Challenges of Aeromedical evacuation in the post-cold-war era

Aerospace Power Journal, Winter, 2001 by Bruce Brig Gen Green

During Desert Shield/Storm, several significant issues arose to challenge the AE forces, including the lack of Kevlar protective equipment for many of the Guard/Reserve personnel; the need for contingency training for the ground AE elements as well as a more streamlined, coordinated process for patient regulating; and review of interface points with the AE system. Nonetheless, the mission involved the largest deployed AE force in history, totaling over 12,632 patients evacuated on 671 AE flights with no in-flight deaths--a complete success.

Change in the Nineties

A new era in airpower history began on 1 June 1992 with the inactivation of MAC, Strategic Air Command, and Tactical Air Command. Two new organizations--Air Combat Command (ACC) and AMC--developed from the elements of the deactivated commands. Shortly afterward, AMC divested itself of infrastructure and forces not directly related to Global Reach. Among the units affected were C-130 airlift squadrons and AE squadrons at Rhein-Main AB, Germany, which transferred to United States Air Forces in Europe (USAFE), and similar squadrons at Yokota AB, Japan, which transferred to PACAF. These transfers--along with the majority of active and ARC C-130 airlift squadrons; the active-duty AE squadron at Pope AFB, North Carolina; and the 19 gained AE squadrons from the ARC--all went to ACC in order to align all theater (combat) support under one command. However, in 1997 these same assets were transferred back to AMC.

In 1996 the Global Patient Movement Requirements Center (GPMRC) was established within US Transportation Command to facilitate and streamline patient validating and regulating. Theater Patient Movement Requirements Centers also stood up in US European Command and US Pacific Command. These centers are responsible for definition and management of patient-movement requirements, patient in-transit visibility and collaboration with their respective theater or joint-task-force movement-control agency to coordinate bed and lift plans.

Because of lessons learned in Desert Shield/Storm, an Aeromedical Evacuation Contingency Operations Training (AECOT) course was developed and fielded at Sheppard AFB, Texas, in September 1998. The course trains AE personnel in a standardized manner regarding general philosophy, capabilities, organization, operations, [C.sup.2], and support required to provide full-spectrum AE capability during contingencies.

In 1999 a Critical Care Air Transport Team (CCATT) course was developed at Brooks AEB, Texas, to prepare teams of physicians, nurses, and technicians to provide structured en route care for critically ill and injured patients whenever and wherever required. The course includes a detailed review of the CCATT mission, equipment, and organization, as well as familiarization training with AE aircraft, orientation to the stresses of flight, and refresher training through a fundamental critical-care support course.

Throughout the nineties, AE units continued to be engaged in a variety of contingency operations covering multiple theaters. AMC and AMC-gained units deployed 60 medical personnel for 90 days in the fall of 1994 to manage an air-transportable hospital in support of Operation Uphold Democracy. Those medical personnel were responsible for treating and aeromedically evacuating, if necessary, all military personnel deployed. In addition, Air Force medics deployed to austere locations throughout Haiti to take part in the humanitarian-assistance program.