The U.S. Army Burn Flight Team has transported patients twice from Singapore back to the U.S. Army Institute of Surgical Research at Joint Base San Antonio – Fort Sam Houston, Texas, and both flights resulted in record-breaking missions.
The Burn Flight Team is a five-person team that flies burned military personnel from anywhere in the world back to the USAISR Burn Center, which is the only burn center servicing the Department of Defense. A team consists of a burn surgeon, a critical care registered nurse, a licensed vocational nurse, a respiratory therapist and a forward operations noncommissioned officer. Four teams rotate call, so that two teams are always ready to deploy.
The team’s first mission to Singapore, on Feb. 22, 2013, was the longest nonstop flight in the team’s history. Because of the patient’s critical status, the Air Force critical care transport team operating the C-17 Globemaster III refueled inflight, allowing the Burn Flight Team to get the patient to the burn center as soon as possible.
“They have a hook up in the front, and then a little fueling plane flies ahead and lets out a little cable, and they have to connect them,” said Sgt. Matthew Anselmo, NCO in charge of the burn team. He is a respiratory therapist who worked as the rear operations NCO for that particular mission.
The team flew for 19 hours straight over 9,850 miles to bring the patient home. As the Burn Flight Team is not part of the plane’s crew, they are not afforded crew rest. But the team members said they didn’t mind the exhaustion. Getting their fellow service member back home safely was the only thought in their minds.
The second and only other time the flight team transported a patient from Singapore was Nov. 9, 2015. This flight also resulted in a record-breaking mission, but for a different reason. It was the first time the team used a kidney dialysis machine to provide continuous renal replacement therapy inflight.
The patient, a Marine who had suffered severe electrical and thermal burns, was experiencing kidney failure, and would not have survived the flight without the procedure, said Staff Sgt. Daniel Zimmerman, the NCOIC of the team at that time and the respiratory therapist on the flight.
Continuous renal replacement therapy, or CRRT, is similar to regular dialysis in that it removes blood, filters it and then replaces it back in the body. It is different, however, in that it is a slow, continuous process. Because CRRT pulls blood at a slower rate, it does not disrupt the patient’s hemodynamics.
“Without CRRT, that patient would have had to stay at that remote hospital, being treated in another country,” said Staff Sgt. David Shelley, a licensed vocational nurse and assistant NCOIC of the flight team. “So the medical director decided we needed to do what it takes, get this service member to the best place in the military to treat burns, and we made it happen.”
“We are always ready,” Zimmerman said. “I was the NCOIC at the time and the only respiratory therapist on the team, so I was basically on call for two years straight. When you get that call, it’s exciting.”
And this time, the team members knew the flight would require them to use equipment they had never before taken on a flight. The team now considers CRRT part of its capabilities and has dedicated transport equipment, but on that flight, the team used equipment from the intensive care unit.
“Everything went as planned in so much as we had never done the CRRT before,” Zimmerman said. “We weren’t sure what complications we were going to run into, but it was overall a pretty uneventful flight, and that is definitely a success.
“Every successful mission comes with a very rewarding feeling,” he said. “To go pick up a critically injured service member who really needs attention that they can only get in the ISR in our unit, to be able to get them back here safely and see them get better — it is a very rewarding feeling.”
Noncommissioned officers play a crucial role on the U.S. Army Burn Flight Team, which is prepared to fly any time, anywhere to transport burned military personnel to the U.S. Army Institute of Surgical Research Burn Center at Joint Base San Antonio – Fort Sam Houston, Texas.
During the height of the War on Terror, the flight team would routinely meet injured service members at Landstuhl Regional Medical Center in Germany. Since the drawdown of the war, however, flight team members will tell you that the frequency of calls has slowed significantly and that every mission is unique.
Since the 1950s, the team has successfully transported service members suffering from both combat- and noncombat-related burns back to the United States from far-off locations including Honduras, El Salvador, Argentina, Norway, Japan, Korea, Guam, Vietnam and Singapore.
