The first photo was taken inside the Contingency Aeromedical Staging Facility. The CASF is a medical facility for patients who have been cleared from the nearby CSH or Combat Support Hospital for medevac to Germany.
As you can see by the second photo, the patients are loaded on to the aircraft at night - somewhere around 0200 local time. That's midnight in Germany, and that's when the Missions Team at Landstuhl receives the final flight manifest which contains all relevant patient information.
From there, the patient information goes to the Triage Team. They determine where the patients will be admitted at Landstuhl: outpatient facility or hospital inpatients by ward or ICU. If necessary, additional nursing or surgical staff are called in so everything is prepared for the patients' arrival in the early morning German time.
Over 60,000 patients have been medevaced to Germany from Iraq and Afghanistan since 2003, a number that would overwhelm any other hospital and which makes Landstuhl the busiest trauma hospital in the world.
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