AFSOC CASEVAC: training for "Care under fire"

DA SWO

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http://www.afsoc.af.mil/news/story.asp?id=123218229

Interesting story from the AFSOC page. I put the link up so you can look at the photo's.

Nasty-Any comments on this?
I find it interesting that AMC is apparently developing a similar capability, I thought this is what Aerovac crews were for?

by Senior Airman Ryan Whitney
1st Special Operations Wing Public Affairs

8/19/2010 - HURLBURT FIELD, Fla. -- The Air Force Special Operations Command Casualty Evacuation course recently graduated five Airmen and one Navy physician from the quarterly course conducted by the Tactical Operations Medical Skills Lab, part of the Special Operations Forces Medical Element, Aug. 13, at Hurlburt Field, Fla.

The two week course, which trains special operations medical forces to retrieve, treat and transport wounded servicemembers through any means possible, places students in stressful situations to help them apply their skill sets in locations they aren't familiar with, for instance, the back of a C-130 during low level flight.

"The ultimate goal is for these students to be able to provide advanced trauma life support in a harsh, hostile environment," said John Frentress, AFSOC CASEVAC instructor. "We aren't necessarily teaching them new skills; they are already medical professionals. What we are doing is expanding their expertise to be utilized in austere and dangerous conditions and increase the level of care they are able to provide to their patients."

During the course, a strong emphasis is placed on the use of TCCC, or tactical combat casualty care, and how it relates to CASEVAC, working and integrating with aircrew and various air assets, and applying advanced trauma life support during transportation.

To better familiarize the students with air assets and the challenges associated with the treating patients of patients onboard, a simulated CASEVAC mission was flown on an MC-130 assigned to the 6th Special Operations Squadron.

During this mission, students were given a few minutes before the flight to prepare the MC-130 to accommodate patients. Anything not accomplished during this time had to be completed after takeoff while en route to pick up patients.

After picking up the simulated patients, comprised of volunteers from across the base, the medical teams were tasked with locating, assessing and treating the patients injuries based on the vital signs provided from the course instructors.

If this task didn't seem daunting enough, it was done wearing full armor and protective equipment while the aircraft performed nausea-inducing evasive maneuvers 300 feet off the ground for nearly 45 minutes.

"This training was my first experience in performing patient care out of a hospital, so it really removed me from my comfort bubble and challenged me in a way I'm not used to," said Capt. Olivia Jackson, registered nurse and CASEVAC student from Travis Air Force Base, Calif. "You really have to be able to think outside the box and use the resources around you to the best of your ability to take care of your patient."

Though usually reserved for special operations medical members, this class consisted of two AMC medical members who will be applying what they learned in conducting training for a new deployment code the command is constructing to better prepare their medical forces for this unique mission.

"The new unit type code we are building in AMC is going to be used to move critical care patients, and we want to make sure the echelon of care that patients receive will remain at the highest available level, even during transportation," said Tech. Sgt. Jeremy Clyde, paramedic and CASEVAC student from Travis AFB. "This course helped me understand that in unregulated patient movement, you have to be flexible, and be able to change up how you operate at a moments notice."

Unregulated patient movement consists of using all means and resources available to transport patients to safety from the point of injury, while under constant threat.

"This training provided me the ability to hone a set of skills that, as a physician, I would not usually utilize," Navy Lt. Seth Fischman, Naval Air Station Key West physician. "But the scenarios that the TOMS Lab presented us provided a unique experience that I think will be invaluable in a hazardous environment."
 

amlove21

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Wow. Really? I dont really know how to respond to this- but the AF already has a pretty freaking capable CASEVAC capability. It's called "Pararescue" specifically, the GAWS as a whole, and apparently those guys are pretty freaking good at "provide(ing) advanced trauma life support in a harsh, hostile environment".

I dont know enough about this program or it's intent- but i am having a very aggro, alpha type reaction to this post. It seems as if these medics have been trained in a handover-type scenario- because i will tell you one thing, they will not be at the point of injury, as the article states. Period. Theyre working off a 130- and that, my friends, is MEDEVAC, not CASEVAC.

Again, maybe its the article and not the intent.
 

AWP

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Is this maybe a by-product of the decision a few years ago to have IDMTs go along with the PJ's doing CASEVAC missions in Helmand and the surrounding area? Did the AF potentially think that PJs aren't needed to do the mission? I recall several articles out of Kandahar in 2006 where IDMT's were on Pavehawks with zero mention of PJ's.....

Please note, I'm not "anti-PJ", far from it, but I know the AF has a nasty history where PJs are concerned and to the outsider this looks like another attempt to marginalize the PJ's role and mission.
 

DA SWO

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Wow. Really? I dont really know how to respond to this- but the AF already has a pretty freaking capable CASEVAC capability. It's called "Pararescue" specifically, the GAWS as a whole, and apparently those guys are pretty freaking good at "provide(ing) advanced trauma life support in a harsh, hostile environment".

I dont know enough about this program or it's intent- but i am having a very aggro, alpha type reaction to this post. It seems as if these medics have been trained in a handover-type scenario- because i will tell you one thing, they will not be at the point of injury, as the article states. Period. Theyre working off a 130- and that, my friends, is MEDEVAC, not CASEVAC.

Again, maybe its the article and not the intent.

I took it as getting patients off the helo and on the 130 to be flown back. I would guess that the term CASEVAC is used to keep the conventional AF and Aerovac folks from sticking their fingers in and gumming the works up, but I could be wrong.
 

AWP

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Is it a lack of understanding for the Green Feet and their mission that causes the tention you mentioned FF?

