NANGARHAR PROVINCE, Afghanistan - When the Vietnam War was well underway and U.S. combat involvement was still in early stages, helicopter pilots ferried the wounded from the battlefield. In 1963, the U.S. Army 57th Medical Detachment (Helicopter Ambulance) commander started using the radio call sign "Dustoff" for his medical evacuation chopper.
The name arose, in part, because of the clouds of dust that would billow up when the helicopters took off or landed.
All MedEvac choppers assumed the "Dustoff" call sign; it lasted throughout the war and is still in use today.
The MedEvac platoon at Forward Operating Base Fenty, Nangarhar Province, Afghanistan, is comprised of Soldiers from the Michigan and New Hampshire National Guard, and continues the Dustoff tradition of providing timely aid to injured service members on or off the battlefield.
Meeting the demands of the MedEvac profession requires constant training.
Because of this, U.S. Army Soldiers from the MedEvac Platoon "Dustoff," Company C, 3rd Battalion, 238th Aviation Regiment, Task Force Dragon, conducted hoist exercises on a mountaintop near Forward Operating Base Fenty, Sept. 16.
A hoist allows MedEvac crews to raise and lower personnel and supplies by cable into areas too dangerous for the UH-60 Black Hawk helicopters to land. Given the steep mountains covering much of Afghanistan, mastering the use of hoist equipment is a necessity.
"We pick up anyone who's injured or wounded from the battlefield," said Capt. James Balloch, of Glastonbury, Conn., who is the forward support MedEvac platoon leader. "It's all about bringing them to a higher level of care."
At one time, casualties traveled from the battlefield to aid stations by either ground or air; now MedEvac choppers bear the brunt of the work.
"Instead of having to wait around for an ambulance to bounce along the road -- they're not that fast [and] not an optimal solution when time is really critical - we do most of our patient transport now by helicopter," said Staff Sgt. Jonathan Boeddiker, of Claremont, N.H., a Dustoff flight medic. "We've seen great improvements in patient outcomes because of it."
These improved patient outcomes spring from the reaction speed of the Dustoff crews as well as the quality of care patients receive inflight.
MedEvac crews have a 15-minute reaction time window, said Staff Sgt. Steven Schenk, of Livonia, Mich., the Dustoff flight medic non-commissioned officer in charge. In other words, as soon as the MedEvac request comes in to Dustoff's command group, the crew on call has 15 minutes to be ready to liftoff.
"It's the whole firefighter mentality," Boeddiker said.
From Fenty, the MedEvac teams can be at the casualty pick-up site within minutes, landing or descending on hoists to take over patient care. Once the patient or patients are secured, Dustoff medics or flight surgeons work to stabilize them, or keep them stable, while en route to a medical treatment facility.
Tending to patients in the back of a Black Hawk presents many challenges.
In addition to very limited space and supplies, patient monitoring equipment is often affected by chopper vibrations, said Boeddiker. Flight medics can't communicate with casualties about their injuries: it's too loud.
"Every possible distractor that you can throw into the situation is there," Boeddiker said. "It's a very challenging environment to provide care in."
Even so, Dustoff crews are determined to provide the best care they can. This means constant training, whether in the classroom or in the field.
Schenk, who has been a civilian paramedic, said the level of care he and his flight medics provide exceeds the standard of the wider medic field. While most Army medics have the training and experience equivalent to civilian emergency medical technicians, MedEvac care requires more knowledge, more training.
"The critical care platform we provide is an advanced stage," Schenk said. "It's like a mobile intensive care unit."
The combination of knowledge and training allows these MedEvac crews to walk in step with the Dustoff tradition: airlifting casualties to a higher level of care.