“As soon as we get notice of the mission, the team pulls together,” said Staff Sgt. David Shelley, a licensed vocational nurse and assistant NCO in charge of the flight team. “We want to get there as fast as possible and make sure we have the ability to take care of that service member. There is just that drive to make sure everybody comes home safely and gets the best care possible.”
Roles of the NCO team members
The flight team is composed of active duty Soldiers and DA civilians who work daily in the Burn Intensive Care Unit at the U.S. Army burn center, which is the only burn center servicing the Department of Defense.
A team consists of one burn surgeon and one critical care registered nurse, both officers, and one 68C licensed vocational nurse, one 68V respiratory therapist and a forward operations NCO. A rear operations NCO also assists the team from Fort Sam Houston. Four teams – about 20 personnel – rotate call, so that two teams are on call and deployable at all times.
Both the vocational nurse and respiratory therapist positions are filled by NCOs. The vocational nurse provides wound care to the patient during the flight and works closely with the surgeon and other nurses, while the respiratory therapist manages the ventilator and everything related to the patient’s airway and lungs.
“The nurses and doctors are all concentrated on wound care and the other aspects of the patient’s health, and we (the respiratory therapists) are pretty much on our own there,” said Sgt. Matthew Anselmo, a respiratory therapist and NCOIC of the flight team. “We manage our ventilators. If the pressure changes, we change the ventilators as we see we need to. We are the only ones who can manage the ventilators as we do. Nurses and doctors are trained on basic ventilator management, but [respiratory therapists] are really needed in this situation because of the specialized equipment and circumstances.”
The forward operations NCO, usually either a vocational nurse or a respiratory therapist, is responsible for getting the team from point A to point B and makes sure all of the equipment traveling with them gets there and back. The rear operations NCO stays behind in San Antonio to act as liaison between the flight team and the Institute of Surgical Research leadership during the mission. The rear operations NCO is also responsible for providing the team with logistical support during the flight and arranging transportation from the airport for the team and the patient once they return. The forward and rear operations NCOs work together to make sure the team has everything it needs and to ensure the logistics of the mission run as smoothly as possible.
“The forward operations NCO is really coordinating the entire movement, and they are responsible for accountability and really every aspect of the team’s movement from when we leave here in San Antonio to wherever we arrive, getting to and from the hospital and getting back,” said Staff Sgt. Daniel Zimmerman, a respiratory therapist. “The forward ops and rear ops are constantly dealing with all levels of command. Some of our missions are very high visibility; sometimes they go all the way to the Secretary of Defense for approval. Communication is key to our missions, and the operations folks have to handle all of that.”
The team’s NCOs are offered frequent opportunities to use their leadership skills in unique ways, Zimmerman said. The NCOIC in particular is responsible for training and teambuilding exercises for a team of mostly officers, and all of the NCOs are involved in setting up that training to make sure the team stays current on certifications and is familiar with the different types of equipment they may need to use.
“The NCOIC is responsible for the training and the readiness of this team that is mostly officers,” Zimmerman said. “It can definitely be challenging to have influence over people you really don’t have authority over. So it is definitely about tact and mutual respect, team building, gaining the confidence of everyone. Everyone on the team is very professional. It normally runs pretty smoothly, but it can be intimidating.”
Bringing them home
Team members have regular jobs providing daily care to patients at the hospital. But once they get that text message notifying them of a mission, they have two hours to be ready to fly. The forward and rear operations NCOs quickly get to work arranging transportation, because their goal is to have the team in the air within six to eight hours.
The five-member team travels to the patient’s location on a commercial flight, bringing with them eight large cases of specialized equipment, each weighing about 70 pounds. The forward and rear operations NCOs coordinate with the Air Force through the Theater Patient Movement Requirements Center to arrange the team’s travel back on the nearest C-17 Globemaster III, which is operated by an Air Force critical care air transport team.
