Staff Sgt. Jennifer Gray, an independent duty medical technician, discusses the intense training she received at the Centers for Sustainment of Trauma and Readiness Skills program at the R Adams Cowley Shock Trauma Center in Baltimore. The C-STARS program helps the Air Force train and maintain the highest caliber of trauma medics for expeditionary duties. (Produced by Andrew Breese and Tech Sgt. Bennie Davis)
The phone is ringing.
Instantly, people stop talking mid-sentence, keyboard clicks cease and heads turn with anxious expressions painted on their faces.
The only sounds are those that can’t be silenced, the machines that beep and tell the medical personnel hearts are beating and patients are breathing.
A small group begins to gather around the phone as a lady in pink scrubs rushes toward it.
The woman picks up the handset and answers, “Shock trauma.”
Immediately, the silence is broken. The phone is on speaker, and a man’s voice broadcasts from it, relaying information in an anxious, but controlled, manner. Sirens blare in the background.
“You have Trooper 1 inbound in approximately 15 minutes. Patient is male, approximately 35 and was involved in a motorcycle accident. He has multiple injuries. Right leg, nose and left wrist have exposed fractures. Internal injuries and possible bleeding also present.”
As the information is relayed, the woman writes it down on a whiteboard next to the phone. Behind her, the small group of onlookers has scattered, each person now running off to perform a specific job. Bandages are prepped, IV bags are collected, and medical machines are turned on and calibrated.
A few people grab a gurney and head for the elevator that will take them to the roof, where Trooper 1, a Maryland State Police helicopter, will land in a few minutes with the patient.
Staff Sgt. Susanne Fry is one of them. Normally, she doesn’t see many interesting patients. As an independent duty medical technician with the 21st Medical Operations Squadron at Peterson Air Force Base, Colo., her days are typically filled with administering blood pressure checks, conducting routine patient-health assessments and taking down patient information.
This is not one of those days. She’s already given aid to a girl who flipped her car because she was texting while driving, helped stabilize a man whose tractor rolled over with him on it, bandaged another man who fell off his porch and fractured his skull and comforted a third man who was severely beaten by three assailants.
And the day was only half over.“You never know what you’ll see coming through those doors,” — Master Sgt. Charles Halcome
This is no ordinary shift. On this day, Fry is thousands of miles from Colorado. She is working in one of the busiest trauma centers in the nation — the R Adams Cowley Shock Trauma Center at the University of Maryland Medical Center, located in the heart of Baltimore — as part of an Air Force medical training program called the Center for Sustainment of Trauma and Readiness Skills, or C-STARS.
C-STARS is a three-week program where Air Force medical personnel work side by side with their civilian counterparts and learn the ins and outs of trauma care. The goal is to prepare the Airmen to treat injuries they may see while deployed to Southwest Asia.
“The program was developed as a result of studies performed after the first Gulf War that indicated military medicine was not as prepared as it should have been to treat combat casualties,” said Lt. Col. (Dr.) Raymond Fang, the C-STARS director.
Before C-STARS was created a decade ago, military medical personnel saw very few trauma cases and looked to civilian centers to treat military trauma patients.
Now, through the C-STARS program, Air Force physicians, nurses and medical technicians can work alongside civilian medical staff as they provide hands-on care to trauma patients.
“It’s a great experience,” Fry said. “We get to do and see things here we normally wouldn’t get to at our home stations.”
There’s a lot to see and do in the STC. The center cares for more than 8,000 patients annually, with injuries ranging from stabbings and shootings to motor vehicle and industrial accidents.
According to Fang, this made the STC an easy choice for the course.
“We knew we needed a place where there would be a lot of trauma patients and that stayed busy,” he said.
The course is broken into three separate areas: lecture and simulation to start, followed by hands-on work in the STC and concluding with a field exercise meant to test what the Airmen learned.
“The simulations are nice, but you learn the most by getting to work with real patients in the center and being trained by some of the best trauma people in the world,” Fry said.
The training takes place in numerous areas throughout the center, including the operating rooms, orthopedics and the burn center. But where the students said they learn the most is in the trauma resuscitation unit, located on the second floor.
This is where every patient comes first, either by helicopter or ambulance, and is examined and stabilized before being sent anywhere else, such as to X-ray or one of the operating rooms.
“You never know what you’ll see coming through those doors,” said Master Sgt. Charles Halcome, a C-STARS instructor. “It may be someone who burned his or her hand, or it could be someone who was hit by a car and is in pretty bad shape.”
Either way, he added, the key is getting the patient the best care possible, and quickly.
“This is exactly what the students will need to know how to do when they’re caring for service members who are injured in improvised explosive device blasts or other accidents in Afghanistan or anywhere else,” Halcome said. “So the training here is designed to take them out of their comfort zone and learn new things, new ways to help our military guys who are getting hurt over there.”
For some students, this is the first time they will have any real hands-on experience with a trauma patient or working in a trauma environment. This often leads to confusion, anxiety and nervousness among the students.
That is exactly one of the reasons the program was put in place.
“We’d rather have the students feeling shell-shocked here, where they can get the support and skills they need, rather than when they are working at their deployed location,” Fang said.
Because of this, each shift has an instructor assigned to it, someone who can answer students’ questions, guide them in the right direction and encourage them when needed.
“It can be overwhelming,” said Master Sgt. Misty Talley, another C-STARS instructor. “So sometimes we’re teachers, sometimes we’re mentors and sometimes we’re counselors, telling the students, ‘Hey, you can do it. You’ve got this.’”
Reaching the roof, this message is going through Fry’s mind. As the elevator doors open, her team rushes out and scans the horizon, looking for any sign of a helicopter. Eventually, it appears and begins its descent to the landing pad marked with a giant red cross.
As soon as the helicopter lands, Fry’s team hurries outside and toward the aircraft. Once there, they load the patient onto the gurney and rush back inside and into the waiting elevator.
The patient is unconscious, bleeding from multiple wounds, and his breathing is faint. His body has a pale hue and his hands and feet are white as death.
“This man needs some blood,” one of the medical technicians says.
The elevator doors open, and the team rushes out and down a winding corridor and into the TRU. Here, they wheel the patient into an empty bay, and immediately, the man is swarmed by dozens of medical people who begin poking, prodding and examining the patient.
Fry helps insert several IVs. Some contain medicine, others blood. The man’s clothes are cut off, and a tourniquet is applied to his right leg, which is broken and bleeding profusely. Within minutes, the man is prepped for surgery and wheeled off to the operating room.
The TRU, which only seconds before had been in a state of controlled chaos, is now calm. People are talking and joking, keyboards are clicking and a small group gathers around a sink, each person waiting to wash his or her hands.
Then, everyone in the room falls silent and heads turn expectantly.
The phone is ringing.