The blast from an improvised explosive device tore his trachea, damaged his cervical spine, resulted in an open eye injury and fractured his tibia.

The 34-year-old sailor was left with a 2 percent survival rate following the detonation of the IED he was attempting to clear during an operation in Syria, according to Air Mobility Command.

The severity of his injuries “were massive,” said Maj. Joshua Hamilton, a Critical Care Air Transport Team physician.

“Many of us were shocked he survived the initial injury,” he added.

Hamilton and other members of the Critical Care Team began performing an emergency thoracotomy — a surgical procedure to open the chest cavity — in order to manually massage the sailor’s heart while they waited for a C-17 from Joint Base Andrews, Maryland.

Critical Care Teams consist of physicians, intensive care nurses and respiratory therapists. Together, they’re able to turn regular medical transport flights into intensive care units, increasing the chance a wounded service member survives their injuries.

“Our team receives specialty training to allow us to provide critical care delivery to patients in austere environments,” Hamilton said. “We are able to arrive at a location and assemble ICU level support, as well as provide intensive care in the air throughout the flight, and deliver the patient to other facilities for ongoing care.”

Maj. Andrew Vandertoorn from the 452nd Air Mobility Wing, March Air Reserve Base, California, commanded the C-17 performing the air evacuation.

“At the time, we were preparing for a contingency mission to Al Udeid Air Base,” Vandertoorn said. “When the crew got the call, we sprung right into action. We knew how serious this mission was and started making the right decisions to make this mission a success.”

Once the patient was in the air, the severity of his injuries required a unique flight plan.

“We were restricted to a cabin altitude of 5,000 feet, meaning we had to maintain an altitude of 28,000 feet,” Vandertoorn said. “This meant we burnt more fuel, were subjected to different routings and encountered more adverse weather.”

Mid-flight, diplomatic concerns prevented the crew from transgressing Turkish airspace. They were forced to skirt around the Black Sea, avoiding Turkish authorities altogether, according to Capt. Tim McCammon, who was coordinating flights between Germany and Baghdad.

“There was some discrepancy between our actual diplomatic clearance number for overfly and the one given to the Turkish authorities,” McCammon said. “This was a frustrating ordeal because we knew this mission was extremely time-sensitive and could literally mean the difference between life and death of a service member.”

While the aircrew navigated international airspace, the medical team kept working on the patient. A specialized tool — called an Extra Corporeal Membrane Oxygenation pump — was used to keep the oxygen circulating throughout the patient’s body.

“ECMO provides support to the body and compensates for lungs that are not adequate to bring oxygen into the body or take away the carbon dioxide the body produces,” Hamilton said. “Even with the restricted cabin altitude of 5,000 feet, without ECMO, the patient would not have survived the trip.”

The level of care Hamilton and his team were able to provide is “something that can happen in no other military force on the planet,” he said.

“This mission embodies the hopes we all have as we chose military medicine over civilian practice,” he added. “To serve those injured protecting our country is the highest calling.”

Despite the long hours, and brutal conditions faced during a regular day of work, “it’s a mission like this that reminds you why you do what you do,” McCammon said.

Kyle Rempfer was an editor and reporter who has covered combat operations, criminal cases, foreign military assistance and training accidents. Before entering journalism, Kyle served in U.S. Air Force Special Tactics and deployed in 2014 to Paktika Province, Afghanistan, and Baghdad, Iraq.

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