Thursday, March 8, 2012


A reader brings our attention to Michael Yon's reporting on 23/02/12 - Re: the medevac situation in Afghanistan:

Army Dustoff Medics Unprepared

“After more than 9 years of conflict and more than 40 AAR’s recommending the evolution of MEDEVAC to current civilian standards, no institutional change has been made. Continuing the legacy model has resulted and continues to result in documented sub-optimal outcomes and increased deaths among patients transported by helicopter in the current conflict.”

Robert L. Mabry, FS, EMT-P
Lieutenant Colonel, MC
JTTS Medical Director, Enroute Care

Yon continues:

The United States Army has failed with extraordinary dexterity while executing the helicopter MEDEVAC plan in Afghanistan. On the surface, the Army advertisement campaign sells a story that their performance is exemplary and unprecedented in the history of war. The press machine churns out sound bites, which are picked up in major media without the barest pretense of auditing. For instance, senior Army officers saying and committing to writing that the Army has achieved a 92% success rate on MEDEVAC. The Army peddles this message, and yet nobody says, “Show me the money. Where do you get these figures?” There is growing evidence that the 92% figure is hollow and fraudulent.

You can read the rest of it HERE

Well I have a lot of contacts and one of them is Doc, an Army PA who soldiers the same way I do - at the groundpounder level, ant's eye-view; with occasional forays into the Corridors of Power. I'll let Doc tell it:

"I called in 48 medevacs for 62 of my patients in my 14 months in Afghanistan. I lost no one. Commo was bad in most places and I used a Roshon cell phone over the local system to the BAF switchboard to accomplish the mission. Some bright light thought VOIP phones were adequate commo. When my calls kept getting disconnected on VOIP in the middle of my 2d or 3d medevac, I went to a cell phone.

This dissection of a report written by folks who want Joint Commission standards implemented on the battlefield is a paper drill by people who never experienced real combat. The Dustoff, run out of BAF in 08-09 was run by an E-8 named Kevin Zites who was instrumental in the development of the SpecOps casevac protocols. He trained his people well and those boys saved lives. So did the AF PJs who came to our rescue especially when the weather kept green army aircraft on the ground. The PJs and their pilots flew in conditions that amazed me.

What is not considered in any comparison with the civilian "life flight" system is the pre-evacuation care and packaging of the wounded by competent medics and PAs all over the battlefield. Where paramedics in the civilian community pick up patients with no prior treatment, the military medics and corpsmen do an excellent job of stabilizing the patient's before the medevac ever arrives. My patient's made it because we stabilized them before they were handed over to Kevin's boys, who then kept them alive on the way to the OR. Our transfers took seconds. No long delays while paramedics from the aircraft stabilize patients; that'd already been accomplished. I can only tell you my experience and the medevac system worked very well, especially considering the distances and weather conditions of the battlespace spread out all over Afghanistan. The administrative types who are busy color-coding bedspace and denying medevacs were, in my considered opinion, the real problem. Pretending that Afghan hospitals and clinics are capable of treating seriously wounded is wishful thinking and committing seriously injured local civilians or ANA or ANP patients to their care is unconscionable. I was constantly being told the bedspace was "amber" and we should send our Afghan patients to the local Afghan clinic. Hell, they came to us from that clinic, where their wounds were beyond the capability of an inadequate afghan medical system. I refused to send them back and fought an uphill battle to get the airframes committed. I was very successful but unpopular among the admin types. They had a model of a working Afghan system and believed if they forced the Afghans to care for their own, they'd step up to the plate. All the Afghans could do with their seriously wounded was bury them.

Do what works, and don't rely on what is supposed to work . . ." - DOC

Doc is an Army PA who has served in every significant military conflict the United States has been involved in since Vietnam - to INCLUDE Vietnam. He is also a personal friend and a mentor, one of the bravest men I know and certainly one of the most inspirational. Doc taught me self-discipline, compassion, how to channel my aggression, a LOT about SCUBA and motorcycles, just enough about Army Aid Bag medicine, introduced me to Scotch and and shared with me THIS Gem of Wisdom: "GUNS ARE FOR KILLING COMMUNISTS ! ! !" Thanks for everything, Doc. I never forgot a thing you taught me - S.L.

Today's Bird HERE