CAMP PENDLETON, Calif. – Whenever a wounded Marine needs critical care in a combat zone, aircraft provide the means to get them to the care they require. However, during these casualty evacuations, each passing minute in flight subtracts from the Marine's "golden hour." Communication between the care teams in the helicopter and the care facilities on the ground is critical and can often mean the difference between life and death.
Corpsmen from Alpha Surgical Company, 1st Medical Battalion, 1st Marine Logistics Group, teamed up with data network specialists from Headquarters Regiment, 1st MLG, to add minutes to the first critical moments of a traumatic injury by leveraging an emerging communications capability called digital interoperability, during an en-route care exercise aboard Camp Pendleton, Calif., Jan. 26-29, 2015.
"We are utilizing wave forms and tablet computers to provide in-patient care tracking while in the air," said Maj. Elishama Wheeler, G-6 Operations Officer, HQ Reg. "Right now the gap that exists between the patient tracking continuum is en route from point of injury to the care facility. The providers in the back of the plane don't have any communications outside of the aircraft, so the care facilities don't know the status of the patient until they arrive, which can become problematic."
This exercise marks the first time that this method is being implemented in the medical field within the Marine Corps.
The advanced waveform network works just like the Wi-Fi network used in homes. Tactical radios are tuned into a specific frequency that is then transmitted to computer tablets. Radio signals can reach up to 20 miles and users are able to instant message and send data files simultaneously.
"There is great potential for this to save lives," said Wheeler. "Instead of a patient coming off of a helicopter and having to share their status as they get off, they could potentially already know before they arrive, giving them a chance to better prepare. A care facility knows, even if it's only an additional 10, 15 or 20 minutes prior to a patient arriving, every second counts."
Patient information is currently tracked on a piece of paper that stays on the aircraft until they land. The only way for the care team to communicate outside of the aircraft to provide critical information is through the pilot. This can prove to be slow and often leads to miscommunication, said Lt. Cdr. Joe Pinon, Alpha Surgical Company Commander.
During the four-day exercise, corpsmen trained to prepare a Special-Purpose Marine Air-Ground Task Force group that is going to forward deploy later this year. The more than 40 corpsmen set up a shock trauma platoon facility, or mobile emergency room, to treat simulated casualties. The casualties were stabilized in the STP and then flown out via aircraft.
"En-route care is a very challenging job for a variety of reasons," said Pinon. "Just the logistics of knowing what equipment you have to have before you fly out and knowing how to set up your equipment on a litter so it doesn't blow away adds a challenge. It's a very different environment. Doing care in the air is very different because you don't have the resources you would have in a hospital. In the air, you can't call lab to come help draw blood or call radiology to come see how a tube is placed. It's just you and your very small team of two or three people that are providing care in a very small space."
En-route care has been around for a long time, since the Napoleonic war through the Vietnam era, but it wasn't until World War II that the Army established the first program of record for en-route care and not until the later part of Operation Iraqi Freedom that the Army again developed an en-route care program, said Pinon. As of now, it is the only en-route care program of record that the Marine Corps can use.
"The challenge for us is getting people in those programs because of our deployment tempo," added Pinon. "Often times our deployments don't line up with their course dates. So the medical battalions have been required to provide en-route care training to the individuals that are deploying so that we can be mission ready and meet the capability that we have been tasked with. What I'd like to see is for the medical battalions to establish a program of record so that we aren't relying on outside sources to provide the training that we need. This would enable us to be ready to meet any mission that comes up."
Whether wounded Marines spend three minutes or three hours in flight, the corpsmen can help give those Marines more minutes on the golden hour through in-depth training such as this.
"As a company commander, what I've tried to provide for my team is to have them rehearse everything because that is really key," said Pinon. "It's also really important to make the training as realistic as possible so they experience the stress and appreciate the challenges, because again unless you do it you really can't anticipate these things."