The 934th Forward Surgical Team

Has been called to duty in Afghanistan.

They will be serving the United States of America

In support of Operation Enduring Freedom

Sunday, December 5, 2010

934 FST: Anatomy of the life-saving process

Written by U.S. Air Force 1st Lt. Mark Lazane Paktika Provincial Reconstruction Team Public Affairs Thursday, 21 October 2010 01:31
Part two of a three-part series

PAKTIKA PROVINCE, Afghanistan - Members of the 934th Forward Surgical Team unload a patient from the back of a field litter ambulance at Forward Operating Base Sharana recently. The 934th FST is a team of Army and Air Force medical providers who treat coalition force and Afghan casualties from the battlefield and prepare them for a higher level of care. The goal of the unit is to cut down the mortality rate of battlefield injuries by ensuring all patients see a medical provider within one hour of their time of injury. (Photo by U.S. Air Force Master Sgt. Demetrius Lester, Paktika Provincial Reconstruction Team Public Affairs)

PAKTIKA PROVINCE, Afghanistan -- “In the medical field, especially in trauma situations, you have a goal of what’s called the ‘golden hour’ from the time of injury to the time you get to see a doctor,” said U.S. Army Staff Sgt. Kyle Jennings, 934th Forward Surgical Team member and a licensed practical nurse from Deweyville, Utah. “Patients who arrive within that one-hour window have a much greater chance of recovery. Without an FST in place, a Soldier could go a long time before they see a surgeon or an operating room, and it’d be a lot harder for that person to meet that critical golden hour goal.”

The Emergency Operations Center of the 934th Forward Surgical Team, located on Forward Operating Base Sharana, is where the action begins.

“We are the eyes and ears of the battle space, always on the lookout for medical calls coming in” said U.S. Army Staff Sgt. George McGraw, a native of Clarksville, Tenn.

At the EOC, soldiers man the phones, radios and computers, waiting for alerts to potential medical casualty evacuations that could be coming their way.

Once a patient is confirmed to be arriving, the EOC has to act quickly because it can take just a matter of minutes for a helicopter to leave their station, pick up a patient and drop them off at the FST.

Members of the EOC instantly begin to spread the word around the facility, and information snowballs to the rest of the unit.

Paul Revere-style runners, perhaps shouting, “The whirly-birds are coming, the whirly-birds are coming,” are dispatched to locate medical personnel, helped in their task by large white boards throughout the unit with up-to-date locations for unit personnel.

“There’re not that many places to go on this base, so finding people is usually pretty easy,” said U.S. Army 1st Lt. Austin Adamson, the 934th FST executive officer from Preston, Idaho. “It’s not like someone can go off and really hide someplace for very long, so tracking people down to get them in here quickly is usually pretty simple.”

The first qualified responders to the unit jump into the prepositioned field litter ambulance and rush to receive the patient.

“Being the medic in the back of the ambulance is really exciting,” said U.S. Army Staff Sgt. Benjamin Chou, an Army paramedic from Salt Lake City who is also the noncommissioned officer in charge of the Advance Trauma Life Support section of the FST. “When you’re in the back of the ambulance, it’s just you and the patient. You’re responsible for them until they get up to the unit. That’s what we’re trained to do, so I feel a little more comfortable in the back of the ambulance. Even though it’s a short transport, we still get people who are in a great need of care so sometimes you have to do a lot of stuff just to get them to a provider.”

Those awaiting the return of the ambulance prepare gurneys and equipment for the patient’s arrival, as well as ensure each member understands his role with the patient.

“If you’re not on the ambulance, you’re back at the unit preparing for whatever might be coming,” said Chou. “We make sure that prior to arrival, all team members know what they’re responsible for, that way there’s no confusion when it’s time to perform.”
When the patient arrives to the clinic, things occur in rapid succession.

