By Col. Kevin J. Keehn, 108th Operations Group
/ Published November 06, 2011
JOINT BASE MCGUIRE-DIX-LAKEHURST, N.J. -- The 108th Wing flies in support of numerous higher headquarters missions such as airlift, air refueling, coronets and various exercises.
The aforementioned missions are demanding and fulfilling for the flight crews to accomplish. But no mission we are tasked to do is more fulfilling and demanding of the flight crew's skills than of the medical air evacuation missions, or medevacs.
The medevac mission first came to the KC-135 community in 2003 when the Air Force began to phase out the C-9 aircrafts. And the 108th WG flew its first medevac flight into the CENTCOM area of operation (AOR) in December 2007.
The mission typically begins with the aircraft departing from McGuire Air Force Base for a short flight to Andrews Air Force Base, Md. While at Andrews AFB, the aircraft is refueled and reconfigured into its medevac configuration. Starting from the front of the cargo compartment and going aft, this configuration consists of three patient support pallets which provide 15 litter spaces, four airline seats and nine regular passenger seats.
Once the aircraft is configured, it will depart to Ramstein Air Base, Germany, where the flight crew will remain for 12 days and fly four to five missions into the AOR. Upon arrival at Ramstein AB, the flight crew receives an intelligence briefing, and is then put into crew rest while they wait for their first mission. Also, at Ramstein AB, the KC-135 flight crew will meet the medical personnel that will fly with them on their missions into the AOR. The medical crew, led by the medical crew director, is made up of seven people consisting of flight nurses, charge medical technicians, and air evacuation technicians.
One of the major differences between a medevac mission and a regular mission is that there are really two commanders in the aircraft during a medevac. On any other mission the aircraft commander is in charge of the entire aircraft. The commander has the final say on everything that occurs at both front and back of the aircraft. On medevac missions, the aircraft commander works in conjunction with the medical crew director on decisions involving all areas other than aircraft safety. In matters of patient care the medical crew director decisions are final.
The mission out of Ramstein AB is a six-and-a-half-hour flight, which takes you over Eastern Europe, the Black Sea and down into the CENTCOM AOR.
The arrival and departure in to the AOR occurs during darkness to minimize any surface to air threat the crew may encounter. Both the airfields and the terrain surrounding some of the airfields can also pose a threat. Some mountains are up to 12,000 feet in elevation, and many of the airfields are poorly lit. In addition, some airfields have marginal navigational aids and poor runway conditions.
With an average of only two and a half hours on the ground at the AOR, the aircraft is refueled and the evacuation crews load the patients - who range from civilian contractors to U.S. and coalition military members - onto the aircraft and prepare them for the flight to Germany. In addition, during this time, the flight crew receives a weather update, files the required mission paperwork, and the KC-135 prepares for its seven-and-a-half-hour flight back to Germany.
There are circumstances where the normal medical team cannot adequately care for a certain patient. These cases normally involve patients with severe trauma such as amputations or burns. In cases such as these a team known as the Critical Care Air Transportation Team, or CCATT, is added to the crew. The CCATT is a three-person, highly specialized medical asset that can create and operate a portable intensive care unit (ICU) on board any transport aircraft during flight. The CCATT team consists of a physician specializing in an area such as critical care emergency medicine, anesthesiology, surgery, etc., along with a critical care nurse and a respiratory technician. The CCATT, with special medical equipment, can turn almost any airframe into a flying intensive care unit within minutes. The team is experienced in the care of critically ill or injured patients with multi-system trauma, shock, burns, respiratory failure, multiple organ failure, or other life-threatening complications.
During the return flight to Ramstein AB, the medical crews monitor the patients, take their vitals, provide medicines, and try to assist with the patient's comfort levels. Once the plane lands at Ramstein AB, the aero-medical ground crews offload the patients on K-loaders and transport them via an ambulance to the hospital at Landstuhl, Germany. There the patients receive the critical medical attention they require.
After the patients are offloaded, the flight crew will assist the medical team in down loading their equipment. After the down load is complete the flight crew returns to operations where they turn in their required post mission paperwork and are re-entered into crew rest for the following day's mission.
As stated at the beginning of the article, this is a very demanding mission for the flight crew. It is typically a 23 hour day from report time at Ramstein AB until engine shutdown back at Ramstein AB.
I have personally flown on a few of these missions. I have to say that the level of care that is given to our wounded is outstanding. From the time they are taken off the ambulance and put on the aircraft in the AOR, to when they are offloaded at Ramstein, they are treated with the utmost care and respect.
This was certainly displayed on one of the missions I flew. One of our patients out of the AOR was a triple amputee whose wounds were caused by an improvised explosive device. From the moment his litter was loaded onto the aircraft, to the moment he was off loaded at Ramstein AB, there was a flight nurse at his side taking care of him. Except for the actual takeoff and landing, she stood by his side the entire seven-and-a-half hour flight back to Ramstein AB.