On the final day of PA week we would like to highlight the efforts of those in deployed locations and one of the unique roles Aeromedical PAs serve.
Maj Brandon Mondfrans
42 G Operations Officer
Major Stephan Kesterson is a Physician Assistant, currently serving as Chief, Expeditionary Medical Support and Training, at the Air Force Medical Readiness Agency, Falls Church Virginia. In 2019, he deployed in support of Operation Octave Shield, leading a Role I clinic at the remote cooperative security location, Manda Bay, Kenya (Camp Simba). As the Senior Medical Officer and sole healthcare provider, Major Kesterson oversaw care across four joint commands, including Military Working Dog (MWD) support. From infectious and tropical disease surveillance to activating ACLS protocols, he evaluated a broad spectrum of disease and non-battle injuries (DNBIs), to include critically ill or injured situations requiring immediate medical evacuation.
Upon arrival, he prioritized fostering host-nation and mission partner relationships in order to “organize, train, & equip” additional ancillary and medical support. Furthermore, he identified vulnerabilities to the camp, implementing TCCC training, and recruiting personnel for more advanced Combat Life Saver and Walking Blood Bank skills application.
On 5 January 2020, Major Kesterson’s efforts and capabilities were tested when Al Shabaab conducted a synchronized, complex terrorist attack on the compound and airfield, resulting in multiple casualties and the loss of three American lives. In recounting his experience, Major Kesterson stated, “We emphasize Trusted Care throughout the MHS. Going into this deployment knowing the challenges our medical team would face, it became apparent that Trusted Care starts with trusting each other”. He credits the collaborative effort of both organic and inorganic medical assets for the care, prolonged stabilization, and evacuation of critical casualties. “From the initial response to recovery efforts, extraordinary people performed extraordinary tasks; and when you define readiness, it comes down to both the willingness and ability to perform those tasks”.
Following the attack, Major Felipson Ramos, the 822nd Base Defense Squadron’s Medical Flight Commander and fellow PA, arrived at Manda Bay. He provided additional medical support and Operational Medicine experience.
Major Ramos was the architect behind pioneering Manda Bay’s trauma bay and TCCC sim lab as well as the first disease containment tent in response to the COVID-19 pandemic. Together Major Kesterson and Major Ramos built and equipped a geographically separated full mission capable aid station to handle outside-the-wire-patrols’ casualty care and routine sick complaints. Additionally, the two assisted with host nation MASCAL & surgical support (instrumental in launching a stored whole blood bank within the AO).
Finally, PAs Kesterson and Ramos were highlighted by AFRICOM for paving virtual Clinical Laboratory Improvement Program certification on the BioFire Polymerase Chain Reaction system, which allowed forward locations, throughout the continent, to test any patient with COVID-like symptoms.
As we celebrate National PA Week, it’s important to recognize Majors Kesterson and Ramos’ efforts. These PAs exemplify the AFMS’s strategic objective to “Evolve for Tomorrow”, reminding us the necessity to adapt ourselves as a ready medical force in any contested environment. #PAsdothat
Major Nathaniel Beaty is currently an Aeromedical Physician Assistant (APA) assigned to France E. Warren AFB, Cheyenne Wyoming. While his primary duties are Flight Commander of the Warrior Operational Medicine, Personal Reliability Program and Flight and Operational Medicine clinics, he also serves as a mission crew member for the bases’ Search and Rescue (SAR) Team. The SAR team covers the Tristate area of Wyoming, Nebraska, and Colorado and is trained on techniques such a rappelling and providing emergency medical care in austere locations.
On one recent rescue mission, Major Beaty was patched through to helicopter ops by command post at 0400. Apparently a hunter had gone missing and flight medicine was being activated to support the rescue. He was advised that crew brief would begin at 0600. This gave him little time to get ready, grab his go-bag, meet up with his enlisted teammate, and inventory their SAR equipment. Once they were ready to go, they began to run through possible scenarios based on what little information the local Sheriff had given the operations desk. They knew the hunter was in rough terrain and it had snowed the previous night. The crew was concerned about trauma, hypothermia due to exposure, and the possibility of a body recovery. Based on these scenarios, Major Beaty advised the aircrew on likely injuries, the location of the nearest trauma center with the right capabilities, and what he may need during flight. Collaborating with local civilian officials and civilian search and rescue members, Major Beaty and his team were able to successfully locate the lost hunter and return him to safety.
As we celebrate National PA Week, it’s important to highlight the accomplishments of the over 100 men and women who serve as Aeromedical PAs. This vast specialty operates in multiple arenas and is tasked to serve the many operational needs of the Air Force. Without these providers, AFMS’s mission to provide medically ready Airmen and ready Medical Airmen would be greatly diminished. #PAsdothat