Air Mobility Command medevacs patients quickly with streamlined process
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The increased use of all types of aircraft is part of Air Mobility Command's streamlined aeromedical evacuation system that uses available airlift instead of dedicated airframes. The ability to use opportune airlift is the direct result of incorporating AE controllers within the AMC Tanker Airlift Control Center along with airlift controllers.
This new way of doing business debuted Sept. 25 for Operation Enduring Freedom and officials say the successful results mean better service and patient care for all military members.
Transport aircraft such as the C-130 and C-17 can now be configured to pick up and move injured patients, a task that once belonged primarily to C-9s and C-141s. Along with transport airframes, AMC plans to use aerial refueling aircraft, such as the KC-10 and KC-135, once specialized,
self-contained AE kits for them become available.
"It makes good economic sense to use our limited resources this way," said Lt. Col. Sandra Schneider, senior duty officer for AMC's AE control center here. "The AE community has spent the past three years laying the groundwork to make this happen logistically, and we're
now seeing the benefits of it for the first time as a result of performing our OEF missions."
Quicker response has come about not only from using available airlift to transport patients, but also the technology to configure the aircraft for the AE mission.
"Manufacturers built the newer aircraft like the C-17 with organic medical equipment needed to support our mission with items such as oxygen systems and electrical outlets which can accommodate ventilators and suction apparatus," said Schneider. "Litter stanchions are also onboard, though we're working to increase the number available. For the older airframes, we use portable support systems along with litter stanchions. Tankers will also use self-contained systems that have been designed, but are not in place in theater yet."
Using the variety of available airlift is just one aspect of an entire AE system makeover. While getting patients aboard the aircraft required greater interaction between the AE and aircraft schedulers in theater, additional focus has been placed on training to configure the various aircraft, and constructing a smaller, quicker initial response force package that places smaller AE and medical elements near the front lines.
Schneider, a guardsman from California's 146th Airlift Wing, deployed to Saudi Arabia Sept. 25 and while there was called to active duty for a year. While in theater she and a team of four AE controller/planners-Guard, Reserve and active duty-worked jointly with the airlift schedulers to coordinate patient movement.
"Having an AE presence right where air operations folks are building the flight plans and cargo requirements is something we've not done before. The AE teams' role was to help the logisticians and airlift planners from the Air Force, other services and allied countries understand our role and capabilities and work side by side to subsequently plan, task and execute AE missions. The end result was that we achieved efficient and timely aeromedical evacuation."
Maj. Kurt Faubion, deployed deputy commander for the 43rd Expeditionary Aeromedical Evacuation Squadron in the Arabian theater, said AE has been involved in every single "headline" event of the War on Terrorism.
"We've evacuated casualties from all of the combat operations, but combat casualties represent only a small fraction of the patients that AE evacuates," he said. "Combat injury is not the only risk faced by soldiers, sailors, Marines and airmen. The material we handle, the equipment we work with and the conditions we are exposed to all combine to potentially cause illness or injury."
Schneider said that in this war, American mass casualties may consist of 10 people or so, and that historically only a small fraction of aeromedical evacuation falls into the "life threatening" category. What keeps AE so busy are the routine and priority (needs care within 24 hours) cases. However, AE crews do continue to plan for large-scale casualty scenarios.
She said the AE community has stepped up its training programs, across reserve, guard and active duty units alike to include training on several types of aircraft. Airlift aircrews are also getting trained on their new multi-role missions. Along with additional training, the AE world realigned its force structure to streamline deploying elements from large and cumbersome to light and lean.
The old paradigm was to have a robust medical and AE presence far from the front line. But the large air transportable hospitals and Mobile Aeromedical Staging Facilities were too cumbersome and arrived too late in the deployment to respond as quickly as needed. Patients were
initially stabilized and moved to the field hospitals for surgery or advanced care, then scheduled for AE flights to established hospitals in theater or stateside after a period of recovery. Many times patients were ready to travel, but had to wait for dedicated airlift.
Now, smaller Air Force medical and AE teams deploy earlier and have the ability to care for far more seriously wounded or sick patients through early stabilization and surgery very close to the frontline. The medical crews on the ground use "backpack" medical technology, meaning they can give the same quality care as a larger hospital, but they're using lighter, leaner equipment that allows them to deploy very close to the front lines of battle. Once medical teams have cared for the patient, the co-located AE crews along with Critical Care Air Transport Teams maintain the continuity of intensive care on the first-available flight to a facility that can render even more definitive care or rehabilitation.
Brig. Gen. Bruce Green, U.S. Transportation Command's and AMC's command surgeon, said the next step for the AE community is to continue to communicate its vision, and to continue to address the shortage of airlift resources.
"Rapid evacuation of stabilized critically injured patients is the new mission. This 'targeted medical capability' cannot be achieved without full integration of air evacuation into the airlift command and control network. We have pilots, crew chiefs, doctors, nurses and medical technicians working together every day and doing a great job," said the general.
Faubion agreed that the people he's encountered in the field, working these issues hard, will make all the difference to military members who find themselves in need of medical care.
"Feast or famine is generally the nature of the operational tempo. It has been frustrating at times, because communications are difficult across long distances, and technology fails frequently. It has been tense at times, when the outcome of events isn't within personal control,
or information isn't available to support your best performance. It has been heartbreaking at times knowing in near 'real time' that lives are being lost. However, it has been exciting and rewarding overall, knowing that I have been involved in making a difference . . . I've been inspired by the hard work being done by the people I encounter throughout the theater. My movements around the theater of operations have exposed me to places and conditions that make me extremely grateful to be an American, and a member of the U.S. Armed Forces."
(FROM AIR MOBILITY COMMAND PUBLIC AFFAIRS)
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