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Deployed Guard Airmen bring medical skills to CENTCOM

An Air National Guard Critical Care Air Transport Team, deployed from the 125th Fighter Wing, Florida Air National Guard, give medical attention to a patient during a six-month deployment to Bagram Airfield, Afghanistan. The CCATT’s mission is to transport critically injured service members from the point of injury to a hospital where they can receive the advanced care needed. (Courtesy Photo)

An Air National Guard Critical Care Air Transport Team, deployed from the 125th Fighter Wing, Florida Air National Guard, give medical attention to a patient during a six-month deployment to Bagram Airfield, Afghanistan. The CCATT’s mission is to transport critically injured service members from the point of injury to a hospital where they can receive the advanced care needed. (Courtesy Photo)

BAGRAM AIRFIELD, Afghanistan -- During 2019, United States service member casualty rates reached a five-year high. Providing expert medical care in remote locations can be challenging, but that did not stop this deployed Air National Guard Critical Care Air Transport Team.

During the course of their six-month deployment featuring numerous high-profile missions and mass casualty events, this team did not lose a single U.S. casualty under their care.

Critical Care Air Transport Teams (CCATT) are experienced in the care of critically ill or injured patients with multi-system trauma, shock, burns, respiratory failure, multiple organ failure and other life threatening complications.

Their mission is to transport critically injured service members from the point of injury to Bagram Airfield. From there, patients are passed into the care of medics at the Craig Joint Theater Hospital, the most capable Role III trauma hospital in Afghanistan.

CCATTs are highly specialized medical assets that create and operate as a portable intensive care unit on board any available transport aircraft during flight.

“Caring for patients in-flight brings a unique set of challenges,” said Maj. Tracy Provenzano, a CCATT nurse from to the 125th Fighter Wing's Medical Group, Florida Air National Guard. “The aircraft is noisy and we are unable to use the stethoscope as you would in a hospital setting, so we had to use other means to monitor for changes in our patients’ status. Our training gives us the ability to provide our patients the same level of care we would give any ICU or trauma patient, while taking into the account the stressors of flight they may encounter.”

These teams consist of a critical care or emergency medicine specialized physician, a critical care nurse and a respiratory therapist.

“In CCATT, every member is equally important whether deployed or moving patients stateside,” Provenzano said. “We all bring specific skill sets to the team, but learn in our training to work seamlessly in caring for our patients.”

The team’s physician and CCATT officer in charge, Maj. Andrew Kurklinsky, also from the 125 FW, is experienced in critical care, flight physiology and other aspects of emergency medicine. Bringing this medical expertise and leadership to the CCATT maximizes the medical support for missions.

“I had one opportunity to participate in a vascular surgery at a forward operating base, when the surgical team asked me for assistance as soon as I arrived,” Kurklinsky said. “The patient had a bullet shatter the bones and arteries in his leg, and if the blood flow could not be restored, he would lose the leg. We saved the leg and brought him to Bagram. When I met him the next day in the hospital, he was thankful with tears in his eyes, which gave me a lump in my throat too. Experiences like this are priceless.”

Provenzano’s primary responsibility as the nurse is to manage bedside care such as medications, IV drips, vital signs, and blood administration. Air National Guard CCATT nurses are required to work in an intensive care unit, emergency room or trauma centers full-time in their civilian jobs to hone their skills.

“Most of our experience comes from working Pediatric ICU, Pediatric Emergency Department, Neonatal ICU and Adult ED,” Povenzano said. “I was able to volunteer my time in the trauma center and ICU as a resource and to assist caring for the patients at BAF. My years working in a trauma ICU and Pediatric Trauma Center gave me the skillsets that I needed to respond to the high acuity patients we transported as CCATT.”

The final team member is a respiratory therapist, Tech. Sgt. Brian Schneider, from the 190th Air Refueling Wing’s Medical Group, Kansas Air National Guard. His day-to-day operations consist of patient assessments to include diagnosing lung and breathing disorders, physician consultant, airway management, respiratory medication disbursement, chest and lung physiotherapy, blood gas analyzation, and managing ventilation and oxygenation devices. These are crucial steps in caring for causalities of war.

During the deployment, the team participated in five mass casualty missions, evacuating more than 60 patients. The missions lasted up to 12 hours, so they had to be prepared for any contingency in flight.

“Guard and Reserve Airmen bring a unique Citizen Airmen array of skills and experience to the fight,” said U.S. Air Force Col. Justin Waggoner, U.S. Air Forces Central Command Air Reserve Component Advisor. “Growing coalition partnerships and executing complex missions in contested environments have required seamless synergy on multiple fronts over a long period of time.”

Being able to leave their homes behind and step up on the front line to save lives is an opportunity that many Guardsmen and Reservists are humbled and proud to perform.

“To know that I am among a handful of such teams in the entire world is a humbling realization," Kurklinsky said. "The Guard is being tapped specifically for the expertise that its members bring from the civilian world where they interface with a full spectrum of medical problems.”

This total force teamwork improves longstanding partnerships and makes the U.S. Air Force a stronger fighting force.

“The ANG CCATT members are a highly skilled and experienced cadre of medical professionals making special sacrifices to save lives,” Wagner said. “The immediacy of impact in saving lives of our warriors and coalition partners is a skillset that is unmatched.”

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