“You fly there, you have all of this adrenaline, excitement, nervousness, going through the steps A, B, C of what you need to look out for on this particular patient,” Shelley said. “We get an outlook of what the patient’s picture is, so we always have that in the back of our minds. It’s important to try to calm yourself down and get the rest you can get, because there will be no sleep on that long flight back.”
As soon as the patient is ready, they begin the journey home.
“I think the biggest feeling we have once we leave ground is of being … alone,” Anselmo said. “You know, once you are in the air, it’s your team. That’s all you’ve got. There is no one else who can help, especially when you are over the ocean.”
Because of that, the team is prepared for anything and everything to go wrong. Elevation affects patients’ blood pressure levels and airway pressures, and any movement brings some sort of risk. The team monitors all of those things as well as the patient’s hydration and temperature, which are key to the healing process.
As soon as they land, they are met by the rear operations NCO and other team members who were not on the mission to help load the patient into the ambulance and then get the equipment back to the hospital, break it down, clean it, restock and make sure everything is ready to go again.
Getting into this line of work
Shelley initially came into the Army as a 68W combat medic. Anselmo began as a 19K M1 armor crewman. Both of them, like many of their fellow NCOs, changed their MOSs and were eventually assigned to the Institute of Surgical Research.
“As soon as I found out I was coming here, one of my main goals was to get on the flight team,” Anselmo said.
A year of experience in the Burn Intensive Care Unit is required for vocational nurses and respiratory therapists to be considered for the flight team. Both Shelley and Anselmo said it takes a lot of work to ensure you have the needed capabilities.
“For example, we use different ventilators up here that really no conventional ICU would use, so it takes a lot of training,” Anselmo said. “It just works with pressure – it doesn’t give you any numbers, so you really have to know what you are doing with it before you take it in the air.”
All of the extra work is worth it, Shelley said, because working closely with a small group like this is an opportunity unlike any other.
“To have such an impact around the world for fellow service members is amazing,” Shelley said. “That’s why I got into the medical field – to help other service members, and it’s been great to be there in their critical time of need and to provide such a high level of care at the top of my scope of practice.
“I hope other NCOs learn that the Army has this type of capability,” he said. “Respiratory therapists and vocational nurses – or even medics looking to become one of those MOSs, if this is the route that they want to go, they should work hard to hone their skills in a critical-care sense. It’s an amazing chance to grow as a leader and as a clinical expert. They will have to work hard, but the opportunity is here.”
The ceremonial splendor on display during inaugural festivities never fails to transfix the Soldiers of The U.S. Army Band “Pershing’s Own,” whether it’s their first presidential inauguration or their sixth. The band’s noncommissioned officers fully understand their responsibility in representing the Army and their fellow Soldiers on that global stage.
“When we put on that uniform, we want to make sure that we are representing Soldiers absolutely the best we can,” said Sgt. Maj. Jerry J. Amoury, the senior enlisted leader for The U.S. Army Concert Band. “We provide musical support and we represent the Army, but are also there to represent our brothers and sisters in uniform. If there is an NCO who is downrange and they see us marching [in the inauguration parade], I want them to know that we think about them when we put our uniform on.”
Tradition dictates that the 99-piece band, which is made up of members of the Ceremonial Band, Concert Band and the Army Blues jazz ensemble, lead the official Presidential Escort down Pennsylvania Avenue in Washington, D.C., from the Capitol to the White House parade reviewing stand. The band has held the honor since March 4, 1925, during President Calvin Coolidge’s second inauguration. Joining “Pershing’s Own” in this celebrated custom are honor platoons from every branch of service and Maj. Gen. Bradley A. Becker, the commanding general of the Military District of Washington.
At the reviewing stand, another team from “Pershing’s Own” takes over. The U.S. Army Herald Trumpets are ready to welcome the new president to the White House by playing the famous “Hail to the Chief” anthem.
On Jan. 11, then President-elect Donald J. Trump sung the band’s praises during a news conference.
“I look very much forward to the inauguration,” Trump said. “It’s going to be a beautiful event. We have great talent, tremendous talent, and we have all of the bands … from different segments of the military. And I’ve heard some of these bands over the years. They’re incredible.”