“We have five people assigned to each bed. Trauma is already a pretty chaotic event so we try to maintain as much order as possible,” said Chou. “Every person surrounding the patient has a specific job to do when that patient arrives, and all do it well.”
The five members of the team include a team leader; usually a physician who quickly assesses the patient and supervises patient care to ensure no detail, no matter how small, is overlooked.

Additional team members include a certified registered nurse anesthetist who looks after the patient’s airway and performs neurological assessments, a nurse who monitors the patient’s vital signs, and up to three paramedics who help prepare the patient for surgery by inserting intravenous and other access lines, as well as help check for injuries that may have been previously missed.

“Even though there is just one team leader, there are always four additional sets of eyes on the patient; so everyone is helping to see if there is anything else critical going on with the patient that may have been missed,” said Chou.

For some of the personnel in the unit, the types of patients treated by the FST are different than what they usually see in their daily careers.

“Back home, where I’m stationed, we don’t do trauma,” said U.S. Air Force Capt. Elizabeth Norris, of New Madrid, Mo., the officer in charge of the ATLS section. “Here, all we do is trauma. I’m an emergency room nurse by training, so it’s not that much different for me, thankfully. We perform well by working together. The team concept we do here works really well in helping a patient survive.”

The entire ATLS process takes as little as ten minutes.

In the best circumstances, the patient only requires small-scale medical procedures, such as suturing wounds or a brace for an extremity, in which case the ATLS section is the first and only stop for the patient, said Chou.

Sometimes, however, the patient requires more invasive care, at which point the patient is prepared for the operating room.

In the operating room, patients are watched closely by at least one surgeon, a certified registered nurse anesthetist, a nurse and a surgical technician.

“Penetrating wounds, usually from shrapnel or gunshots, are the most common injury seen in our operating room,” said U.S. Army Staff Sgt. Nathan Carrico, of Logan, Utah, the noncommissioned officer in charge of the operating room.

The energy inside the operating room is usually far more subdued than that of the ATLS department, and for a good reason, said Carrico.

“In the OR, we try to keep the atmosphere toned down a little more, in order for the physicians to be able to focus on the task at hand,” said Carrico. “Unless you know what you’re doing, it’s difficult to be able to lend a hand, so that cuts down on the amount of people surrounding the patient.”

Though all team members have experience working in surgery, the types of patients they encounter in the operating room here can be far different from what they’re accustomed.

“Back home, I work a lot with elective-type surgeries, whereas here, if we’re in the OR, it’s a serious injury,” said Carrico, a civilian surgical technician when not actively engaged with the FST. “There is no such thing as a ‘typical’ surgery, ever. Every patient responds differently to their injuries and to the medication they’re given. Also, sometimes, once we open up the patient, we’ll discover a lot more work needs to be done than we originally thought, so doing this job definitely keeps things interesting.”

Each person in the operating room has his own role, but all are dedicated to ensuring the procedure being performed is done efficiently, safely and without delay.

“To me, success in the OR is completing the procedure and having the patient survive the surgery,” said Carrico. “If you do everything you can for the patient every time while they’re in your care, there’s never remorse should something unfortunate happen to the patient.”

Following surgery, the patient is brought to the intensive care unit, where another team of medical professionals monitors their recovery.

“Primarily, we help recover patients after surgery and prepare them for evacuation to a higher echelon of care,” said Jennings. “We also help out in the trauma bay to augment the five-person team when needed.”

Depending on the procedure, a patient may be in the intensive care unit as little as 30 minutes following surgery, said U.S. Air Force Maj. Virginia Dunn, a native of Indianapolis, who is the officer in charge of the ICU unit.

Sometimes, they are forced to hold the patient longer.

“Our goal is to get them to the next level of care,” said Dunn, deployed from Peterson Air Force Base, Colo. “A patient only stays overnight if we have bad weather and can’t fly. We’ve had situations where patients have stayed 24, 48 hours, but it doesn’t happen very often.”

