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Military medics combine ultramodern and time-honored methods to save lives on the battlefield

U.S. military helicopter crews are key elements in the battle to save wounded soldiers' lives in Afghanistan, facing the risk of attack to pick up the injured, employing evolving front-line strategies to treat them and then racing to transport them to the hospital.

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By David Brown
Washington Post Staff Writer
Sunday, October 17, 2010; 1:14 AM

FORWARD OPERATING BASE WILSON -- The first sign this isn't a routine pickup is the rhythmic right and left banking of the helicopter.

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It's the kind of thing kids do on bikes to feel the thrill of heeling over. Only this is done to make the aircraft a less easy target.

At 6:09 p.m., Dustoff 57 has just left this base deep in Taliban-infiltrated Kandahar province, headed for a POI, or point of injury. On board are two pilots, a crew chief and a flight medic, as well as two litters for carrying the wounded and numerous black nylon bags stuffed with ultramodern medical gear and some of the oldest lifesaving tricks of the battlefield. That combination of new and old - of specially developed porcelain-powder gauze and old-fashioned tourniquets - is key to keeping gravely wounded soldiers alive in the minutes before they get to the hospital. It's also the basis of evolving frontline strategies that may eventually trickle down in modified form to civilian ambulances, emergency rooms and trauma centers in the United States.

Somewhere ahead of the aircraft is a soldier who minutes earlier stepped on an improvised explosive device, the signature weapon of the wars in Iraq and Afghanistan. All the helicopter crew knows is that he's "category A" - critical.

The sun is down but there is still a little pink in the western sky. Beneath the helicopter, the ground is made of what the troops call "moon dust." Fine-grained and dry, it is a color not as dark as dirt and not as light as sand.

The aircraft weaves over compounds enclosed by mud walls and surrounded by fields of grapes and vegetables. Farther away on the sere, unirrigated plain are the domed tents of herdsmen, their cooking fires glowing like terrestrial stars.

The trip out takes nine minutes.

The helicopter lands, stirring up a cloud of moon dust that nearly obscures six soldiers kneeling and standing around the wounded man, 50 feet from the aircraft. Their headlamps make tiny blue searchlights. The 28-year-old flight medic, Sgt. Cole Reece, runs toward them.

Cpl. Deanna Helfrich, 22, the crew chief, climbs out of her window and walks around the nose of the aircraft trailing a communication cable that allows her to talk to the rest of the crew. She stands near the open door where the wounded soldier will be brought, holding her rifle.

The weapon is a reminder: The crew is here to save lives, but Rule 1 of the Basic Management Plan for Care Under Fire is: "Return fire and take cover."

There is no enemy fire this evening, but there is so much dust in the air and the rotors are spinning so fast that the leading edges of the blades light up like sparklers, flint on steel.

Fifteen minutes have now passed since the soldier was wounded. The details of how it happened don't matter to Reece. There are a limited number of things he can do between this nameless spot and the hospital at Kandahar Airfield, where they will soon be headed. What he needs to know he will see and feel for himself.


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