JOINT BASE SAN ANTONIO-CAMP BULLIS, Texas – Airmen from the 343rd Training Squadron/Operating Location-A teamed with National Guard Soldiers and Air Force Reservists to strengthen their warfighting skills and joint partnerships with a medical evacuation (MEDEVAC) exercise Jan. 9 and a sling load exercise Jan. 27.
The first exercise was an impressive day-long display of Total Force, tri-service MEDEVAC synergy as 16 patient/actors were MEDEVAC’d from Camp Bullis to Chapman Annex. This joint cooperation was in full display when a Marine was hoisted up by a team of active duty 343rd TRS medics to a waiting Texas ARNG air ambulance crew from Company C, 2-149 Aviation “Alamo Dustoff” hovering overhead in a Black Hawk helicopter. They were then subsequently flown by Reservists from the 433rd Aeromedical Staging Squadron for treatment and ground transport to higher-tier care. One of the key components is the 9-line MEDEVAC request – a formatted radio message for front-line troops to request medical care.
Tech. Sgt. Casey Pritchett, 343rd TRS/OL-A, NCOIC for Medical Operations, outlined his team’s involvement.
“We participated with four independent duty medic technicians (IDMTs) and four 4Ns (aerospace medical service specialists),” Pritchett said. “We MEDEVAC’d moulaged patients from multiple landing zones (LZs) throughout Camp Bullis, we did 9-line call outs on tactical radios, and conducted LZ signaling with smoke and signal panels – the whole nine yards! And each time it culminated in active loading on the UH-60s.”
Pritchett underscored the comprehensive preparation for the mission’s multi-service aspects.
“Beforehand, we reviewed our tactical combat casualty care (TCCC) tactics, how to call in 9-line MEDEVAC requests, and the details of working with joint partners,” he explained. “We need to understand how Army procedures may differ from our Air Force side, and while it would be generally about the same, they might use different terms. All of our extra reviewing and training really paid off when we teamed up with the Army out there in the field.”
Army Sgt. 1st Class Dion Cortez, Readiness NCO, for C/2-149 Aviation, Texas Army National Guard, Martindale Army Airfield, planned the patient scenarios for each MEDEVAC.
“For each injury, the ground unit sends up a 9-line MEDEVAC request that our unit receives,” Cortez said. “After launch approval, the aircraft arrives at the point of injury, our flight medics conduct a patient-transfer with the ground unit, assess, then load the patient onto the aircraft, continue treatment, and evacuate the casualty to higher echelons of care.”
Pritchett explained how the 343rd TRS team postured itself for the patient transfer.
“After an initial 9-line MEDEVAC request was sent in, there could be some time before an aircraft arrives, and the patient’s condition or the tactical situation can change. So, just as the aircraft was approaching, the ground medics gave an update report to the air ambulance team on what’s happened since we called in the initial request,” Pritchett said. “Now the air ambulance team knows what they are getting into and can prepare to receive the patient, either to perform the necessary medical interventions or sustain our interventions to get the patient safely back to the next tiered hospital.”
Army Sgt. Sydni Smith, C/2-149 AV flight medic, elaborated on her role in receiving patients from the 343rd TRS.
“You find out what they saw, what treatments they’ve given, and confirm if those interventions are still in place and working,” Smith said. “For instance, if they put a tourniquet on, make sure that it’s on right. The transfer can be fast-paced, so we have to monitor and re-evaluate the patient while flying in the back of the helicopter. You have to be prepared with what you need to get things done in place.”
While the myriad MEDEVAC tasks can seem chaotic, the rapid-fire transfers were seamless to the simulated casualties. Marine Sgt. Robert A. DiEnno, an instructor-supervisor for the Military Working Dog Handlers Course at the 341st Training Squadron, offered his perspective as a patient/actor.
“Once the helicopter arrived, it was a really quick process getting loaded up safely and quickly. It was nice to see how everybody worked together, even though it was probably the first time these different units had ever met,” DiEnno said. “They all knew the same procedures from operating in the same environment, and that kept things going smoothly. After that, it was a quick flight over to Chapman Annex. As soon as we landed, the Army flight medic handed us over to the Air Force aeromedical staging team. Then they put us in a Humvee and drove us off to our simulated hospital.”
Pritchett said his entire team felt great about the training.
“Our more junior members were able to cement their technical skills, build confidence working around active aircraft, and operationalize their classroom training,” he said. “This is what we train for, and it really inspired confidence in my guys to be able to work with Black Hawks on a real-world aeroevac at Camp Bullis. And we are able to share this knowledge and experience with students as well.”
He added that it was important to be able to work closely with joint partners.
“It allowed us to discuss procedures – what’s different, what we’re doing well, where we can improve. We can sort things out now, where you may not have the time when caring for an actual casualty. That builds our knowledge base for future operations both in peacetime and in war. And those kinds of interactions … well, you really can’t put a price on them,” Pritchett said.