As soon as possible, patients are moved to more permanent hospital arrangements. If that individual needs to be flown to a neighboring hospital, they are prepared for evacuation and their care is handed over to in-flight critical care nurses, such as U.S. Army Capt. Jason Montgomery of Fort Hood, Texas.

“During a medical evacuation, you need someone on the aircraft who can monitor the patient for changes to their condition as well as provide continual care until they reach their next destination,” said Montgomery. “Also, the FST only has a certain amount of beds, so we need to move patients as quickly as possible to make sure the FST can continue to receive patients.

Montgomery is one of a handful of critical care nurses added to the FST to ensure a qualified nurse is available to fly with the patient at all times.

“I’m really lucky to be a part of something like this,” said Montgomery. “We honestly could be making history here with our efforts each day. They’ve never embedded critical care nurses with an FST, so we’ll see how it goes, but it definitely has merit. Though we’re just a piece of a larger team medical approach, we’re lucky to be here.”

So, regardless of where you or your injury may originate from, the 934th FST is prepared to assist you, every step of the way.

PAKTIKA PROVINCE, Afghanistan - Members of the 934th Forward Surgical Team assess a patient in preparation for treatment at Forward Operating Base Sharana recently. The 934th FST is a team of Army and Air Force medical providers who treat coalition force and Afghan casualties from the battlefield and prepare them for a higher level of care. The goal of the unit is to cut down the mortality rate of battlefield injuries by ensuring all patients see a medical provider within one hour of their time of injury. (Photo by U.S. Air Force Master Sgt. Demetrius Lester, Paktika Provincial Reconstruction Team Public Affairs)

PAKTIKA PROVINCE, Afghanistan - U.S. Army Capt. David Anderson, 934th Forward Surgical Team officer in charge of the operating room, charts a patient’s information during an assessment recently. The 934th FST is a team of Army and Air Force medical providers who treat coalition force and Afghan casualties from the battlefield and prepare them for a higher level of care. The goal of the unit is to cut down the mortality rate of battlefield injuries by ensuring all patients see a medical provider within one hour of their time of injury. (Photo by U.S. Air Force Master Sgt. Demetrius Lester, Paktika Provincial Reconstruction Team Public Affairs)

Tuesday, September 28, 2010

943 FST: Waiting Patiently to Save Your Life

Written by U.S. Air Force 1st Lt. Mark Lazane Photos by U.S. Air Force Master Sgt. Demetrius Lester Paktika Provincial Reconstruction Team Public Affairs Monday, 27 September 2010 00:42

PAKTIKA PROVINCE, Afghanistan - U.S. Army Staff Sgt. Benjamin Chou, a native of Salt Lake City, the non commissioned officer in charge of the Advanced Trauma Life Support section of the 934th Forward Surgical Team, inspects medical instruments prior to receiving patients at Forward Operating Base Sharana Sept. 9. Chou's unit provides traumatic life, limb or eyesight care to coalition force units, Afghan civilians, Afghan National Security Force members and anyone else affected by the actions of war, regardless of how or by whom they were hurt. Normally a mobile unit, the mission of the 934th FST, an Army Reserve unit from Salt Lake City, has changed from following units on the battlefield to a support role inside the base, where they stand by ready to assist patients as necessary. The FST serves as the first point of treatment after a casualty (ground) or medical (air) evacuation has been performed. Since they arrived in country, members of the 934th FST have been augmented by both Air Force personnel and U.S. Army critical care nurses in an attempt to further improve the quality of care given to patients from the point of injury until they arrive at a full support hospital. (U.S. Air Force photo by Master Sgt. Demetrius Lester)
Part one of a three-part series.


PAKTIKA PROVINCE, Afghanistan-- “In the medical field, especially in trauma situations, you have a goal of what’s called the ‘golden hour’ from the time of injury to the time you get to see a doctor,” said U.S. Army Staff Sgt. Kyle Jennings, 934th Forward Surgical Team member and a licensed practical nurse from Deweyville, Utah. “Patients who arrive within that one-hour window have a much greater chance of recovery. Without an FST in place, a soldier could go a long time before they see a surgeon or an operating room and it’d be a lot harder for that person to meet that critical golden hour goal and get the treatment they deserve.”

