NANGARHAR, Afghanistan — It was like a scene out of “M*A*S*H” as Airmen, Soldiers, Guardsmen, Reservists, civilians and Afghans from the Nan garhar Provincial Reconstruction Team provided assistance to the survivors of a recent suicide bombing in Jalalabad.

Tech. Sgt. Jason Williams, a mechanic for the PRT deployed out of Andrews Air Force Base, M.D., rushed into the dining facility and shouted “the birds are on their way, and there are wounded coming in.”

In a mad dash, trays, still filled with hot chow, were frantically discarded as the entire facility cleared out. The team poured out of the doors and headed for the landing zone to meet the helicopters.

Everyone used the abilities they had to assist. Even the Afghan Security Guards, which had no medical training, held tarps over patients and shooed the flies away during the two hours that the wounded lay in the 100-plus-degree heat, waiting for the ambulances to arrive.

Wounds varied in magnitude; most patients had what appeared to be bullet wounds and shrapnel. No one turned away from the blood and suffering. Everyone rolled up their sleeves and jumped in to help, regardless of skill set. Capt. Scott Carbaugh, Tech. Sgt. William Allison, Staff Sgt. Ruth Koehler, and Staff Sgt. Daniel Perry are all Air Force medics assigned to the PRT that reacted to the incident.

Sergeant Perry is an emergency medical technician assigned to the 23rd Medical Group at Moody AFB, Ga.

In addition, Army Capt. Timothy O’Donnell, civil affairs officer and Army Guard Spc. Edward Fisher, security forces member, were among the PRT-trained medical personnel, but there was also an army of qualified combat lifesavers in the crowd that were out there assisting them.

Several Reservists and Guardsmen also had medical backgrounds that came in useful during the mass casualty response.

“I was in the JOC when the initial reports came in on the explosion in Khogyani. The initial report indicated 35 local nationals were wounded,” said Capt. Gregory Rogers, operations officer.

Rogers, a Camden, S.C. native, was activated on Individual Ready Reserve status.

Carbaugh, Nangarhar PRT physician assistant, coordinated the arrival of the helicopters from the Joint Operations Center.

“Capt. Carbaugh did a great job organizing the whole thing from the JOC while keeping in contact with his medics, still rendering aid once all coordination was made,” Perry said.

Meanwhile Koehler notified the other medics that patients were coming. Perry was sent to the landing zone, Allison was positioned at the clinic, while Koehler headed to the gate to escort the ambulances to the landing zone.

“The inbound choppers radioed and said that they were bringing the routine, or less injured, local nationals here,” Rogers said. “But when they arrived, it was obvious that these patients were not routine; they were urgent surgical.”

The team was surprised when two helicopters delivered seven patients in critical condition. They had been told that they would be stabilizing walking wounded in minimal condition until they could be transported to a medical facility in Jalalabad City by ambulance.

“It had to be a sickening feeling being the only one on the [landing zone] and to pull one casualty after another off of the bird in critical condition,” said Carbaugh about Perry’s experience.

Perry took each patient off of the bird and laid them out, re-triaged them to determine their wounds. Each was riddled with holes and in dire straights.

“I was a little overwhelmed,” Koehler said. “I was in the middle of trying to escort the ambulances to the LZ, and we only had one person down there with two birds and seven patients.”

Carbaugh was coordinating with the director of health to get the ambulances to the PRT from the JOC when he heard frantic calls over the radio from his team.

“It was garbled; all I could make out was ‘we need an airway,’” said Carabaugh.

It was then that he knew something was wrong. Carbaugh headed for the landing zone to assist his team, soliciting the first sergeant to gather people to help.

“First Sergeant (John) Okerson was instrumental and was everywhere; he got the people and equipment that we needed down to the LZ,” Carbaugh said.

“The team made a huge difference,” Koehler said. “Everyone was very attentive to the patients and did everything they could to make them comfortable.”

The patients who were conscious were very appreciative and understanding, he said.

“There was blood everywhere,” Rogers explained. “We carried the patients off of the bird and put them on the LZ so that the helicopter could return to the scene and get more patients.”

“You can tell a lot about people when you put them under stress,” O’Donnell said. “The people here at the PRT passed the ‘stress test’ when it counted most.”

“It was interesting to observe the dual nature of National Guard and Reserve personnel,” Rogers said. “These folks are Soldiers when mobilized, but also possess a breadth of civilian credentials; two of them are civilian emergency room nurses.”

Capt. Timothy O’Donnell, Nangarhar PRT civil affairs and registered nurse, was returning from a mission and heard over the radio that there were wounded inbound to the PRT landing zone and went straight the site to help the medics.

O’Donnell is not assigned to the PRT in the capacity of a nurse and was out on a civil affairs mission when everything happened.

“He didn’t have to be there with us on the LZ, but he jumped off of his convoy and headed straight down there with us,” Carbaugh said. “He never hesitated and he saved lives.”

One of the most impressive actions by a medic, according to Carbaugh, was Sergeant Koehler’s response to a collapsed lung.

“Sergeant Koehler did an invasive procedure that contributed to saving his life,” Perry said. “She should be commended on her quick response and calm demeanor. We had a patient with a pneumothorax that I performed a needle decompression on to help him breathe.”

“Koehler diagnosed something subtle that is often missed in chaotic situations like this,” Carbaugh said. “Then she had the (guts) to decompress his lung and save his life, all on her own.”

Koehler said that the collapsed lung was not difficult for her to deal with, but that her greatest challenge was to stabilize a dying 10-year-old boy.

The boy passed away later that night, but Koehler and her team did all that they could to get him to the next level of care alive.

“He was in a bad way, and unfortunately there wasn’t much we could do for him” Koehler said. “The fact that all the patients got out of here stabilized and alive is always a good feeling.”

“The experience demonstrates the unique nature of the PRT mission and the experience the National Guard and Reserve personnel contribute from their civilian professions,” Rogers said. “

Because we are in a fairly stable province, we don’t always experience some of the realities of being in a combat zone; it’s reassuring to know that we have competent and compassionate medical personnel in our PRT,” he said.

“I am so proud of each and every member of this team; I could not have asked them to do any better. The best part is ... I didn’t have to ask,” said Lt. Col. Paul Donovan, Nangarhar PRT commander. “They are a giving group of highly trained and motivated Soldiers and Airmen.”

The Nangarhar PRT medics have responded to more than 20 incidents at all hours of the day and night since the team’s arrival in early March.

Civilians and military are flown through the PRT as an alternate LZ when needed until the patients can be transported to a military medical facility or to the appropriate civilian facilities for higher levels of care elsewhere.