During an address to an audience at the Air Force Association’s Air and Space Technology Exposition in September, Acting Secretary of the Air Force, Eric Fanning talked about how getting to anywhere in the world rapidly is part of what the Air Force does. He also talked about how adaptable our Airmen can be in times of stretched defense budgets and the many issues that come with maintaining an Air Force. The issue of ways to save costs, and encouragement of integrating efforts was also discussed and has been a topic of discussion for many years. Locally, this Total Force Integration initiative is being seen more and more as we carry out our daily work activities.
In late September a medical evacuation mission, with members from the 912th and 336th Air Refueling Squadrons, departed March Air Reserve Base, Calif., on a KC-135 and headed north to Travis Air Force Base.
“This was a mission that exemplifies the concept of Total Force Integration,” said Lt. Col. Nathan Howard, one of the pilots for the mission. “As it progressed, the mission grew in size and complexity to include six squadrons, one medical group and three major commands.”
The aircraft was enroute to pick up an aeromedical evacuation crew from the 375th Aeromedical Evacuation Squadron, Scott AFB, Ill. The medical equipment, pre-positioned at Travis AFB for their use, was loaded aboard the aircraft for their departure to Hickam AFB, Hawaii.
Upon their arrival at Hickam, another AE crew, this one from the 18th AES, Kadena Air Base, Okinawa, Japan, joined the mission. The next destination was Andersen AFB, Guam. Before departing Guam, a check of the weather at Kadena Air Base confirmed that a tropical storm was headed toward the Japanese location and the storm’s winds would be out of limits for the aircraft to continue the mission. The mission would be delayed for four days.
A decision was made to shorten the time on the ground at Kadena. When they arrived there, the aircrew was augmented by members of the 909th ARS and two Neonatal Intensive Care Unit teams from the 18th Medical Group, Kadena AB. The augmentees joined the med-evac activities to help transport two ‘priority’ NICU patients from Okinawa and one NICU patient from Yokota AB, Japan. These patients were considered priority because they needed advanced care and had to be moved within 24 hours, with one of the NICU patients needing to be transported from Yokota AB to Hawaii.
The KC-135 left March configured for a routine ‘WestPac’ med-evac mission but on preparing for their departure from Kadena AB, the mission status became priority because of the care needed for the three babies and the impending storm, which had become two, high-velocity typhoons.
Onboard conversions to the aircraft transformed it into a flying NICU and involved various modifications. Capt. Mathew Beeman, 375th AES, Scott AFB, the mission’s primary Medical Crew Director, talked about what needed to be done.
“The first thing we do is setup the aircraft like a hospital. This involves building Patient Support Pallets that have litter stanchions,” said Beeman. “Then we need to load on our three 20-Liter, 144-pound Liquid Oxygen Systems for patient oxygen. We put up our new LED lighting system, and convert the aircraft’s 400Hz power into 60Hz power with our Frequency Converters.”
Once the aircraft is configured to safely accommodate the assigned patient load, they do their enplaning of patients. With the NICU patients this is a critical step because the transfer of Neonatal Transport Systems must be done carefully from the High Lift Patient Loading Truck onto the KC-135.
“As the MCD, I’m responsible for the safe accomplishment of the aeromedical evacuation tasking,” Beeman said. “I ensure all of the patient’s standards-of-care are met and everything is done safely and by the AFI. I’m also responsible for communicating my crew’s needs to the pilot in command and boom operator.”
As the complexity of the mission seemingly grew during each phase, so did the number of patients and accompanying passengers.
“Not only did we have the NICU babies, but we also had two patients with moderate mental illness and a newly-diagnosed, 4-year-old girl with diabetes.” added Beeman.
The patient roster got even larger when patients in their mid-twenties and thirties were added and, according to Howard, one patient older than 70 years. He also noted that getting these patients on and off the plane was not like a C-17, where patients have a loading ramp. Getting them on and off was always an issue when the aircraft required taking on fuel, he said.
Transporting these patients and their accompanying family members was all part of the mission but so was transporting all of the equipment associated with such a complex mission.
“Not only does the boom operator do his primary job during these missions, but he is also a loadmaster and it’s pretty darn complicated. To get all of that stuff onto the plane, work with the AE crewmembers and get it all secured, and then run weight and balance, is complex,” said Howard.
“It’s got to be done right. It has got to be positioned and secured in a way that we can safely fly the aircraft and also allow the technicians in the back to safely do their jobs. I haven’t done a whole lot of the aero-med stuff, but I was surprised at how much equipment came on and came off at each stop.”
When the aircraft departed Hawaii for return to the mainland, it stopped at Naval Air Station North Island, Calif., to deliver the two remaining NICU babies to awaiting ambulances for transport to San Diego area hospitals.
“This whole mission was pretty impressive. Everywhere we went there was an ambulance there to deliver or pickup patients,” said Lt. Col. Mike Goyette, primary aircraft commander for this mission.
Although the days were long for everyone, Goyette said they may have seemed longer for the guys in back.
“Everywhere we went and every time we landed there was a new change. The point is that everything got done. It was really the back-end guys; they were extremely impressive in doing their jobs.
An environment with high temperatures and humidity make the KC-135 very he added. It made getting the engines started, and taking off as fast as possible, a priority in order to get the air conditioning going, especially for the babies on board and the equipment used to care for them.
When the mission was completed the aircraft had flown 6,500 miles over a 24-hour period. Successful completion of such a complicated, yet critical, mission demonstrates the incredible teamwork that a Total Force Integration effort can achieve.