Members of the 934th FST, a U.S. Army Reserve unit deployed from Salt Lake City to Forward Operating Base Sharana are learning how to maximize the quality of care provided to the patients who come to them.

Their vitally important mission is unique, interesting and constantly requires unit members to be on their toes.

Just ask them.

“An FST is designed to be a mobile unit,” said U.S. Army 1st Lt. Austin Adamson, 934th FST executive officer from Preston, Idaho. “It used to be, an FST would roll out with infantry units as they advanced through a battle space. That’s how it’s been for other deployments this unit has been on. But the mission here is different. Coalition forces aren’t necessarily advancing across terrain here, so instead, we stay back and stand by to assist the wounded should they arrive.”

The mission of the 934th FST is to provide traumatic life, limb or eyesight care to coalition force units, local nationals, Afghan National Security Force members and anyone else affected by the actions of war, regardless of how or by whom they were hurt.

The FST also provides follow up care to many of the patients they treat; helping to ensure the patient receives the greatest possibility of healing from what ails them.

The team is made up of approximately two dozen nurses, surgical technicians and paramedics as well as a group of medical doctors and nurse anesthetists who rotate in and out of theater.

Even though they’re not on the physical front lines of battle, the team’s daily actions positively affect the war effort significantly.

The FST serves as the first care center between the battlefield and a full-service military hospital for coalition forces, said Adamson.

“Medics who are out in the field with the maneuver units encounter patients on a daily basis, whether they are coalition forces, our Afghan security counterparts or local nationals who have been injured,” Adamson said. “After initial treatment, they are transported by medical evacuation (air) or casualty evacuation (ground) to our facility where they are stabilized and then pushed on to the appropriate higher level of care, whether that is a military facility or an Afghan hospital.”

Naturally, as the base continues to expand, so does the role of the FST.

“When we first arrived a few months ago, half the team we were replacing was here and half were at another base in a different province to the south,” said Adamson. “We got here, to a rapidly-expanding base, and were told we’d be consolidated into one full FST that wouldn’t be separated. It’s a very unique challenge we have here, but a good challenge.”

Though the unit is still considered an FST, the operations tempo and patient care load mirror care rendered at much larger medical units.
“We’re kind of growing towards being a combat support hospital,” Adamson said. “A full CSH would have certain services available, such as dental and other specialties that we don’t have here, so we’re kind of growing towards a CSH minus. But we’re getting busy, and our unit is doing some great work to help the Afghan people.”

To further augment the team, the FST unit was augmented shortly after arrival by both Air Force nurses and medical technicians as well as Army critical care nurses, who, among other duties, help transport patients from the FST to a higher level of care.

The members of the FST didn’t show up in Afghanistan unprepared, however.

To prepare for the changing dynamics of their current role, the entire unit, prior to leaving for their deployment, spent two weeks working at an advanced trauma care center in Miami.

“I think mentally and clinically, the training in Miami kind of gave us a picture of what this deployment was going to be like, and now that I’m here, I’d say it was pretty close,” said U.S. Army Staff Sgt. Benjamin Chou, noncommissioned officer in charge of the Advanced Trauma Life Support section of the FST from Salt Lake City. “The mechanisms of injury are different, but there were definitely a lot of traumatic injuries with which to practice our skills. Here, though, it’s a more hands-on environment in working with the patient.”

The training undertaken in Miami benefited the entire unit, even those whose role doesn’t necessarily lead to direct patient care.

“The time we spent in the trauma center was eye-opening, especially for me, not coming from a patient-care medical background,” said Adamson, who is a school psychologist when not activated with the unit. “In Miami, we developed cohesion and we got to see and practice the steps involved with trauma care. There is a specific chain of events trauma workers try to follow on every patient they see. Trauma departments try to follow the same procedures with each patient to make sure the most important life-saving interventions are not overlooked.”

