Airmen from the 43d Aeromedical Evacuation Squadron Detachment 1 and 60th Medical Group Critical Care Air Transport Team treat simulated patients Dec. 18, 2019, on a C-17 Globemaster III from Travis AFB, CA. The 43d AES and the 60th CCATT practiced their AE capabilities during their first integrated mission. USAF photo by SrA Jonathon Carnell
Capt Ivy Ramirez, 60th Medical Group critical care nurse, treats a simulated patient Dec. 18, 2019, on a C-17 Globemaster III from Travis AFB, CA. USAF photo by SrA Jonathon Carnell
Airmen from the 43d Aeromedical Evacuation Squadron (AES)Detachment 1 perform medical operations on Lt Col Michael Earl, 43d AES Detachment 1 Director of Operations, who simulates having a heart attack to test the team’s capabilities Dec. 18, 2019, on a C-17 Globemaster III from Travis AFB, CA. USAF photo by SrA Jonathon Carnell

Full Spectrum Readiness: Aeromedical Evacuation

By Ms. Betty Nylund Barr, Staff Writer

In a previous issue of The Mobility Forum, we examined Full Spectrum Readiness as it applies to airlift operations. In this issue, we will delve into Full Spectrum Readiness as it affects aeromedical evacuation (AE).

Under normal circumstances, people who are sick, injured, or need ongoing medical services can either drive or have someone else drive them to medical facilities. At times, they may need to enlist the services of an ambulance.

In a war zone, however, or in an area that has been ravaged by a hurricane, wildfire, flood, or other natural disaster, those modes of transport may not be available. In those circumstances, AE may be the lifesaving answer.

AE began early in the 20th century—virtually as soon as fixed-wing aircraft were invented. Dr. Bruce Green, 20th Air Force Surgeon General, described how U.S. Army medical officers Capt George H.R. Gosman and Lt A.L. Rhodes designed and built the first “air ambulance” for transporting patients using their own money.[1] Its first—and last—flight occurred in 1910 at Fort Barrancas, Florida; the plane crashed after flying only 500 yards. That flight may have been unsuccessful, but it was just the beginning.

Air Mobility Command (AMC) oversees “an integral system of command and control, training, communications, staging, and patient care” and describes the mission of the Air Force’s AE System as “to provide fixed-wing movement of patients requiring supervision by AE personnel to locations offering appropriate levels of medical care.” An AE crew must be able to take care of not only the systems on a huge, highly sophisticated aircraft but also the needs of critically sick or injured people. That is where Full Spectrum Readiness is needed.

A basic AE crew consists of two flight nurses and three AE technicians. That crew must consist of Airmen who have the full spectrum of training, education, and character to meet those needs—medical, mechanical, and electronic—and who are brave enough, confident enough, and focused enough to dismiss thoughts of their safety and put the needs of their patients first.

The U.S. Air Force School of Aerospace Medicine, Wright Patterson Air Force Base (AFB), Ohio, conducts a Flight Nurse and AE Technician Course that provides realistic, hands-on simulation of possible events that AE crews may encounter. Course planners may even “seed” the training with Airmen, who create fictitious dangerous scenarios, to prepare trainees to handle all types of situations. Students must complete 40 hours of missions on a mock-up of a C-130H aircraft. Other AE courses may take place on a C-17 mock-up. Those “classrooms” simulate conditions on an actual mission, including the sounds of the aircraft engine, explosions, and crash landings. They can also simulate decompression, complete with the necessity of the students to use oxygen masks as they attend their patients.

At any time of the day or night, an AE crew may be mobilized to respond to a medical emergency, whether it involves two or twenty individuals, so they have to be ready. They have to be willing to drop what they are doing and go to the aid of others.

When military personnel become sick or wounded in combat, medics administer first aid and then typically arrange for AE to transport them to the closest hospital abroad—away from the combat zone—where they can receive the care they need. If they cannot receive the care they need abroad, AE medi-flights them to a U.S. hospital.

The following examples are just a few of the lifesaving efforts that AMC AE crews have accomplished:

  • In October 2017, three hurricanes ripped through the Caribbean in a relatively short time, leaving millions of people without safe drinking water, shelter, food, power, or a means of communicating with the world beyond their homes. The 375th Medical Group’s En Route Patient Staging System, Scott AFB, Illinois, deployed to the island of St. Croix, U.S. Virgin Islands, and picked up 100 kidney dialysis patients and delivered them stateside, where they could receive necessary medical treatment.
  • In November 2017, the 379th Expeditionary Aeromedical Evacuation Squadron, Al Udeid Air Base, Qatar, picked up sick and wounded Soldiers in Iraq and transported them to hospitals with a higher echelon of care.
  • In November 2018, a group of reservists from the 315th Airlift Wing, Joint Base Charleston, South Carolina, was in Germany waiting for severe weather to clear so they could head home to South Carolina. A call came in for emergency medical evacuation for a Soldier in Turkey who had been electrocuted and was suffering from second- and third-degree burns on 40 percent of his body and also had a broken femur. “There was not one hesitation; the entire crew stepped up,” according to Capt Dennis Conner, the mission’s aircraft commander from the 701st Airlift Squadron, Charleston AFB, South Carolina. “They put their civilian lives on hold to do this; they missed work and school to get him home.” The team successfully delivered the injured Soldier to Texas after a brief refueling in Boston.
  • In August 2019, AMC’s 618th Air Operations Center (AOC), Scott AFB, Illinois, learned of a severely wounded Soldier at Bagram Air Base in Afghanistan who urgently needed aeromedical evacuation. The AOC devised a mission called REACH 797 to get that soldier to needed care.

Regardless of the location or danger, Airmen on an AE team are always ready, willing, and able to risk their lives to help save other people’s lives. Day or night, winter or summer, rain or snow, these critical Airmen answer the call!

[1] Green, Bruce. “Challenges of Aeromedical Evacuation in the Post-Cold-War Era,” Aerospace Power Journal 15, no. 4 (Winter 2001): 14ff.