Army Medevac Unit Races Against 'Golden Hour' The first hour after an attack is crucial for wounded soldiers. Injured troops who get medical help have a 95 percent chance of surviving. Eagle Dustoff, a medevac unit in Iraq, keeps its mission simple: Evacuate the wounded as quickly as possible.
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Army Medevac Unit Races Against 'Golden Hour'

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Army Medevac Unit Races Against 'Golden Hour'

Army Medevac Unit Races Against 'Golden Hour'

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Nearly 30,000 U.S. troops have been injured in Iraq, about half of them with permanent disabilities. In Iraq and Afghanistan, troops who were wounded in an attack have a 95 percent chance of surviving. It's the highest survival rate in the history of warfare. An injured serviceman or woman enters a kind of conveyor belt of treatment, the evacuation from the battlefield to the trauma ward at Balad Air Base, and finally thousands of miles away to the U.S. Army hospital in Landstuhl, Germany. It's a cycle that sometimes takes just a few hours.

This morning, NPR defense correspondent Guy Raz begins a three-part series on critical care in the war zone. It starts with a look at an Army helicopter unit that flies to the battlefield to rescue those injured.

Unidentified Man #1: Eagle Dustoff operations. Cruiser one, two. Roger. Please (unintelligible). Cruiser one, zero, out.

GUY RAZ: Around midnight, the radio traffic gets heavy. This is the operations center for an Army MEDEVAC unit called Eagle Dustoff. It's located in a remote part of Balad Air Base, about 60 miles north of Baghdad. About every half hour this night, an alert comes in - a call or a radio transmission or an electronic voice tied to an instant messaging system.

(Soundbite of instant messaging system)

Unidentified Woman #1: LN2 has shrapnel all over the body. A hole in his back may be an exit wound from a chest injury.

RAZ: This night, at least two people have been injured - one shot in the thigh, another riddled with shrapnel. An exit wound from a chest injury likely means there's heavy bleeding.

First Lieutenant Sam Diehl from Fredericksburg, Virginia, one of the younger pilots in the crew, describes what he is likely to encounter.

First Lieutenant SAM DIEHL (Pilot): The majority of injuries are pretty much traumatic amputations from explosions, and a lot of extremity gunshot wounds because, you know, they're covered by the body armor.

RAZ: Chief Warrant Officer Mary Rone from Berkeley, California, the only female pilot in the unit, explains that at this moment an emergency medical concept known as the Golden Hour begins.

Chief Warrant Officer MARY RONE (Pilot): The Golden Hour is basically 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.

RAZ: Inside the operation center, one of the dispatchers grabs a walkie-talkie to alert the rescue crew on call to get moving.


RAZ: Eight soldiers walk into the operations center. They'll split up into two groups. One will fly the lead chopper, the other a chase helicopter to follow. The unit's commander, Major Michael Pouncey, studies the latest intelligence on enemy activity in the area. A large flat screen TV displays an electronic map of Iraq with shifting vectors colored in red. The red zones are no-go areas this evening, so Pouncey will spend a minute or so figuring out the safest route.

Major MICHAEL POUNCEY (Unit Commander): Echo, Juliet, to a point head south. Stay on the east side of - well, we don't want to necessarily stay on the east side of H-Town.

RAZ: It's been about two minutes since the MEDEVAC alert came over the walkie-talkies. The crew gets their orders and races out to the flight line in near-pitch darkness.

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

(Soundbite of helicopter)

RAZ: Inside the darkened cabin of the Black Hawk, 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. The helicopter hovers over a blackened field and attempts to land.

Unidentified Man #3: Zero, three, one, six, Oscar, Romeo, Tango, Lima.

RAZ: 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 Black Hawk's security. They lean out the windows and scan the ground, hoping no one's aiming anything at the helicopter.

(Soundbite of helicopter)

RAZ: Finally, it lands. The medic, Sergeant Christopher Blesset, slips out of the open window to link up with the ground contact. Three soldiers are dragging a nylon litter through the dusty field. It's too loud to exchange any words, but the medic, Sergeant Blesset, knows it's been about 15 minutes since the person lying in the litter was shot. Blesset and the three soldiers load the litter into the Black Hawk.

In what seems like seconds, the helicopter rises into the sky. The two pilots, Alex Bonilla and Mary Rone, cut through the darkness at top speed. Bonilla will later describe what goes through his mind.

Chief Warrant Officer ALEX BONILLA (Pilot): My goal is for the patient not to die in my aircraft. We do whatever we can, you know, to keep that patient alive until he gets to a higher medical care.

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

(Soundbite of hospital)

RAZ: The handoff is complete. In less than 25 minutes since the attack, the patient is now inside the trauma ward at the Air Force hospital inside Balad Air Base.

(Soundbite of hospital)

RAZ: Guz Raz, NPR News.

NEARY: In an audio slide show at, you can follow patients from Balad Air Base to the U.S. Army hospital in Landstuhl, Germany. And later today on ALL THINGS CONSIDERED, you can hear what happened to the soldiers brought into the trauma ward.

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