Air National Guard to Augment Active-Duty Critical Care Air Transport Teams

The Air National Guard will station at least one critical care air transport team, or CCATT, at Ramstein Air Base for the next two years. The Guard units will help ease the load on active-duty CCATT units, such as this one, which flew patients from Afghanistan to Germany in April last year. Photo: Daniel Riley/Courtesy of U.S. Air Force.

The Air Guard will be reinstating their critical care air transport program which was phased out about five years ago.

RAMSTEIN AIR BASE, Germany — Mounting evacuations (see related story here) have led the Air National Guard to start fielding critical care air transport teams, medical specialists who treat severely injured servicemembers during flight.

“The active-duty side is getting heavily stressed continually manning all these missions,” said Air Force Dr. (Lt. Col.) Raymond Fang, trauma director at Landstuhl Regional Medical Center in Germany. “So having another pool of personnel who are capable and willing to help is welcome.”

At least one, three-member critical care air transport team, or CCATT, from the Air Guard will be stationed at Ramstein Air Base for the next two years, said Brig. Gen. John D. Owen, assistant to the command surgeon for Air Mobility Command. The team’s primary mission will be to care for patients as they make the long journey across the Atlantic to Joint Base Andrews in Maryland, and then on to Walter Reed Army Medical Center. But the team could deploy worldwide, including to Iraq, Afghanistan or Africa.

“They could be airborne to anywhere in the globe in three hours,” Owen said.

The Air Guard currently has about 18 CCATTs from 17 states.

To make it easier for the guardsmen to take time off from their day jobs, the tours have been shortened to between 30 and 120 days, Owen said.

“Our civilian physicians, many of them have private practices, and they cannot leave for long periods of time,” he said. “This allows them to come over here.”
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“Planning is extremely important,” said Dr. (Col.) Bruce R. Guerdan, state air surgeon for the Florida Air National Guard, who is leading the guard’s first CCATT rotation at Ramstein. “You have a lot of capabilities, but the only capabilities you have are the ones you bring with you. You can’t call for extra supplies or extra blood or the specialist while you are flying over the Atlantic or flying downrange.”
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Not only do the guardsmen provide much needed manpower, Fang said, but they also bring expertise. Guerdan has worked in emergency medicine for more than two decades.

“There is not a wealth of critical care experience on the active duty side all the time,” Fang said. “The guard folks, that’s what they do in their everyday job in civilian hospitals all over the U.S.”

This is not Guerdan’s first time leading a CCATT. He had been a part of the Air Guard’s previous critical care air transport program, which was shut down about five years ago. He is eager to be doing it again.

“You do all this intensive training,” he said, “and you want to use it. Also is there a more important mission? I don’t think so.”

According to Air Force Brig. Gen. John Owen, who is the Air Guard advisor to the Air Mobility Command air surgeon, the Air National Guard has developed new technologies and processes for the CCATT mission.

The biggest technological change to the aeromedical mission has been the transition from the C-141 Starlifter to the KC-135.

“Those planes are in the boneyard now,” said Dr. (Col.) Bruce Guerdan, a Florida Air Guard state surgeon who is a member of the first Air Guard CCATT currently deployed here [at Ramstein]. “The tanker was not designed to carry patients. We have changed lighting, oxygen systems, stanchions for the stretchers. That plane has been turned into something that it never was.”

The 50-year-old airframe is not the same plane it was about five years ago. “There has been a huge investment of times and energy to make those planes adequate air frames to carry patients,” Guerdan said.

Owen said the tanker was chosen, because it is fast, can carry a lot of fuel and can fly long distances.

“The KC-135 can fly back to the U.S. from Afghanistan unrefueled with the proper clearances,” he said. “The aircraft is very stable. It does have some limitations, but with the modernization it provides a very capable platform.”

He added that the C-17 is the premier aircraft for aeromedical evacuation, but the Air Force doesn’t have as many available for the mission.

More coverage of this story at DoD Live and the Air Force Times.