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Phone: (813) 827-5894; FAX: (813) 827-2211; DSN 651-5894

December 27, 2003
Release Number: 03-12-66



BAGHDAD, Iraq - A bomb explodes in Baghdad. People are injured and need medical treatment quickly. But a security team is needed for the military medical emergency response team to travel outside the "Green Zone" in the city. How long can the injured wait while the two teams - security and medical - scramble together?

A group of medics from the Colorado National Guard are developing a pilot program in coordinated military medical emergency response. The Rapid Advance Medical Team, or RAM-T, concept was developed following the U.N. bombing in Baghdad Aug. 17.

Leaders noticed that the coordinated response by the medical and security communities weren't optimized, said Maj. (Dr.) Mark H. Chandler who is a physician and officer in charge of the medical clinic at the former Presidential Palace in Baghdad where the reconstruction and security coalitions are headquartered.

"Based on (the response to the U.N. bombings), we realized we needed a faster, more coordinated response," explained Chandler who has called Denver home for the past 10 years.

Chandler and the other seven medics working in the palace are members of the Colorado National Guard. They belong to C Company, 109th Area Support Medical Battalion headquartered in Iowa.

The Colorado National Guard sent a four-member team to Baghdad in April by way of Kuwait. In October, four more members of the Colorado National Guard arrived.

The small medical team is responsible for the treatment and care of up to 2,500 people assigned to the Coalition Provisional Authority and the Combined Joint Task Force 7, the civilian and military coalitions responsible for the reconstruction and security of Iraq. The medical staff sees an average of 50 to 80 patients a day in their one-room clinic.

In addition to caring for the civilian, military and contractors at the headquarters, the medics provide emergency care for Iraqis.

But there seemed to be a 'disconnect' between the military and Iraqi civilian health care systems, Chandler said. That disconnect is what the RAM Team is all about.

"We scrounged and put together an emergency response team," said Chandler.

He contacted his civilian employer, Denver Health Medical Center, who donated materials including advanced airway equipment.

The University of Colorado donated laryngoscopes used to establish airways.

"We also received a new civilian ambulance that's worth $180,000," said Chandler.

As Chandler explained, a military field ambulance does not have as much sophisticated emergency equipment as a civilian ambulance. The goal for a field ambulance is to stabilize a patient long enough to remove him or her from the "front lines." Thanks to the extensive equipment on the civilian ambulance, more intensive treatment can also be administered during transport.

The innovative concept for the RAM Team was to integrate a physician or physician's assistant, such as Capt. Michael Adams from Norwood, into the response team.

When an incident occurs, the 30th Medical Brigade provides the logistical information to the team and within a few minutes, the RAM Team is ready to roll - usually within 3-5 minutes.

"We're generally in a higher state of readiness," said Sgt. Sheldon Smith, the noncommissioned officer in charge of the evacuation. "We have a higher medical response profile because of the PAs (physician's assistants) and doctors on the team."

Coordination for these emergencies involves more than sending out an ambulance with the medical experts on board. Security teams are needed to protect the medics en route to an incident.

"We had problems coordinating security so we started to do our own," said Smith who works as a deputy sheriff for San Miguel County when he's not serving as a National Guardsman.

The medics split the duty for the response team with some providing security and others assisting with medical treatment. The other team members are Sgt. Kyle Kosman and Specialists Jeffrey Oldaker, Duane Ziegler and Antoine Brown, all from Montross, and Spc. Aaron Hall from Crested Butte.

The concept for the team was developed by Maj. John Kerstettler, a member of the Iowa National Guard, but "it has evolved because of the personnel here," Smith said.

"Our missions have matured as the team became more proficient," Chandler said.

The team's mission became more than a concept when all the ideas came together to form their response to the Baghdad hotel bombing earlier this year. "By then we had our security team put together . everything went much the way it was supposed to," said Smith who, along with his wife and three children call Montross home.

Since the team provides its own security, it's important for them to know their response area.

"We know what's safe, what's not safe," Smith explained. "And we know where all the hospitals in the area are - not just the military ones."


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