Rav, I can't speak to the "why" behind it, but I know back in the late 80's there was a movement to drop a PJ from each crew and replace him with an aerial gunner. Eventually the AF added the gunner without deleting the PJ slot, but the 80's were a rough time for them from what I've read and been told by the older guys. Quite a few pilots were butt hurt over an incident or two during Desert Storm, and I'd have to refresh my memory on that.....but I want to say it was a coordination issue and not a failure of Pararescue.

You'll always have detractors/ enemies in any organization, but look at how the AF has handled the SOF component since the end of Vietnam, Rescue Squadrons being in ACC, then in AFSOC, and back to ACC (I think), the lack of organization and guidance for the CCT's until Col. Carney took over. As outside looking in it appears that the AF in general has a problem with PJ's and CCT's. If Rescue was a priority wouldn't CSAR-X be in the history books by now?
 

Teufel

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Wow. Really? I dont really know how to respond to this- but the AF already has a pretty freaking capable CASEVAC capability. It's called "Pararescue" specifically, the GAWS as a whole, and apparently those guys are pretty freaking good at "provide(ing) advanced trauma life support in a harsh, hostile environment".

I dont know enough about this program or it's intent- but i am having a very aggro, alpha type reaction to this post. It seems as if these medics have been trained in a handover-type scenario- because i will tell you one thing, they will not be at the point of injury, as the article states. Period. Theyre working off a 130- and that, my friends, is MEDEVAC, not CASEVAC.

Again, maybe its the article and not the intent.

The terms Medevac and Casevac are thrown around a lot and are often mistakenly used interchangeably by many. A medevac is a dedicated medical platform (can be air or ground) with a big red cross on it that carries appropriately trained medical professionals that can provide en route medical care. With the red cross comes a the stipulation that they do not carry any armament larger than personal weapons. A medevac bird can recover a patient from the point of injury and take him to the follow on care facility but often handles the movement of patients from the level 1 or 2 triage center to a facility capable of providing a higher level of care such as Balad, Landstuhl, etc. The term CASEVAC indicates that the platform is not dedicated for medical care. This can range from a random CH-46 being vectored in from another mission to a CH-53 that is on strip alert to go get casualties. How is that not a medevac platform? Because the CH-53 in this case does have a big "don't hurt me" red cross on it and carries weapons. Also the medical crew on the bird can probably provide initial trauma management but cannot do en route care to the same level that the medevac bird can. For those that still don't get it, amlove21 is pointing out the absurdity of a C-130 going in to scoop up some patients.

That being said, I have seen a lot of medevacs and I have yet to meet a PJ. I was also refused medevac so I could have used some Green Feet for sure. Afghanistan is a big place and PJs can't cover down on the entire AO. It doesn't hurt to have redundant capabilities. To be honest though, all I saw was Army and Marine Corps air frames. I think some PJs came in after I left. It may have had something to do with the question I asked the Commandant when he visited our FOB: "Why our pilots have the balls to pick up severely wounded Marines during a fire fight?" (the proposed LZ was 800 meters away from the contact with fixed and rotary wing support and continuous SEAD from 81s, 105s and 120s.)
 

Nasty

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The PA crew that wrote this kinda sorta took things out of context, CASEVAC IS NOT from point of injury; it is meant to be means to transload the Pt, a hand-off from the PJ, team medic.... This is an AFSOC program and has been around in one form or another since the early '90s. The intent is to go where Big Blue aero-evac cannot go. It is in no way intended to replace PJs, it is meant to receive Pts from the Js and take them to more definitive care.
 

Chappy76

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AE guy here. Sounds like they are basically training up a Critical Care Air Transportation Team (CCATT) to be used on "unregulated" patient moves. Personally, and this is just me speaking, our AE system will never be able to provide adequate patient care that the PJ's provide. Big Blue AF will never let it happen and a lot of people in AE aren't as high-speed as they claim to be. I'm sure you'll here lots of talk about IDMT's saying they should be doing CASEVAC missions but besides medical care they cannot provide SAR capabilities if the need were to arise on a mission. Just my .02 cents.
 

Nasty

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Someone smarter than me explains CASEVAC

The Special Operations Forward Medical Element (SOFME) provides the critical link between the combatant medic and surgical care. Based on the conventional Squadron Medical Element concept, the team consists of two Independent Duty Medical Technicians (IDMTs) and a flight surgeon. In some cases, a Flight medicine Physician’s Assistant will substitute for one of the IDMTs on a team. Besides their core task of providing flight medicine support to deployed AFSOC aircrews, they are trained to provide initial trauma resuscitation both on the ground and on SOF air frames. They are trained and equipped to manage airborne casualties for extend periods to meet the reality that the nearest trauma surgical care may be thousands of miles away in some theaters. The IDMTs receive additional training to include NEMT-Paramedic and CASEVAC training. Because of this additional training, the PJ can be confident that transferring a patient to the SOFME IDMT does not in any way degrade the quality of trauma care provided to the patient. Effectively, the SOFME allows the combatant medic to transfer the casualty once out of the non-permissive environment to another qualified medic so the PJ can more rapidly return to the conflict and support his unit. The SOFME Flight surgeon can augment the IDMT’s on board the aircraft as needed but traditionally provide online medical control for both the PJ’s and the IDMT’s at the JSOAC. In the role of online medical controller, the flight surgeon will determine whether to have the casualty sent to his/her location or direct that the mission overfly the forward operating base to another location better able to manage the patient’s injuries. If the casualty arrives at the Forward Operating Base, the flight surgeon takes over management of the patient until aircraft are ready to provide evacuation to a site where trauma surgical care is available.
 
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