At Joint Patriot 2001, a team works to load a simulated casualty onto a C-130 for transport. (Photo by Capt. Len Gratteri)

In June, members of the 142^nd Aeromedical Evacuation Squadron ventured to Fort Drum, NY to participate in "Joint Patriot 2001." The exercise is sponsored by the National Guard Bureau and employs U.S. military and multinational forces in a joint training environment.

During Joint Patriot, airmen and women of the 142^nd worked side-by-side with other Air National Guardsmen, Army Guardsmen, Active Air and Army, Air Force Reserve and Great Britain’s Royal Auxiliary Air Force. All honed their skills in every aspect of medical evacuation operations - transporting casualties from the battlefield all the way to appropriate medical facilities.

Patients are transported from the Mobile Aeromedical Staging Facility (MASF) into the C-130 and secured on the aircraft’s litter racks. (Photo by Capt. Len Gratteri)

The basic mission of an Aeromedical Evacuation Squadron is to move casualties from point of origin to a pre-arranged medical treatment facility, said Lt. Col. Virginia Schneider, commander of the 142^nd. The Air Force is responsible for Domestic and Intertheater Aeromedical Evacuation, along with Intratheater Aeromedical Evacuation not provided organically by Army, Navy or the Marine Corps, she explained.

A typical casualty would come in from the battlefield, be treated at an aid station or Combat Army Surgical Hospital, staged at the MASF and loaded on an aircraft for movement back to the states, explained Master Sgt. Aloysius Muscella, a radio operator from the 142^nd.

Medics from the Army’s 10th Mountain Division, located at Fort Drum, serve as an Aeromedical Evacuation Liaison Team and practice caring for a patient in the field. (Photo by Capt. Len Gratteri)

Sounds simple enough, but these different areas are often far apart and might not even be on the same continent. In the Joint Patriot scenario, we have teams on the battlefield, in Turkey, Germany and the U.S., said Muscella. You also have to remember we are transporting casualties who need medical attention along the way, too, he added.

The whole process starts with a casualty requiring evacuation. The Aeromedical Evacuation Liaison Team is located on the battlefield and generates an air evacuation request, called an Alpha Message, detailing specifics such as priority, number of patients and location, he said. This information is received by the Aeromedical Evacuation Control Center, who coordinates with the Air Operations Center to obtain transport. Additionally, the Mobile Aeromedical Staging Facility (MASF) is contacted to stage multiple patients to prepare them for the evacuation flights.

Master Sgt. Aloysius Muscella (left), a radio operator from the 142nd Aeromedical Evacuation Squadron carefully checks his information before transmitting a message. (Photo by Capt. Len Gratteri)

"This is a realistic exercise because in a real evacuation we would normally be working with these same organizations. That’s the value – working out problems inherent to joint warfare," said Lt. Col. Dave Rich, Health Services Administrator from the 142^nd. "Although we all speak English, there are still language barriers between different organizations that can cause problems in a real evacuation," he added.

For example, an "urgent" patient to the Army must be moved within two hours. For the Air Force, "urgent" means 12 hours. That can cause problems when you are trying to coordinate a movement window with the aircraft, said exercise First Sgt., Senior Master Sgt. Jay Martin of the 142^nd. "Then try to communicate your needs to someone from another country’s military and it’s a recipe for disaster," he exclaimed.

A British airman notices the litter isn’t secured correctly. (Photo by Capt. Len Gratteri)

Commander Nicki Edwards, Squadron Leader from Great Britain’s Royal Auxiliary Air Force added that there are challenges with equipment incompatibilities as well. "We try not to mix equipment. For instance, a British litter (a stretcher used to carry casualties) won’t fit in your C-130s and an American litter won’t fit inside one of our ambulances." But interoperability is what it’s all about, so this exchange of ideas is wonderful, she said.

The exchange of ideas from prior exercises is already paying dividends. Right now the 142^nd has personnel serving in Macedonia, as part of the 166^th Airlift Wing’s participation in the Aerospace Expeditionary Force rotation. They are treating and evacuating real casualties while working with other branches of our military and militaries of our allies, noted Schneider.

"This year we learned a lot about the Brits and we look forward to next year and possibly working with them again or working with another branch of our service like the Marines," said Muscella. "But either way, this is great cross training and information we really do use," he said.