The elite musicians perform in countless high-profile events for the Army during their careers and are seasoned professionals. Major events such as the inauguration give the band’s NCOs an opportunity to bring their leadership training to the forefront.
“Any training opportunity is a great opportunity for an NCO because that is what we do: We train, we educate, we prepare the future of the Army,” said Sgt. Maj. Julian R. Ayers Sr., the band’s drum major. Ayers performed at his fifth inauguration Jan. 20. “These experiences certainly help me to figure out how I can be a better leader. The way I see my role, the band is outstanding, all I need to do is provide Soldiers with the avenues for success. I try my best not to get in their way and give them all the information that they need. Then I let them fly, and I just stand up in the front and dance and do my thing.”
After 27 years in the Army and performing in five inaugurations, Amoury said Trump’s inauguration would be his last. Amoury said he has used such events to impress upon Soldiers the importance of how much their participation matters.
“I have told this to many people over my years: You don’t think that what you are doing is important, but you are going to get that phone call from an aunt or an uncle or an old teacher or someone in your town saying, ‘I saw you do something,’” he said. “We just did something for the CBS This Morning show a couple months ago. [CBS This Morning’s] Charles Osgood retired, and he is a former member of the Army Band. I can’t tell you how many calls I have received. An old trombone teacher said, ‘I saw you on television.’ It’s not me, it’s the organization.
“And so as an NCO you really are actually doing something that’s going to be remembered,” Amoury said. “You matter, and sometimes you don’t get that feeling as an NCO because you are always answering to other people. You are more of an enforcer, less of a planner. I have been lucky because I have had a lot of great NCO mentors in my career who have done that for me. I just hope to pass that [knowledge] on to my peers and my colleagues, the people who are going to replace me. It’s all about setting up your replacements for success because my replacement is already in the building somewhere. So if I am not preparing those folks to do my job, then I fail as an NCO.”
Whirlwind of activity
Members of “Pershing’s Own” began preparing for the inauguration well before the main event. One of the many rehearsals included a full-dress rehearsal of marching down Constitution Avenue in Downtown Washington, D.C., in the early morning hours the Sunday before Inauguration Day. In between other rehearsals, band members also performed a number of gigs, which included Army ceremonies for members of the Cabinet. The day before the inauguration, “Pershing’s Own” was tasked with opening the Making America Great Again Concert at the Lincoln Memorial.
Performing at many high profile events never loses its luster for Staff Sgt. Sidonie H. Wade, who performed at her first inauguration.
“Being in the Army, we are able to participate and be a part of history every single day, which is extremely cool,” Wade, a percussionist in the band, said. “Living in the District of Washington and working in the military district of Washington, there’s just so much history happening all the time. History is being made on a daily basis in the Army, and it’s really cool. It’s really humbling.”
Some members of “Pershing’s Own” even took part in the pre-planning of the inauguration, working with the Presidential Inaugural Committee and the Joint Force Headquarters – National Capitol Region leadership. Amoury served as a planner for President Barack Obama’s second inauguration in 2013.
The PIC, a private organization, is one of three entities who take charge of inauguration festivities and celebrations. The Joint Congressional Committee on Inaugural Ceremonies plans the swearing-in ceremonies of the president-elect and the vice president-elect. The Joint Force Headquarters – National Capitol Region is responsible for planning military support for the inauguration and many of the parade logistics. Lastly, the PIC is in charge of planning and funding all of the events surrounding the swearing-in ceremony.
“The inauguration is a very coordinated, cue-driven event,” Amoury said. “I was a supporter for the music playing lists of the ceremony, so I got to see a different side of it.”
Ayers hopes “Pershing’s Own’s” performance inspires NCOs watching events such as the inauguration.
“I want them to appreciate and understand the importance of Army music,” he said. “Military music has such a great importance in the lives of the American people.”
As Amoury gets ready to transition, he has many past performances with “Pershing’s Own” upon which to reflect.
