The converted Blue Bird school buses that lumbered for many years transporting wounded soldiers from Andrews Air Force Base in Maryland to Walter Reed Army Medical Center in Washington, D.C., are no more.
They have been replaced by larger, better-equipped vehicles that make the 30-minute journey easier and more comfortable for patients and medical personnel.
The three new patient evacuation vehicles known as PEVs built at a cost of $1.5 million, were unveiled in June. Forty feet in length and 13 feet high, the PEVs are much larger than the previous vehicles and each can accommodate up to 16 litter patients and 12 ambulatory patients, plus a small medical staff that typically includes an RN, a medic, and a technician, reports Maj. Barbara Bakowski, RN, an air evac nurse at WRAMC.
“From my experience working with both vehicles, the PEVs are a great improvement,” Bakowski says. “We now have more of a capability for troubleshooting and caring faster for the patients.”
“The Blue Bird buses did the job, but they didn’t do it as elegantly,” adds Patricia Cassimatis, a spokesperson for Walter Reed Army Medical Center. “It’s the difference between a Ford and a Cadillac.”The order for the new vehicles came in October 2006 when then Army Surgeon General Dr. Kevin Kiley directed Walter Reed Army Medical Center to develop requirements for vehicles specifically designed to meet the unique transport medical needs of critically injured service personnel. The vehicles are the first of their kind purchased by the Army Medical Command.
One of the biggest issues with the Blue Bird buses was a frustrating lack of storage space. “Everything had to be brought on board in little crates or bags,” Bakowski notes. “We couldn’t store any of the equipment that we needed to take care of the patients.”
Space is much less an issue with the new PEVs, which Bakowski describes as “mini ambulances,” because the vehicles were designed with increased storage and more work space for medical teams to move among patients.The 40-foot-long PEVs can accommodate up to 28 patients and a small staff that includes an RN.
“Because the flights from [Landstuhl Regional Medical Center] in Germany are quite lengthy, a lot of times when we pick up soldiers they may need immediate treatment, such as a wound dressing or a fresh IV,” Bakowski notes. “We can now keep these supplies on board.” Life-support systems such as air, suction/vacuum, and oxygen were also built into the vehicles’ walls so that each litter patient can easily be connected. The PEVs also have the capability to support the military’s mobile life support gurney, known as the LSTAT, which is self-contained with a ventilator, monitor, and other equipment. However, the LSTAT is more commonly used in theater, Bakowski notes, and none has yet accompanied a patient arriving from Germany.
Advanced hydraulics provide a less bumpy (and therefore a less painful) ride for patients, who also enjoy amenities such as privacy curtains, adjustable air conditioning, and even DVD players. Bakowski is quick to note, however, that the entertainment systems have yet to be utilized. “We travel with [flashing] lights and sirens from Andrews Air Force Base back to Walter Reed, and can make the trip in about a half hour,” she explains. “A lot happens during that half hour, so we don’t have much time to play DVDs.”
The new vehicles are in constant use as flights inbound from Germany arrive at Andrews Air Force Base every Sunday, Tuesday, and Friday night. More than 7,800 wounded or ill soldiers have arrived at Andrews and been transported to Walter Reed since the beginning of Operation Enduring Freedom and Operation Iraqi Freedom.The new PEVs include state-of-the-art equipment.
The most critical cases are often accompanied by a Critical Care Air Transport Team (CCATT) consisting of a physician, a critical care nurse, and a respiratory therapist, all of whom are members of the Air Force. These patients and their support teams are the first to be off-loaded from plane to PEV, with less critical patients following in a second vehicle.
The CCATT’s mission is essentially to operate an airborne ICU as they travel from Germany to Andrews Air Force Base. The teams assume responsibility for the critical care patients originating from Landstuhl Regional Medical Center, and that responsibility ends only when the patients have been placed in a critical care unit at Walter Reed.
Though a rare occurrence, if a critical care patient starts to crash en route from Germany, the transport plane will divert to the nearest military treatment facility and transfer the patient, or take the patient directly to the emergency room at Andrews Air Force Base upon landing.
The PEVs at Walter Reed are currently used only to transport incoming and outgoing patients, but they were designed with another important mission use as well – to provide medical support for mass-casualty events in the Washington, D.C. area, notes Bakowski.
“Thankfully,” she says, “we have yet to have cause to use them for that.”
Donald Vaughan is a freelance writer.
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