Nine liner

[PuckChaser]

Escorts overseas were Apaches that launched with the Blackhawk. Line 4 is special equipment and line 5 is number of patients. The rest of the info they can get in the air as its only the nationalities of casualties and marking method.

 

[brihard]

What kind of escort helos were they using for the Blackhawks - other Blackhawks or Apaches?  Were the escort helos already on station or did they launch with casevac?

Not sure that it is realistic to have rotors turning after 5 lines - they still need a mission brief and need to know what equipment to have on board.

They do have lots of great kit but the mission risk level determines the approvals required for launch this results from assessment of ground activity, security level at HLS , do other ops with higher priority for casevac, patient census level and Operating Room status at  closest treatment facility.

Realistic scenarios would allow some prep work before launching high priority assets.

Line 4 gives 'special equipment required'. Other than that, a bird used primarily for CASEVAC should be pretty loaded to the gills with most of anything needed; I would contend that very few combat casualties will require equipment over and above that carried routinely in a CASEVAC bird, and that the tradeoff of faster response times is worth the slight chance that one particular piece of equipment may be missed if they're wheels up before MIST is out.

Worst case, while they're in the air and en route, the decision to scrub or to hold off pending the arrival of escorts can be made as the tactical situation is fleshed out. The 9 liner is not the only source of relevant tactical information, after all- contact reports and SITREPs should have filled in much of that anyway. If the pilot has a 4 figure grid, he doesn't need an 8 or 10 or a method of marking until he's a few minutes out. If armed escort is made a default, that also will count towards faster response.

The tactical questions in this case play second fiddle to the larger strategic issue that even small numbers of casualties have become. If we get back into a war where there IS an 'acceptable loss ratio', then it's a different matter. But with every name and face having political ramifications, the 'side of caution' would seem to be the fastest CASEVAC achievable.

 

[Gunner98]

I am merely indicating that based on the 325 Medical Evacuation Missions that I coordinated at the RCS JOC Med Ops desk in 2008, things did not happen that quickly for all of the 530 casualties involved.  Response times vary with location, nationality of casualties,  and the situation on the ground.  In more than a few cases the casualties were inside burning vehicles or in firefights and it was impractical to have the birds on station while extraction took place.  Without the launch authority from the JOC or TOC which took anywhere from 2 minutes to 2 hour to obtain, it did not matter how quickly the crews readied their choppers they were not going anywhere fast.

The 9-line does not mean launch authority is automatic and depending on the nationality of the casualties and the destination med facility may change from where the helos will launch.  Without the complete MIST nobody was going anywhere.  Unless the casualties maintain heartbeats and functioning lungs, they could quickly become a routine ground transport issue.  US blood products at US facilities are normally reserved for US casualties when the US ground forces are busy.  Having one non-US casualty arrive at a facility and drain the 40 units available is not good for morale.  Likewise Afghan civilians, military or police casualties were often diverted to local medical facilities.

During 2008, most escorts from the launchpad were other Blackhawks and the Apache if available would meet up with them on approach since the speed and the range of the two helos differ significantly. Similarly an Apache sitting idle waiting for a med escort tasking is firepower that was seldom a luxury item that could not  be put to better use in a fight.

 

[Armymedic]

Simian,
By your own admission, that was Afghanistan. While that may still be true in RC south (it was as of Dec 11), it has been my experience that that is not a standardized SOP across the wide range of US military operations.

Flights for US and NATO allies tend to be launched very quickly, and info past during time of flight. Specifically I have seen this inside the US when there is no "local nationals", to be dealt with.

That being said, the report to launch time varies widely, and professional medical authorities need to ask that question of thier tactical medevac asset providers.

 

[PuckChaser]

The requirements seemed to get more and more stringent in RC(S) as time went on. When I got to theatre for Roto 4, we needed a full 9-liner and MIST was sent in the air. We had been told previously that only 4 lines were required and the remainder was sent in the air or as the crew was prepping. Typically you're not going to send half a 9-liner anyways, so its almost a moot point.

 

[Gunner98]

As has been pointed out my experience is Afghanistan-based, however, I have been on exercises and Joint Planning courses with the US before and after my deployment and the thing that often is absent is a sense of realism.  Time, space and risk are often discounted in order to speed the Major Events list along.

As wonderfully skilled as the PJs were in Afghanistan, the one thing that the MIST often provided was whether there was a need for a physician on board or in the case of the Brits it would be a Chinook containing a surgical team.  During the busiest day I had in Afghanistan I was coordinating 7 Med Evacs simultaneously and I can assure without a MIST it was difficult to assign priority for mission assets.  Likewise on the evening of a suicide fuel truck which resulted in 34 casualties finding sufficient transport and prioritizing litter cases was a challenge.

The other thing that changed after I left which expedited evacuations was Comd ISAF instituting a strict adherence to the wonderous Golden Hour (HLS to OR), but that is a discussion for another day.

Thanks for re-igniting this thread, it beats the heck out of thinking about year-end financial reporting and the joys of income tax season.