“The thing about being in this job is that I have a lot of these [memories],” Amoury said. “Being in front of people who are world leaders or people who are global opinion leaders, and you are there ─ a trombone player ─ standing in the White House. It’s kind of ludicrous to think, ‘Well, what am I doing here?’ but the job requires my presence. I get to see people who are impacting lives all over the world. To see American government, an American leadership working, and living and talking, people don’t see that very often. These are real people doing real jobs, and it’s not frivolous. They take it seriously, and we get to see that a lot. It’s exciting, and it’s humbling. That’s the stuff I always take away from these kinds of jobs ─ the energy, the moment.”
Being a part of the renowned 3rd U.S. Infantry Regiment (The Old Guard) affords many Soldiers unparalleled opportunities on a global stage. For Sgt. 1st Class Christopher G. Taffoya, platoon sergeant for 3rd Platoon Honor Guard Company, it was an opportunity to perform in his second inauguration in an honor guard cordon – this time, as noncommissioned officer in charge of the ceremonial unit.
Taffoya was in charge of a six-man cordon, which serves as an official escort, for President Donald J. Trump at the Capitol before his presidential swearing-in ceremony Jan. 20.
“We are the first Soldiers that he interacts with, which is really cool,” Taffoya said. “It’s just six Soldiers and me.”
It’s a pretty big deal to the NCO from Montclair, California. His first inauguration was President George W. Bush’s second in 2005, where Taffoya served in an honor cordon for the entire day.
“It’s a big deal to me, being just a kid from California coming from an extremely modest upbringing,” Taffoya said. “And then to be in two presidential inaugurations, making that history, just for my family alone, is really awesome. But to be [a part of] the representation of the free world, showing the world that this is what right looks like. This is how you change power. It’s just really cool. It’s a big thing, and it’s not something I take lightly.”
More than 2,000 Soldiers from the Old Guard were tapped to support the 58th Presidential Inauguration. The Old Guard’s Presidential Salute Battery, the Fife and Drum Corps, as well as Army cordons were among the performers. Service members participating in the inauguration represent a joint force, which includes Soldiers, Marines, sailors, airmen and Coast Guardsmen.
Every Soldier from the Old Guard who has a role in the presidential inauguration has a responsibility to get every detail right.
“The magnitude of the operation was immense,” Old Guard commander Col. Jason T. Garkey, told Army publications. Garkey participated in President Bill Clinton’s second inauguration in 1997 and Bush’s second one in 2005. “In previous inaugurations, I participated in specific parts, but as the regimental commander responsible for Joint Task Force Ceremony, I had visibility on every detail involving the regiment.”
Garkey was pleased with the inauguration planning.
“The complexity and amount of detail developed into the plan was extremely impressive,” Garkey said. “The seamless integration of our ceremonial and contingency tasks capitalized on every aspect of the regiment. It validated everything we have worked toward since this past summer.”
The military’s contributions to the presidential inauguration have evolved into a centuries-old tradition. The U.S. military has participated in inaugurations since April 30, 1789, when members of the Army, local militia units and Revolutionary War veterans escorted President George Washington to his first inauguration ceremony at Federal Hall in the nation’s first capital in New York City.
Taffoya takes pride in the Old Guard’s historical role in such a momentous event like the inauguration.
“One thing in common through all 58 inaugurations is … us ─ from the start with President George Washington until now,” Taffoya said. “The Old Guard has always been a part of inauguration. We have been a part of that foundation, and America has seen us. To be part of that representation is a big deal. It’s an honor. Just being in the unit is cool, but to be able to have the president 1 foot from you, passing you by and being able to render honors to him is just surreal.”
Every NCO in the Old Guard strives for perfection in performing ceremonial duties, and discipline is necessary to serve. Soldiers in the Old Guard must pass the demanding Regimental Orientation Program, a three-week course designed to teach new arrivals the subtle distinctions of the uniforms of the Old Guard, rifle movements and marching that is unique to the elite precision unit. Maintaining ceremonial composure is critical to the unit’s Soldiers.
