open field toward the Marine’s position where the patrol was locked in an engagement with the enemy. Reaching the raised road where the Marines were taking cover, SGT Bugh found that the unit had no means to transport the injured Marine and returned to the aircraft for a litter. SGT Colby immediately took a defensive position alongside the Marines and began to engage the enemy. With rounds cracking above his head and hitting the dirt around him, SGT Colby returned fire to the muzzle flashes that were approximately 200 to 300 feet in front of him.

When SGT Bugh returned to where SGT Colby was providing covering fire, they bounded as a team down the raised road with the firefight continuing around them. Reaching the wounded Marine, SGT Colby took his place in the line of Marines, replacing one who had left his position to aid his buddy. Again, SGT Colby returned fire with enemy rounds hitting around him. SGT Bugh and three other Marines carried the litter while SGT Colby remained in his position until they were clear of the road. He than followed them down the road providing rear security until reaching the aircraft. With the patient loaded and SGT Bugh and SGT Colby secure, DO56 departed towards Camp Dwyer. Once airborne, SGT Colby assisted SGT Bugh by starting oxygen on the wounded Marine as the aircraft raced back to the Dwyer Role II Hospital. The Marine went through intensive surgery at the hospital prior to being transferred to a higher level of care.

SGT Colby’s disregard for his own safety as he left the security of the aircraft to provide cover for SGT Bugh embodies the Warrior Ethos. His bravery resulted in a Marine’s life being saved. SGT Colby’s actions reflect great credit on himself, TF Shadow, TF Destiny, and the United States Army.

In a compelling story published today by the Washington Post, “Military medics combine ultramodern and time-honored methods to save lives on the battlefield” of Afghanistan.

Key Highlights:

  • At 6:09 p.m., Dustoff 57 has just left this base deep in Taliban-infiltrated Kandahar province, headed for a POI, or point of injury. Somewhere ahead of the aircraft is a soldier who minutes earlier stepped on an improvised explosive device, the signature weapon of the wars in Iraq and Afghanistan. All the helicopter crew knows is that he’s “category A” – critical.  The trip out takes nine minutes.  Fifteen minutes have now passed since the soldier was wounded. Speed, simplicity and priority have always been the hallmarks of emergency medicine. The new battlefield care that flight medics and others on the ground practice takes those attributes to the extreme.
  • Four people run to the helicopter with the stretcher holding the wounded soldier. He lies on his back partially wrapped in a foil blanket. His chest is bare. In the middle of it is an “intraosseous device,” a large-bore needle that has been punched into his breastbone by the medic on the ground. It’s used to infuse fluids and drugs directly into the circulatory system when a vein can’t be found. It’s a no-nonsense technology, used occasionally in World War II, that fell out of favor when cheap and durable plastic tubing made IV catheters ubiquitous in the postwar years. Until they were revived for the Iraq and Afghanistan wars, intraosseus devices were used almost exclusively in infants whose veins were too small to find. On each leg the soldier has a tourniquet, ratcheted down and locked to stop all bleeding below it. These ancient devices went out of military use more than half a century ago because of concern that they caused tissue damage. Now every soldier carries a tourniquet and is instructed to put one on any severely bleeding limb and not think of taking it off.
  • Tourniquets have saved at least 1,000 lives, and possibly as many as 2,000, in the past eight years. This soldier is almost certainly one of them. They’re a big part of why only about 10 percent of casualties in these wars have died, compared with 16 percent in Vietnam.  On the soldier’s left leg, the tourniquet is above the knee. The tourniquet on his right leg is lower, below the knee; how badly his foot is injured is hard to tell from the dressings. His left hand is splinted and bandaged, too. Whether he will need an amputation is uncertain. The hospital where he’s headed treated 16 patients in September who needed at least one limb amputated. Half were U.S. soldiers, and the monthly number has been climbing since March.
  • After three minutes on the ground, the helicopter takes off.  Eleven minutes after lifting off from the POI, the helicopter lands at the so-called Role 3, or fully equipped, hospital at Kandahar Airfield, about 30 miles to the east of the also well-fortified Forward Operating Base Wilson. There, surgeons will take care of the injuries before transferring the patient, probably within two days, to the huge military hospital in Landstuhl, Germany, and there, after a week or so, to the United States. It’s been 28 minutes since the helicopter left Forward Operating Base Wilson.

SFTT Analysis:

  • Before every Grunt leaves the wire, they want to know if air or artillery support is readily available and more importantly, if required, will an aerial medevac be responsive – in Joe speak “Time on Target for Air and Arty and a quick Nine-line medevac request . . . how quick will the angels of mercy get here?”.   Quick means quick, the sooner the better obviously, since every minute counts.  Secretary Gates figured this out when he began his battlefield circulation tours in Afghanistan when he became Secretary of Defense and quickly realized that the “Golden Hour”, that period in time that is the standard from time of request for a medevac to arrival at the point of injury and back to medical care on a base, was not being met in Afghanistan due to lack of medevac resources and the distant out-posts that troopers were operating from.  Secretary Gates made it a personal mission to close the gap and ensure that troopers were supported by the “Golden Hour” standard and personally kept the pressure on logistics planners to increase medevac resources and establish medical unit facilities in support of all forward deployed personnel.   The only question SFTT raises regarding this issue is why did it take the Secretary of Defense to correct this situation?  
  • The Washinton Post online article provides a remarkable photo gallery,  – of note is:
    • the destructive nature of an IED that targeted a Mine Resistant Ambush Protected (MRAP).  The simplicity of a pressure plate device loaded with hundreds of pounds of fertilizer (and other components) can defeat US “resistant” vehicles.  More telling is that a device of this size takes time and local support to emplace;
    • grunts not wearing all of their protective gear – no throat, deltoid, or groin protectors – obviously a commanders call, but is the decision not to wear the complete armor suite because of weight and comfort?;
    • the chinstrap for the Advanced Combat Helmet is a flimsy strap of material – no chin pads are provided and the harness is simply used to hold the “brain bucket” in place.  At least the trooper is being medevaced for treatment of a possible TBI.

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