The lessons learned during their short tour at the Miami trauma center were not forgotten by unit members upon deploying.

“After each trauma we see, we do an after action report and make sure we hit those steps we learned in Miami,” Adamson said. “We have a standard of care we know our patients deserve, so after each patient, we ask ourselves what could’ve gone better. Our work here is already what we like to consider above and beyond the call of duty, but now we are working towards the ultimate goal of becoming a utopia of sorts, or the best FST possible.”

One issue the unit deals with is the hurry-up-and-wait nature that can be their job at times.

“Sure, sometimes there are times when it’s quiet in here,” Adamson said. “But it changes every day, because there are times when it’s really exciting and there are all sorts of things going on at the same time. We help people and we save lives when called upon. We are all on call 24 hours a day in case we’re needed and every patient we treat is in great hands.”

“The best part of this job is we’re in a different country helping people,” said Chou. “This deployment has been a great experience because everyone, by working in close proximity with each other, learns something new every day. It’s giving me a pretty good opportunity to see what happens to a patient after you drop them off at a hospital. As a combat medic, I’m trained to stabilize the patient, drop them off at a hospital, and then other people take it from there; so this deployment has helped me understand what happens to a patient after we drop them off at a hospital which in turn helps me provide better treatment to my patients before they ever get to the hospital.”

“It feels like “The Little Engine that Could” around here sometimes,” said U.S. Army Capt. Roger Beaulieu, a native of Moorpark, Calif., and the FST commander. “This unit definitely takes after our symbol, the beehive. We are all hard workers who do whatever it takes to help each other and get the mission done.”

So for Afghan civilians, coalition forces, or anyone else who may be hurt within the 934th FST’s reach, they can take comfort in the fact they are in the hands of a dedicated bunch of professionals who will do everything in their power to help, heal and repair them as close to their former state as possible.
And that’s a golden promise.

PAKTIKA PROVINCE, Afghanistan - U.S. Air Force Capt. Elizabeth Norris, of New Madrid, Mo., officer in charge of the Advanced Trauma Life Support section of the 934th Forward Surgical Team, looks for possible injuries to an Afghan patient upon his arrival at Forward Operating Base Sharana Sept. 9. Norris and the 934th FST provide traumatic life, limb or eyesight care to coalition force units, local nationals, Afghan National Security Force members and anyone else affected by the actions of war, regardless of how or by whom they were hurt. Normally a mobile unit, the mission of the 934th FST, an Army Reserve unit from Salt Lake City, has changed from following units on the battlefield to a support role inside the base, where they standby ready to assist patients as necessary. The FST is the first point of treatment after a casualty (ground) or medical (air) evacuation has been performed. Since they arrived in country, members of the 934th FST have been augmented by both Air Force personnel and U.S. Army critical care nurses in an attempt to further improve the quality of care given to patients from the point of injury until they arrive at a full support hospital. Norris is stationed at Hanscom Air Force Base, Mass., where she is a pediatric nurse. (U.S. Air Force photo by Master Sgt. Demetrius Lester)
PAKTIKA PROVINCE, Afghanistan - Members of the 934th Forward Surgical Team assess two Afghan patients upon their arrival at Forward Operating Base Sharana Sept. 9. The 934th FST provide traumatic life, limb or eyesight care to coalition force units, local nationals, Afghan National Security Force members and anyone else affected by the actions of war, regardless of how or by whom they were hurt. Normally a mobile unit, the mission of the 934th FST, an Army Reserve unit from Salt Lake City, has changed from following units on the battlefield to a support role inside the base, where they standby ready to assist patients as necessary. The FST is the first point of treatment after a casualty (ground) or medical (air) evacuation has been performed. Since they arrived in country, members of the 934th FST have been augmented by both Air Force personnel and U.S. Army critical care nurses in an attempt to further improve the quality of care given to patients from the point of injury until they arrive at a full support hospital. Upon arrival to the facility, each patient receives a thorough examination by a specialized team of medical technicians, doctors and nurses to identify and diagnosis the patient in an attempt to expedite treatment before further interventions or movement of the patient can be initiated. (U.S. Air Force photo by Master Sgt. Demetrius Lester)