“My discipline didn’t start when I showed up to the Old Guard,” Taffoya said. “It started with my first squad leader, who instilled the discipline in me as a Soldier in 2002. I do the same for my Soldiers. Whether it’s here or at Fort Campbell, Kentucky, the one thing that carried through is discipline and enforcing it as an NCO.
“That’s the biggest thing because everything else is a breakaway of discipline,” he said. “You could have all of the Army Values, but if you don’t have the discipline to use them or to implement them, you don’t have any of them. We in the Old Guard take it seriously because we are representing our Army. If we don’t represent the Army right, then we are not doing Soldiers justice, whether we are deployed in Iraq or Afghanistan.”
NCOs such as Taffoya recognize that all of the painstaking attention to detail at the Old Guard helps make for better leaders.
“You have to be on your game,” he said. “This is like our Super Bowl. It comes once every four years, so it’s all hands on deck. A lot of the whole regiment is bringing their ‘A’ game so you don’t want to be that one guy who doesn’t bring his and ends up being the sore spot. I appreciate my subordinates, my squad leaders and team leaders … [because] they know what this involves. They understand that they, too, are making history for their families and legacies.”
When the 3rd U.S. Infantry Regiment (the Old Guard) began to gear up for its role in the 58th Presidential Inauguration, all Soldiers knew the meticulous preparation necessary called for all hands on deck. So, the Soldiers of the Presidential Salute Battery and the Caisson Platoon trotted out their big guns and elegant horses and set about getting them ready to take their traditional spots in one of the nation’s most celebrated parades.
The PSB, which was founded in 1953 and is the only unit of its kind in the Army, fires cannon salutes in honor of the president, visiting foreign dignitaries and official guests of the United States.
Ceremonies require a five-man staff and a two-man team for each gun. The staff consists of the battery commander, who initiates fire commands and ensures the proper number of rounds is fired; the sergeant of the watch, who marches the battery into position, controls the firing of the backup gun, and monitors the watchman and his assistant; the watchman controls the timing between rounds and gives the command to fire; the assistant watchman ensures the watchman stays in time; and the counter counts the rounds and signals the last round to the battery.
The cannons have been fired at presidential inaugurations and state funerals since President Ronald Reagan’s administration, said Sgt. Cody L. Grunwald, an assistant watchman.
“Our number one task is to give the president his first 21-round gun salute,” said Sgt. Jordan Goodman, escort officer. “It is the highest honor that we can render to the president.”
The battery will use four vintage, 75mm, anti-tank cannons from World War II mounted on the M6 howitzer carriage.
“It’s an honor to lead the Soldiers onto the battery for the Inauguration,” said Staff Sgt. Eric Wintzell, the noncommissioned officer in charge. “This is one of the reasons I came to the Old Guard, so that I could render honors to our president.”
Caisson Soldiers also take great preparation for their moment in the inauguration spotlight. Preparing the horses for the festivities often begins in the early morning hours, when Soldiers shine brass and perform horse grooming duties.
“We want to show the public that units like ours are still in existence,” said Staff Sgt. Jonathan English, operations sergeant of the Caisson Platoon. “We are the last full-time equestrian unit. So, it’s important to represent not only ourselves, but the Army as a whole.”
Seeing the Soldiers on their elegant and disciplined horses take their place among the military pageantry often wins the Caisson Platoon many adoring parade fans.
“Proud to have the Caisson Platoon, home of the army’s oldest and most famous horse, Black Jack, take part in Inauguration Day 2017!” tweeted then President-Elect Donald J. Trump on Jan. 2.
Caisson Platoon Soldiers are thankful for the opportunity to render military honors to the new president in the national spotlight.
“All of our Soldiers are excited to be serving in the parade,” said Cpt. Austin Hatch, Caisson Platoon leader. “Whether we are on the side walker detail, helping prepare the horses and tack, or riding in the parade, we are all honored to serve.”
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