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September 7, 2012

Cultural exchange program shares best aeromedical evacuation practices

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by Linda Welz
452 AMW public affairs
davies
Chief Master Sgt. Raejean Huch, 452nd Aeromedical Evacuation Squadron, briefs Royal Air Force Reservist, Sgt. Jon Davies on procedures for operating the Patient Liquid Oxygen, a device used to hold up to 10 liters of liquid oxygen or more than 8000 liters of gaseous oxygen. While onboard a March Air Reserve Base, C-17 Globemaster III, Davies was part of a foreign exchange program between the U.S. and U.K. military forces. (U.S. Air Force photo / Senior Master Sgt. Josephine Carrillo)

Editor’s Note: This is part two of a two-part series.

Royal Air Force Sergeant Jon Davies is a flight nurse with the 4626th Aeromedical Squadron, RAF Lyneham, United Kingdom, who participated in a foreign exchange program here in July.

While training at March Field, Davies was able to experience how a medivac flight is set up, all the briefings and preparation, how patients are on- and off-loaded, how medical scenarios unfold in flight and some of the differences and similarities in the equipment that’s used.

“We fly the C-17 but at the moment we don’t use all the facilities of the C-17,” he said. “Namely, we don’t generally employ the electrical systems because our equipment isn’t rated for that.”

Another significant difference he observed was that the medical staff is considered much more a part of the aircrew here, than in the U.K.

“They have to know exactly what to do in case of an in-flight emergency. Since they are dressed in flight suits, other passengers on the aircraft will be looking to them, asking, ‘What do I do now?’ That’s something I need to take back…your medical staff is well-trained on the aircraft systems, they know what to do and people will look to them,” Davies said.

They could definitely benefit from the comprehensive checklists and documentation used here, Davies said. He noted that during the briefing, people read out bits from the checklist, which demonstrated they were paying attention.

“It refreshes them and the rest of the team on procedures so you are constantly learning. I think that was an excellent thing to see,” he said. “Unfortunately, we don’t have the availability of airframes like you have so we tend not to train for flying missions, but we do static stuff.”
Last year one of their psychiatric nurses went to Joint Base Andrews, Md. Because of his visit there, many organizational changes (in the exchange program) came about, Davies said.

His journey here was seamless. He was expected and activities were arranged prior to my arrival, he said. “The system works. We hope this happens every year,” said Davies. We have even discussed having an aeromedical training mission generated to conduct a joint training exercise.

Their training is conducted at York, where they have the Bastian (hospital) simulator. Some people couldn’t believe that they actually have that to work with it, said Davies. A lot of people here want to see how they operate and they share the experience, said Chief Master Sgt. Raejean Huch, 452nd Aeromedical Evacuation. Sgt. Davies thinks it’s a great idea because they can learn so much from each other, he said.

“I’ve been able to show him the different aircraft we fly on. He’s looking at the airplane from our eyes to see how we do oxygen, where we place the patients, etc.,” Huch said. “We’ve been able to show him our Air Force Instructions, which he will take home with him. They give nurses standard protocol and give med techs pre-flight assessment considerations. It’s a cookbook of aerovac.”

Another major difference is the March team is fortunate enough to have the airframes to train with something other than a static, she said.

“From the moment we had our C-17s, we were plugging in all of our equipment into the power on board,” Huch said. “They use batteries and generators for everything, which is extra cargo for them to carry.”

Davies said they have flown on different aircraft that didn’t support their equipment but that they are in line to get new equipment that should be compatible.

“You have more C-17s on this base than we probably have in the whole RAF. It’s about what’s available,” he said. “Because ours are always operational or deployed, we have to do a lot of static stuff. You are fortunate that you have a lot of gear and I’m very jealous.”

They have a standard regulation but not a checklist that can be carried onto a flight, Davies said.

“One of the things I noticed on the flight was every time there was a crisis with a patient, this book would come out. It would be opened to the relevant page and they would use the checklist,” Davies said. “It’s all very well to say, I’ll use my clinical judgment. However, I always tell my students, ‘I don’t care how experienced you are because when you are dealing with an emergency, I want you to start at A and work your way through the alphabet.” Davies, a civilian nurse/trainer said, “That’s what we do. We have an A, B, C, D approach to the patients. That (the checklist) would be a great benefit to us. You may be able to second guess, but if you flip open the book it tells you exactly what you need to do.”

The teams here are used to flying, jumping off aircraft, stowing their kits, etc., Davies said. Therefore, they make a more robust team when in a deployed environment than those who have not experienced regular training flights. The RAF aeromedical teams have three check flights before they deploy, so it takes a little bit more time to spool up again and get up to speed, Davies said.

There was one difference that Huch learned about that was to the RAF’s benefit. Unlike their U.S. counterparts, the RAF Critical Care Air Transport Teams include a repair technician for the ton and a half of equipment they carry in flight, like the portable oxygen container.

Davis said his exchange trip here has given him many best practices to share and experiences including “flying with the best of the best.”

He said his experience with the aircrew was great and that they could not have been friendlier.

“I got to see F-16s being refueled,” he said. “I’ve got more invitations than I can fulfill to come back. Next time, I’ll bring my family. I think I could stay here for a month and not pay a single hotel bill,” he said.

“There are a lot of attractions here for us to see and the beaches are fantastic. So it looks like we’ve got a free vacation here. Now all we have to do is to find the airfare. How can you beat that?”




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