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During a five-day period in March, Rear Adm. Alton L. Stocks, Walter Reed National Military Medical Center (WRNMMC) commander, took a first-hand look at the medical evacuation (medevac) process -- from the Germany arrival of injured service members from the battlefield, to their stateside destination at WRNMMC.

Stocks, a pediatrician, medevaced pediatric patients from Europe to the U.S. when he was stationed in Italy from 2000 to 2003. His March visit to Germany along with senior members of the WRNMMC medical staff responsible for the care of wounded warriors and their families, was the first time he reviewed the medevac process since he assumed command of WRNMMC, the world’s largest military hospital, in September.

Stocks and the command team traveled to Germany on March 25, and flew on the medevac flight back to the U.S. with the wounded warriors on March 30. He explained his trip to Germany, and the subsequent medevac flight, were “to build bridges” with the commands at Landstuhl Regional Medical Center (LRMC), home to the Deployed Warrior Medical Management Center (DWMMC), and the Contingency Aeromedical Staging Facility (CASF), located at Ramstein Air Base. All of the facilities help support the recovery and recuperation of wounded warriors, Stocks added.

“The DWMMC is the eyes and ears for LRMC,” explained Navy Capt. Thomas Craig, incoming director of the Warrior Family Coordination Cell (WFCC) at WRNMMC and a member of the Walter Reed Bethesda staff who reviewed the medevac process. He explained the DWMMC is the coordination point of contact for the U.S. Transportation Command (USTRANSCOM), which includes the Theater Patient Movement Requirements Center (TPMRC) and Global Patient Movement Requirements Center (GPMRC) to medically evacuate patients from in theater.

“DWMMC is alerted when a patient is inbound from theater, and announces that information to the team of physicians that will have the skill set to handle that particular type of injury,” Craig explained. “Upon arrival at LRMC, the patient is whisked up to the intensive care unit ward area and the teams that were alerted hours to days before meet the patient.”

A patient will not be moved on a medevac unless he or she is stable, Craig said. For instance, if a warrior needs surgery to control internal bleeding, the patient will not be moved, he explained.

The CASF at Ramstein is responsible for the safe movement of wounded warriors between medical facilities.

“The Air Force has regularly scheduled flights, [and] with three flights per week, a patient may wait two or three days max, unless the patient needs stabilizing surgery,” Craig said. He added preparing wounded warriors for transport back to the U.S. is “custom tailored to the medical needs of the patient to ensure safe, stable transport. [For example], if the patient has pulmonary contusion and has a hard time getting oxygen into the blood system, then the patient may need O2 supplement; if the patient has an infection, then the patient will need intravenous antibiotics,” he said.

Wounded warriors destined for WRNMMC from Germany generally arrive at Joint Base Andrews, Md., on a C-17 flight usually lasting about 11 to 12 hours.

The WRNMMC command team praised the teamwork between the Army, Navy and Air Force in the care and transportation of wounded warriors during the medevac process. Navy Capt. Christine Sears, executive assistant and part of the WRNMMC team that reviewed the medevac process, described the care of wounded warriors at Landstuhl and during the evacuation flight as “outstanding. All the coordination between the medical care and the services is amazing,” she added.

Care provided by the Critical Care Augmentation Team (CCAT) on the flight was “impressive,” according to Stocks and Sears. The CCAT includes doctors, nurses, technicians and corpsmen trained to treat patients suffering from the most severe injuries while being transported between medical facilities.

Once wounded warriors and Stocks arrived at Joint Base Andrews, Md., the WRNMMC commander accompanied the wounded on the final leg of their journey here to “the Nation’s Medical Center” (WRNMMC) in the Patient Evacuation Vehicle (PEV). The 40-foot-long PEV, staffed with specialized medical personnel, is equipped with state-of-the-art medical systems and supplies to provide the best care to patients during the 30 to 40 minute drive from the runways of Andrews to WRNMMC.