Sunday, August 22, 2010

This summer has been a busy one for us in Afghanistan. There's been some good experiences, though, and opportunities to help many. We've had a young boy who came to us early in July after having his leg run over by a tractor, and has returned many times since for follow-up care. He's about 5 years old, and everyone loves having him around. He's already learning several key phrases in English: Hi, bye, and "Wazzup!", as well as the important cultural hi-five and hand shake. He got a hold of an interpreters helmet, and took a few minutes trying to figure out the chin strap. After a little help, his whole attitude changed and he just looked around, as if seeking everyone's approval of his new apparel.











This of course needed to be recorded.











We recently got three in-flight critical care nurses, who will fly on the blackhawks with our patients up to the hospital in Bagram. They've been helping out in the ICU, which has been great. Below is a picture of two Blackhawks that are taking a patient of ours away.





Other than that, we've just been working hard. Thanks everyone, for your thoughts and prayers. And thank you all who help support our troops who go out every day, prepared to sacrifice everything for our country.

Friday, June 18, 2010

More pics from Ssg. Carrico


"Our trauma center and the crew that made the sign. They are from west virginia."


"The turtle was our mascot"

"Chata is one of our patients"

Saturday, June 12, 2010

Monday, May 24, 2010

Mustache May


For the month of May the 934FST had "Mustache May." I guess this consisted of the Soldier's in the Unit growing out Mustaches. They seem pretty proud of their new facial hair.

Friday, April 30, 2010

Pictures from CPT. David Anderson


Some of the 934fst

"two best flags in the world hanging in our ATLS bay."

934fst working on two patients at the same time.

Wednesday, April 28, 2010

New Home

Picture from the plane descending into Afghanistan.

Here are some pictures of where the 934th do what they do best.


In the hospital

Wednesday, April 7, 2010

Salt Lake Tribune

There have been two articles that I know of that are on the Salt Lake Tribune website about the 934th Forward Surgical Team. If any of you have missed them, here are the links. Just click on the article title.

This is the original article that was on the front page of the paper.
Afghanistan deployment: Preparing families for battle

Here is the latest article.
G.I. Jann left E.R. nurse job at age 50 to join the Army

Tuesday, April 6, 2010


The 934th Forward Surgical Team (FST), deploying to Afghanistan, completed a two week training program at the Army Trauma Training Center (ATTC). The 934th FST from Ft. Douglas, UT is a directly reporting unit for the 328th CSH who is a part of the 2nd MED BDE. The mission of an FST is to provide lifesaving resuscitative and urgent initial surgical care in the combat zone. The ATTC training is vital for preparing FST’s to provide exceptional trauma care to save the lives of wounded Soldiers.

By: 1st LT Austin D. Adamson, Executive Officer, 934th FST.

Sunday, March 21, 2010

Our Heroes as posted on the departure ceremony announcements
March 2, 2010
1Lt. Austin D. Adamson
Lt. Jann Griffis
Cpt. David H. Anderson
Sgt. Kyle J. Jennings
Cpt. Roger A. Beaulieu
Ssg. Frederick Z. Kesler
Spc. T. Jared Black
Sgt. Christopher A. Parks
Sgt. Jeremy M. Campbell
Cpt. Robert L. Phillips
Ssg. Nathan G.P. Carrico
Sgt. Stephen A. Weaver
Ssg. Benjamin C. Chou
Sgt. Brad M. Whitesel
Sgt. KC S. Ellis
Cpt. Jennifer Ysmael
In the Salt Lake Tribune on March 3, 2010 there was a write up about the 934FST on the front page.