Medical evacuation and training during Ranger School

Infantry Magazine, Spring, 2002 by Marc Captain Cloutier

During numerous training events, AARs have brought to light many procedures that save time and prevent confusion. One challenge encountered during MEDEVAC training in the swamps and dense vegetation is signaling techniques. Both the ground personnel and the aircrews must understand each others' signals. Our far recognition signal both day and night is FM communications and a red star cluster (red pen gun flare if the star cluster is not available or is a dud).

When the pilots or our TOC indicate that the aircraft is one minute out, the walking team members fire their star cluster. Smoke, our intermediate signal, is thrown immediately after the star cluster is fired because it takes time to billow and crest the canopy of trees. We use red smoke by day and a white strobe light by night. As the aircraft approaches, it will indicate by FM radio if the smoke or strobe is visible. When the aircraft is within 200 meters of the casualty, the white strobe must be turned off so it does not create a hazardous situation for pilots flying with night vision goggles (NVGs). If the pilots are having a difficult time identifying the signals, FM communications with a clock direction and distance are used to direct the helicopter to the location.

The near signal used by day is a VS-17 panel, which marks where the hoist or helicopter should land. The near signal at night is a swinging red chemical light tied to the end of a two-foot section of 550 cord. If this signal is swung vigorously overhead, the pilots can readily identify it at night. When the aircraft is overhead, FM communication from the ground to the aircraft must cease. At this point the aircraft is relying on instructions from his crew chief and is busy trying to maintain control of the aircraft in a hover. The added radio communication only aggravates an already challenging situation for the pilot. Also at this point, any white light being used to treat a casualty on the ground must be extinguished as this creates another dangerous situation for pilots flying under NVGs. (If light is critical, a red or blue lens filtered light can be used.)

Finally, during a hoist mission, signals must be used to relay when a casualty is ready to be raised. Only one person should give the signals. During the day, a simple thumbs up overhead is all that is required. At night, the same red chemlite on two feet of 550 cord again lets the crew chief know that the casualty is prepared for the hoist. Since the flight medic will first be lowered to the ground to continue treatment of the casualty, he becomes the primary signalman for the hoist. The flight medic also has FM communications with the aircraft. We also have the aircrew activate a red chemlite and attach it to the jungle penetrator during training. This enables the aircrew and the personnel on the ground to see the hoist as it is lowered to help maintain situational awareness.

Although the JP is the primary means of extraction from the swamp, cross training on the SKEDCO litter is essential for cases involving a back or neck injury. During 6th RTB's most recent training, the flight medic was pre-positioned at the extraction location on the ground where he was able to conduct training on the actual terrain where a hoist mission is most likely to become necessary.