DAYTON, Ohio — Shauntel Hass worked as a registered nurse at a hospital when she decided to take her career in another direction. Upward.
The 35-year-old Mountain Home, Idaho, native joined the Air Force and spent her first day in training this month at the U.S. Air Force School of Aerospace Medicine at Wright-Patterson Air Force Base. There, she will earn flight nurse status, a job that will likely jet her across continents and oceans to care for wounded soldiers returning from battle.
Before boarding a U.S. military plane to treat a wounded service member, medical teams from the Air Force, Army and Navy earn the wings on their flight suits at the school, which was transferred to Wright-Patterson three years ago as part of the Base Realignment and Closure commission.
Reporters from this newspaper this month accompanied members of the Air Force Reserve 445th Airlift Wing, based at Wright-Patterson, on a 12,000-mile journey to Bagram Airfield in Afghanistan that also included an evacuation and transport of 11 wounded patients from Ramstein Air Base in Germany to Joint Base Andrews in Maryland.
The reserve wing has an aeromedical team, drawn largely from the ranks of civilian health care professionals in the Miami Valley.
Patient care at high altitudes has its challenges— part of the training at the School of Aerospace Medicine. The school graduates about 300 flight nurses and technicians from its weekslong aeromedical courses each year.
"What we're teaching them is how to take those skills and those capabilities and how to step it up to a point where they are going to be working in an environment at 35,000 feet, which is very unusual," said Lt. Col. Karey M. Dufour, the Wright-Patt school's flight nurse course director and contingency operations chief.
"When you take a patient up to altitude, those stresses of flight really do make a big difference in how we treat our patients. There's certain considerations that we have to make. Otherwise, our patients can really deteriorate very quickly."
Critical care teams of flight doctors and nurses tend to the most severely wounded troops.
"The patients we take in the air are more critical than you're ever going to see in any level one trauma center because of all of the multiple trauma that they have," said Lt. Col. Elena Schlenker, the school's director of critical care courses, which graduate another 125 students or so a year.
The wounded may have head or pulmonary injuries, or "they may have open abdomens and often times multiple amputations," she said. Amputations are one of the top injuries the critical care teams see from a combat zone.
". We'll take a patient that is very critical that you would be concerned about transporting to a CAT scan unit inside of a hospital down a couple of floors (and) we'll take that patient up to 30,000 feet and go up to 12 hours in the air," she said.
Aeromedical crews fly aboard C-17 Globemaster III and C-130 Hercules cargo planes, the KC-135 Stratotanker, and the C-21, a military version of a small Lear business jet.
Flying led Sr. Airman Michael Layme, 30, of Hollywood Beach, Florida, to sign up or aeromedical duty. Layme was a physical rehabilitation specialist before he enlisted. He too marked his first day of aeromedical flight training this month at Wright-Patterson.
"I wanted to fly," he said. "My dad was prior Navy and he always knew that I wanted to do something in themilitary."
Medical teams train in C-130 simulators inside the school before they take a check ride on a training mission in the air.
Real world missions frequently entail long distances, and what crews pack and take aboard the plane is crucial, especially for critical care patients.
"There's a lot of things you have to plan for," said Lt. Col. Linda Renee Boyd, a flight physician skilled in emergency medicine and a school instructor. One example: "We don't have a blood bank in the air so we have to bring blood with us."
Boyd, who has deployed to Iraq, Afghanistan and Germany, said caring for burn patients is the most challenging. There may not be a specialized team on the ground, so flight doctors and nurses take on that responsibility in flight.
At Wright-Patterson, critical care teams undergo 10 days of "intense training," Boyd said. Students undergo an additional 14 days of training at C-STARS, the Center for Sustainment of Trauma and Readiness Skills at the University of Cincinnati Medical Center.
Flight nurses and aeromedical evacuation technicians that treat stabilized patients — or those with less severe injuries — typically fly without doctors. The Air Force nurses and evacuation technicians on those flights must complete a two-phase, 42-day course.
The hardest part of the journey is the time in the air, said Capt. Allen Potter, a flight nurse and school instructor.
"It's tough to communicate that to students in a classroom setting," he said. "Aerovac is a very time consuming occupation. The amount of time you're flying takes a great deal of fatigue on the individual, not only for the patients but you as the medical team as well."
Aeromedical evacuation flights from Germany to places like Iraq or Afghanistan and back can consume 20 to 30 hours.
Every School of Aerospace Medicine aeromedical instructor knows the routine. Each has flown battle-wounded troops out of Iraq or Afghanistan and sometimes both. "We've all deployed multiple times," Schlenker said.
To stay alert on a long mission, Potter walks the aircraft, does push-ups, drinks "lots of coffee" and constantly checks on patients, he said.
"It keeps my mind working while we're on the long flights," he said. "As you can probably guess, at the end of the day my mind is pretty much done."
