Army Medevac Unit Races Against 'Golden Hour'

This is the first in a three-part series.

Map i i

A wounded soldier's journey can go from the battlefield to a field hospital at Balad Air Base — about 60 miles north of Baghdad — and then to an army medical center in Landstuhl, Germany, all in a matter of hours. Lindsay Mangum, NPR hide caption

itoggle caption Lindsay Mangum, NPR
Map

A wounded soldier's journey can go from the battlefield to a field hospital at Balad Air Base — about 60 miles north of Baghdad — and then to an army medical center in Landstuhl, Germany, all in a matter of hours.

Lindsay Mangum, NPR
Chief Warrant Officer Mary Rone. i i

Chief Warrant Officers Mary Rone and Alex Bonilla of Eagle Dustoff, an Army medevac unit, get ready to move out. Eagle Dustoff works out of Balad Air Base, about 60 miles north of Baghdad. Guy Raz, NPR hide caption

itoggle caption Guy Raz, NPR
Chief Warrant Officer Mary Rone.

Chief Warrant Officers Mary Rone and Alex Bonilla of Eagle Dustoff, an Army medevac unit, get ready to move out. Eagle Dustoff works out of Balad Air Base, about 60 miles north of Baghdad.

Guy Raz, NPR

About This Series

Nearly 30,000 U.S. troops have been injured in Iraq — about half of them with permanent disabilities. In Iraq and Afghanistan, troops who are wounded in an attack have a 95 percent chance of surviving. It's the highest survival rate in the history of warfare.

 

Once a serviceman or woman is injured, they enter a kind of conveyer-belt of treatment that begins with an evacuation from the battlefield to the trauma ward at Balad Air Base. Soldiers then go to the U.S. Army hospital in Landstuhl, Germany, thousands of miles away. It's a cycle that sometimes takes just a few hours.

 

NPR's Defense Correspondent Guy Raz presents a three-part series on critical care in the war zone. Part One of the series starts on Morning Edition Thursday with a look at an Army helicopter unit that flies to the battlefield to rescue those injured. Part Two, which airs on All Things Considered Thursday, will examine the air force hospital at Balad Air Base, one of the most advanced combat field hospitals in the history of warfare. Finally, Part Three — which airs Friday on Morning Edition — will follow an injured soldier to a U.S. Army medical center in Landstuhl, Germany.

At around midnight, the radio traffic gets heavy inside Eagle Dustoff's operations center.

Dustoff is an Army medevac unit made up of 90 soldiers and 12 Blackhawk helicopters.

The unit works out of a remote corner at Balad Air Base, about 60 miles north of Baghdad. Their mission is simple: Evacuate anyone injured on the battlefield as quickly as possible.

About every half hour, especially at night, an alert comes in.

An instant messaging system that's attached to an electronic voice blares out the latest injuries in a staccato "Speak & Spell" voice: "LN2 has shrapnel all over the body. A hole in his back may be an exit wound from a chest injury."

It's at this moment that the clock starts ticking and the "Golden Hour," an emergency medicine concept, begins.

A dispatcher inside the operations center grabs a walkie-talkie to alert the crew on call to get moving.

He shouts "MEDEVAC! MEDEVAC! MEDEVAC!" into the two-way radio.

Mary Rone, from Berkeley, Calif., the only female pilot in the unit, is rustled from a deep sleep and rushes to the operations center.

"If a soldier survives the attack, after the first couple of minutes, as long as they're transported to a facility within that hour, their chances of survival are over 95 percent," Rone said.

Within three minutes, Rone will rush to runway to power up the Blackhawk along with the lead pilot, Chief Warrant Officer Alex Bonilla.

Within eight minutes, the chopper will be on its way to evacuate the injured.

First Lt. Samuel Diehl, a recent graduate of James Madison University in Virginia and also a pilot in the unit, says the there are two types of injuries he typically encounters.

"The majority of injuries are pretty much traumatic amputations from explosions and a lot of extremity gunshot wounds, because [the soldiers are] covered by the body armor," Diehl said.

As the on-call unit rushes into the operations center, their commander, Maj. Michael Pouncey, studies an electronic map of Iraq that shows shifting sectors colored in red. The red areas are danger zones — areas where the helicopters are likely to come under fire. So Pouncey quickly works out the safest route to get to the patient.

It's been about 2 minutes since the medevac alert came over their walkie-talkies. The crew gets their orders and races out to the runway in near pitch darkness.

The helicopter swoops up over Balad Air Base and heads east toward the grid coordinates.

Inside the darkened cabin of the Blackhawk, the smell of diesel is thick. Outside, the pitch darkness is illuminated by colored streaks of red tracer fire and the occasional flash from a gun muzzle.

Flying to the Wounded

The helicopter hovers over a blackened field and attempts to land.

But even with night vision goggles, the pilots can't locate a safe place to touch down.

They are tense. They know someone is waiting for them, injured, maybe dying, almost certainly in agony.

For several minutes, the chopper circles just a few hundred feet overhead. The medic and the crew chief double as the Blackhawk's security. They lean out the windows and scan the ground, hoping no one is aiming anything at the helicopter. Experience has shown that the painted red cross on the side of the chopper gives these soldiers little protection from those wanting to shoot it down.

Finally, the pilots find a safe place to land. The medic, Sgt. Christopher Blesset, slips out of the open window to link up with the ground contact.

He sees three soldiers dragging a nylon litter — a type of stretcher — through the dusty field. It's too loud to exchange any words, but Blesset knows it has been about 15 minutes since the person lying in the litter was shot. Blesset and the three soldiers load the litter into the Blackhawk.

In what seems like seconds, the helicopter rises into the sky. The two pilots, Bonilla and Rone, cut through the darkness at top speed. At this point, Bonilla is focused on one thing only.

"My goal is for the patient not to die in my aircraft," Bonilla said. "We do whatever we can to keep that patient alive until he gets to a higher level of care, so he can get better treatment than [what] we provide in the aircraft with the little bit of equipment that we have."

In just seven minutes, the helicopter will touch down at one of the most advanced combat field hospitals in history.

Medics from the trauma ward rush out to the pad to pick up the patients.

Less than 25 minutes since the attack, the patient is inside the trauma ward at the Air Force hospital inside Balad Air Base.

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