Jumping forward two weeks, the 343rd TRS participated in an ambitious day-and-night sling load exercise with Texas Army National Guard Soldiers from C/2-149 Aviation and Air Force Reservists from the 26th Aerial Port Squadron. The two-day event saw the rigging and heliborne movement of over 27,000 pounds of cargo and 14 personnel across Chapman Annex.
Master Sgt. Matthew D. Dibenedetto, 343rd TRS/OL-A, NCOIC of Security Forces Intermediate Course, described the activities of the preparation day.
“On the first day, we started at Martindale Army Airfield to familiarize ourselves with the Black Hawk helicopter and receive a passenger safety briefing from the aircrew. We spent some time discussing the layout of the landing zone; then we sat inside the aircraft, practiced buckling up, and learned the loading and emergency procedures.”
He said that afterwards, they attended a class at the aerial port squadron warehouse, where they learned about rigging and inspecting sling loads, which were water barrels inside of A-22 cargo bags.
“I didn’t have much familiarity with this part of the Air Force – loading aircraft – and I was looking forward to doing something new. I was surprised by the fine detail and thoroughness involved with putting the pallets and loads together,” Dibenedetto said. “While it’s important to understand joint operations, we also benefit within our own service by understanding what other career fields do, to appreciate that we are all working hard to get the job done.”
He added that the first day ended with hookup rehearsals as they organized into two-person teams consisting of a hookup person and a bracer. They practiced how to prepare the load, stand as team against the rotor wash, perform the hookup to the aircraft, and conduct safety procedures.
“The next day, we flew from Martindale Army Airfield to Chapman Annex,” he said. “After landing, we linked up with the ground team, saw the pathfinder managing the aircraft, while the safety NCOs checked the hookup teams, and the hookup teams were performing last-minute checks on the loads.”
Dibenedetto described that with each iteration, the two-person hook-up team would stand by their load as the Black Hawk helicopter approached. Prior to the hookup, the team ensured the breakaway ties were in place on the load, and that the load was safe for the helicopter. The bracer held his teammate by the shoulders against the rotor wash and also gave adjustment advice, as the hookup man waited for the opportunity to attach the load to the cargo hook of the aircraft hovering just five feet over them. The team verified the secure hookup, dashed to their safety point, took a knee, and gave a thumbs up to the Army aircrew to confirm their task completion.
Dibenedetto explained that the daytime and nighttime portions of the exercise operated differently.
“You could definitely feel the difference. Your senses are heightened in the dark. We had to be more careful with low visibility, and used additional safety procedures with glow sticks and reflective safety vests,” he said.
“As a Defender, I was impressed by all of the proficiency and intense training required by the aircrews and ground crews to move each 2,000-pound pallet. I gained a lot of appreciation for what happens behind the scenes to ensure a successful re-supply. That same type of pallet that could be used to bring supplies and ammo to a security forces unit in the field, and now I understand what goes into making that happen,” Dibenedetto said.
“I was able to rotate through all three positions – the hook-up, bracer, and safety NCO. It was awesome!” said Staff Sgt. William F. Torres, 343rd TRS/OL-A, Security Forces Technical School instructor. “Everyone needs to know everyone else’s position. You need to be diverse and know your wingman’s role. As a team member for that first time, you are being tested in every way – cognitive, emotional, and physical. Your nerves are on edge as your ‘fight or flight’ response is present when a helicopter is hovering just a few feet above your head. You have to overcome any uncertainty, and allow your training to give you the confidence to accomplish the sling load tasks, and you have to trust everyone involved with the process.”
“Looking back, I’m just amazed at the versatility of our military to use a helicopter to overcome any terrain to move cargo,” Torres added. “To hover a helo that low to ground and conduct a hookup is quite a feat for everyone involved. I was proud to be a part of this exercise. We were very proficient and very successful with the sling loads.”
Chief Warrant Officer 2 John M. Schiavi, C/2-149 Aviation medical evacuation pilot, was the pilot in command for both exercises and offered the aviator’s perspective on the action.
“The most standout portion was that we had participation from all parts of the military – active component, National Guard, Reservists, a Marine, Soldiers, and Airmen. To see that kind of joint interaction – coming together to accomplish a task, sharing how the services operate, and the cross-organizational cooperation – it’s always a challenge, and everybody rose to the occasion.”
Master Sgt. Zachary W. Hassay, 343 TRS/OL-A, NCOIC of Camp Bullis Operations, remarked how these exercises have improved things for his unit’s technical training of Defenders.
“These exercises align with our squadron’s mission to train and develop world-class Defenders for the Air Force that enable service, joint and coalition missions. We have many tiers of training along the continuum of learning, and the missions give our cadre a wealth of experience for working around live aircraft with joint partners – which mirrors what our student Defenders will experience when they deploy downrange,” Hassay said.
"Our cadre can now share this first-hand knowledge with our students – how a mission involves more than what a PowerPoint slide or classroom training can convey. They can impart the sense of urgency, the need to stay task-focused despite the distractions from aircraft noise and rotor wash, and working through the unfamiliar in joint operations with other services.”