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Few technological innovations have done more to reduce the number of deaths resulting from combat wounds than the helicopter. During combat operations in Korea, the helicopter became an integral part of the process of providing medical care to combat casualties. The early system of putting stretchers on the cross tubes of the H-13 and lashing the patient so he wouldn’t fall out was primitive at best. However, it was an improvement over a ride in an ambulance across rough terrain.
By the time our ground forces became involved actively in the conflict in Vietnam, the helicopter had undergone a number of technological changes that made it a more suitable vehicle for evacuating casualties from the battlefield.
From June 1968 to July 1969, 1 flew a CH-46 Sea Knight helicopter while attached to Marine Medium Helicopter Squadron 164 (HMM-164), Marine Air Group 16, 1st Marine Air Wing. When I first arrived in Vietnam, UH-34 squadrons almost exclusively handled medical evacuation (MedEvac) support. In the fall of 1968, however, the Marine Corps phased out the UH-34 and MedEvacs fell to the CH-46 squadrons. During daylight hours, the MedEvac mission was assigned by the Direct Air Support Center (DASC) on an as-needed/as-available basis to a section of helicopters (two aircraft). MedEvac missions diverted helicopters from other missions. Therefore, the decision to dispatch a MedEvac flight had to weigh the severity of the injuries involved against the operational mission being performed by the helicopters.
There were three classifications for MedEvacs. The first was emergency, indicating that the patient probably would not survive without prompt medical care. Pilots assumed that if someone was hurt seriously enough to require an emergency MedEvac, there was real trouble in the area. In these cases, the air crews often would undertake considerable risk in order to get the patient on board. The severity of wounds, however, was not evaluated always by a trained corpsman. Sometimes, a wound that looked bad to an untrained person would be deemed life-threatening and an emergency MedEvac would be requested.
The second classification was “routine,” meaning the patient needed medical attention, but it could be deferred for a period of time. In this case, helicopters would not be diverted until previously scheduled missions had been completed.
“Permanent routine” was the third classification—the transport of the bodies of Marines killed in action. We tried never to mix loads of wounded and dead, since it was bad for morale. The wounded came out first, then we returned for the dead.
Because of the difficulty of getting in and out of unlighted landing zones, we only flew emergency MedEvacs after dark. We maintained a standby section to fly any after-dark emergency mission, called Bald Eagle. Our aircraft were not configured as flying ambulances because the MedEvac flights usually were diverted
Delegate Astle, who used to fly Sea Knight helicopter* in Vietnam (above), still flies MedEvac missions as a civilian and is in a position to support new legislatm" designed to improve trauma care.
from the primary mission or added on after the primary mission was complete. We carried neither medical personnel nor any medical equipment on board. What mem cal support or treatment the patient received came on board with him when he was picked up from the field- Unfortunately, the corpsmen seldom accompanied patients to the medical facility because getting transportation back to his unit was uncertain. Many times the he 1 copter’s crew chief and gunner administered first aid until the aircraft landed at the hospital pad.
Field units usually used radios to call for a MedEvac helicopter. Sometimes a call would pass through severa levels of command before it reached the DASC and he ^ copters were called. Occasionally the message would ge garbled or delayed, and the birds wouldn’t get to the pickup soon enough to save the casualty.
When a MedEvac helicopter arrived over the area where the casualty was supposed to be, it was necessa; to verify the location to ensure the helicopter landed ^ where the good guys were. Generally the pilot would a-^ troops on the ground to pop a smoke grenade. The P1 then would identify the smoke’s color and confirm h with the ground troops. There were occasions when a pilot asked for smoke and he would get two columns instead of one. In those cases, the pilot knew immed1 ately that the bad guys were trying to bag themselves helicopter.
The changes to MedEvac helicopters are mind- boggling. Today’s MedEvac helicopters are fitted wit the latest medical equipment, just like modem hn\. lances. The MedEvac helicopter carries a medical tec cian, trained in trauma care, who can begin treating a patient while en route to the trauma center. Still, as look back, I don’t think I flew any mission that was a personally satisfying as MedEvac.
Lieutenant Colonel John C. Astle, U. S. Marine Corps Reserve member of the Maryland House of Delegates (D-Annapolis) and MedEvac pilot for the Washington Hospital Center.