December 28, 2017 (by MSgt. Mark Olsen) - As mission starts go, things are starting to look tough.
AFRC Airman with the 514th AES, 514th AMW, board a C-130H Hercules prior to an aeromedical evacuation training mission from Joint Base McGuire-Dix-Lakehurst, N.J., to Joint Base Charleston, S.C., on December 15, 2017. The C-130 is with the 757th AS, Youngstown ARS. [USAF photo by MSgt. Mark C. Olsen]
It's been snowing for two hours – there's about five inches on ground that is already icy slick and with the winter equinox only six days away, the anemic afternoon light has begun to fade away.
Despite the conditions, everyone – all the Reserve Citizen Airmen flight nurses and aeromedical evacuation technicians – are at the 514th Aeromedical Evacuation Squadron (AES), 514th Air Mobility Wing, at Joint Base McGuire-Dix-Lakehurst, N.J., prior to the report time of 5:45 p.m., Dec. 15, 2017.
Prior to mission briefing, it was all talk about the miserable conditions and the crazy drivers, but once the briefing starts, everyone is down to business. Flight nurse Capt. John Bergacs, who is serving as the medical crew director (MCD) for the mission, gives out assignments to the four flight nurses and eight aeromedical evacuation technicians on the training mission to Joint Base Charleston, S.C., Dec. 15-17, 2017.
"Everyone needs to be on task when we get on the airplane," said Bergacs.
The 514th AES will be flying on a C-130H Hercules with the 757th Airlift Squadron, 910th Airlift Wing, Youngstown Air Reserve Station, Ohio. This joint training mission is entirely an Air Force Reserve operation.
Since the Vietnam War, the C-130 Hercules has been the go-to aeromedical evacuation aircraft. The H model can be set up to carry 74 litter (stretcher) borne patients, while the C-17 Globemaster III carries 35 and the KC-135R Stratotanker can handle 15. The C-130 is definitely built to get most wounded out of a war zone. The 514th AES trains on all three aircraft annually.
The typical aeromedical evacuation (AE) team consists of an MCD, who monitors patient loading and works with the aircrew; a flight nurse who can dispense medications, and a charge medical technician who supervises the two aeromedical evacuation technicians who prepare the aircraft for the patients and tend to their medical needs.
"I was initially qualified on this aircraft in 1994," said Master Sgt. Louis Muzyka, aeromedical evacuation technician. "So it was good to be back on again."
The Hercules, like its name, is tough and can land on short, undeveloped runways. It is also cramped and the cargo area temperature can fluctuate, one moment bitter cold, the next, blazing hot.
"It is a very difficult aircraft, and if you go downrange, it's your only plane," said Maj. Heather Moore, flight nurse.
By the time the AE team is driven out to the plane, the snow has stopped. Inside the C-130, the temperature is the same as the outside, hovering around 28 degrees.
C-130 loadmaster Master Sgt. Robert Mitchell with the Ohio team lends a hand as the flight nurses and aeromedical evacuation technicians load their gear onboard the aircraft. He then grins as he pulls out an ancient personnel data assistant and begins calculating the C-130's weight distribution.
"It has a program that helps us do our weights and measurements," said Mitchell. "When a loadmaster retires, they pass their PDA on to a new loadmaster."
Space on a C-130 is at a premium, so the AE team has to be efficient when they set up their working area, which runs nearly the full length C-130's cargo area. Litter stanchions - metal posts – are connected at the ceiling and floor and run down the middle of the aircraft. Straps, also connected at the ceiling and floor, are on either side of the stanchions. This is why the C-130 can carry so many stretcher borne patients unlike a KC-135, where you can strap litters only on one side of the stanchion. Of all the setup tasks on the C-130, assembling the stanchions is the most time consuming.
"When you are building or dismantling the stanchions, everyone needs to be in sync," said Moore.
The AE team start by setting up the litter stanchions, then install oxygen lines, and finally place the equipment that will be used during the mission.
"You really need the team to work together on the C-130," said Tech. Sgt. Donna Trader, aeromedical evacuation technician. "Everyone needs to know their position and their duties in order to make everything work."
The medical gear, which consists of a cardiac monitor, suction unit, a vital signs monitor, IV pump, patient therapeutic liquid oxygen system, and any other equipment that might come with the individual patients, will help them respond to medical issues they may encounter while in-flight.
"Muscle memory is everything," said 1st Lt. Jedd Dillman, flight nurse. "You can read about something in a book, but until you actually lay hands on it and do it, this is where you learn where your strengths and weaknesses are."
Once everything is in place, Bergacs directs the loading of the litters. Four Airmen carry each litter and strap them in place on the stanchions.
"With the C-130's configuration, you have to have the knowledge and be well trained to configure it in the time it needs to be done, especially in a deployed environment," said Tech. Sgt. Anita Maldonado, aeromedical evacuation technician.
Each Airman has a Mission Accomplishment Report Sheet, or MARS form, which is a checklist of tasks and emergencies that each nurse and technician must be certified on to be deployable.
On the flight to Charleston, the flight nurses and aeromedical evacuation technicians put out a simulated aircraft fire, work with self-contained breathing apparatuses and M-50 gas masks, as well as ran through various patient scenarios. On the return trip, the Airmen who were not trained on the Charleston flight received the same or similar training based on their individual training requirements on the trip back to Joint Base McGuire-Dix-Lakehurst. Everyone received refresher training on how to open and close the C-130's two paratroop doors and the crew entrance door in case of an emergency aircraft evacuation.
"I haven't been on a 130 since my last deployment," said Tech. Sgt. Luot Lewis, aeromedical evacuation technician. "It was good to get everyone else's input, as well as a fresh set of eyes on the aircraft from the new students."
When the 514th AE team landed at Joint Base McGuire-Dix-Lakehurst, they performed an engine-running offload. This is what they would experience during a mission downrange where they would be loading or unloading patients with the four turboprop engines running so the aircraft can immediately take off.
It is loud, reeks of jet fuel, and hot in the prop wash behind the aircraft. Everyone has hearing and eye protection on as they remove the litters and equipment they brought with them for the training mission.
The biggest difference, the snow is gone and it is sunny.