Off Is Not Really Off...

From the friend of a family member... Next time you think you're having a busy day at the office...

A Day in the Life of an Air Ambulance Team

This article is a brief synopsis of a day in the life of a US Army Forward Support Medical-Evacuation Team (FSMT) in Iraq. The team has sixteen soldiers and three helicopters. The soldiers are eight pilots, four mechanics, and four medics. The pilots are all commissioned officers or warrant officers. The mechanics and medics are enlisted personnel; mostly sergeants. The flying machines are Sikorsky UH-60A Blackhawks. Each can carry up to six litter patients, or four litter patients plus four ambulatory patients. In the summer heat of Iraq, where 110F is the mid-day norm, the Hawks fly at about 130 knots (twice as fast as your family car on the highway).

The duty cycle for our team is 1st Up, 2nd Up, Chase, Off. Each of these is a 24-hour period, so we are on duty for 72 hours then off for 24 hours. Off is not really off as we have housekeeping chores and home improvement projects going all the time. Currently, we're filling and stacking sand bags around our housing trailers to protect us from near-miss indirect fire attacks such as incoming mortars and rockets. The Anti-Iraqi forces lob a few of these missiles at the base every week.

The base is Forward Operation Base (FOB) Alpha. It is located in the Diyala Province near the Diyala River. The river flows to the Southwest toward the provincial capital of Baquba. The river bottom land between these two towns is agricultural land and known as "The Bread Basket". FOB Bravo is outside of Baquba. Our FOB and Bravo anchor the US military campaign in the Diyala Province.

The people of Diyala are diverse; about 40% Sunni Arabs, 40% Shiites Arabs, 10% Kurds, and 10% Christian Arabs and others. There are over 25 separate tribes and over 100 clans that further divide these people.

The following is a description of the events of June xx, 2007.

3:45 AM: The Cavalry Tactical Operations Center (TOC) tones an alarm and announces over the team's walkie-talkies "MEDEVAC, MEDEVAC, MEDEVAC. Nine-Line follows". The Nine-Line is a mission request with map location, radio frequency, unit call sign, landing zone markings and security, patient numbers and types, etc. First Up and Chase crews scramble out of bed, mostly dressed already, pull on boots, pick up weapons and Night Vision Goggles (NVG's) and run for the aircraft.

The patient is at the Battalion Aid Station (BAS) just a few hundred meters frorm our helipads. A ten year old Iraqi boy has a gunshot wound (GSW) to his head and has had a breathing tube inserted by the doctor on duty. This boy is the intentional victim of terrorist insurgents. The boy is brought to the helipad by humvee ambulance just as the rotors are up to full speed. With the patient loaded, the flight of two Hawks lifts off and speeds toward the Combat Support Hospital (CSH) 45 miles away. The boy survives the trip but his prognosis is not good.

5:15 AM: The mission is over for both crews of four. The medic and one pilot fill out reports. The other pilot and the mechanic fill out the log book and do a post-flight inspection of the machine. Then it's time for morning personal hygiene and breakfast at the chow hall.

8:00 AM: All four mechanics (including the one who's off duty) perform daily inspections of all three helicopters. The pilots check weather, intelligence, moon illumination data, and update maps (and drink coffee).

9:00 AM: Crews meet at the aircraft for daily pre-flight inspections, crew briefs, and run-ups. Run-ups are starting up the helicopters and testing out all systems, topping off fuel if necessary, and then shutting down again to stand-by for the next 24 hours.

10:00 AM: The 2nd-Up aircraft has been grounded since yesterday. After a mission, during shut-down, the tail-rotor gearbox seized up, stopping the rotors. A team of three mechanics was dropped off yesterday with parts and special tools for this major repair. The 2nd Up mechanic is assisting them in the already broiling sun.

10:22 AM: The TOC calls by telephone. A Bradley Fighting Vehicle (Light Tank) has rolled over into a canal. The crew of three is injured but not drowned. They are being brought to the FOB by regular humvee. We wait for them to arrive at the BAS for assessment and initial treatment by the MD or PA on duty there. The "Docs" will determine if there is a need for air medical evacuation in this case.

10:36 AM: Nine Line. The three tank crewmen have either head or spine injuries or both. Off we go again to the "Cash" (CSH).

1:00 PM: Late lunch for 1st Up and Chase crews.

All afternoon and early evening are quiet. Crew members nap in the air conditioning, work out, play computer games, watch DVD's, listen to CD's, study, talk and joke amongst themselves in operations or in the smoking area (too many young soldiers use tobacco). Dinner time comes and goes uneventfully. We like this as it means we are not out flying and at risk, and that no one has gotten severely hurt. Around 9:00 PM the team members start going off to bed in their quarters.

11:40 PM: The day is not over yet. Nine Line. This will be a Point Of Injury pick-up on a road 4 kilometers south of the town. There are possible enemy troops in the area and an Air Weapons Team (AWT) of AH-64 Apache Gunships has been dispatched to watch over 1st Up and Chase. The patient is a Suspected Insurgent (used to be called Enemy Prisoner of War). He made the mistake of attacking a Bradley armored vehicle with an AK-47. One lower leg has been traumatically amputated below the knee by a US machine gun bullet. This mission is more challenging because it is conducted under NVGs and the Landing Zone (LZ) is an unfamiliar road-side location with telephone and power line wire obstacles surrounding it. Also the rotorwash will kick up a blinding dust cloud around the helicopter. 1st Up makes the reconnaissance, approach, landing, pick-up, take-off and departure without a hitch, while Chase circles a safe distance away. The AWT circles right over the LZ looking for trouble. Off to the Cash goes the Med-Evac team again.

12:00 AM: The med-evac flight is sitting on the helipad at the hospital, off-loading the patient and his two US cavalry trooper escorts. We always get escorts for bad guys. The crews will be back at the FOB after midnight. Refueling. Post-flight inspecting. Cleaning up the blood in the cabin. Re-stocking medical supplies. Filling out reports. Washing up and hopefully getting into bed by 2:00 AM the next day.

So it goes, day after day...

Written by: (a National Guard Chief Warrant Officer and Master Army Aviator)
[xx] Forward Support Medical-Evacuation Team
Air Ambulance Company
General Support Aviation Battalion
Combat Aviation Brigade

FOB Alpha, Diyala Province, Iraq
June xx, 2007