FEMANDMS Conference 2006 Aeromedical Evacuation Operations

1
FEMA-NDMS Conference 2006Aeromedical Evacuation
Operations

• Lt Col Jim Reineke
• HQ, Air Mobility Command
• AE Operations

2
A tornado the size of Georgia
3
OVERVIEW

• Aeromedical Evacuation Mission
• A Subset of Patient Movement
• Aeromedical Evacuation Unit Type Codes
• Blocks of Capability and How We Employ Them
• Command and Control of Assets
• Defense Support to Civil Authorities New
  Mission
• Lessons Learned
• Whats Different, Whats Not

4
AEROMEDICAL EVACUATION MISSION
Aeromedical Evacuation A Critical Lifesaving
Link for the Defense Health System

• DoD Patient Movement
• Transport US Military Casualties From Within The
  Combat Zone To Field Or Fixed Medical Treatment
  Facilities Either In Or Out Of The Combat Zone
• Aeromedical Evacuation (AE)
• The Movement Of Patients By Fixed-wing Aircraft,
  Under The Supervision Of Aeromedical Evacuation
  Crews, To And Between Medical Treatment Facilities

5
AE OPERATIONS EXECUTION PMRC AIRLIFT INTERFACE
Mirrors Airlift Process
Source/Treatment Facility Requester

• AIRLIFT CONTROL CENTER
• Decide Method to Accomplish Mission (Organic vs.
  Commercial)
• Determine Aircraft Best Suited for Mission
• Make Final Lift Decision
• Schedule Airlift Routes and Missions
• Task Mission to Appropriate Agency
• Monitor Execution and Flight Follow
• C2 of AE Assets During Execution
• Verify Patient Usage for Billing

AIR FORCE

• Patient Movement
• Requirements Center
• Validate Requirement
• Determine Mode
• Assign to Service Component
• Monitor Performance (QA)
• Oversight of MTF Capabilities

Pass Requirements
Communicate Non--Support

• Pass Requirement
• of Patient Requirements
• Originating Location
• Destination Location(s)
• Pick-up and Deliver Times
• Special Considerations

ARMY/NAVY Other Service
Commercial - Purchase Service - CAA

• Organic
• - Wing
• JOSAC (USAF)
• Coalition (Using AE Assets)

CRAF
6
GLOBAL PATIENT MOVEMENTThe Global Mission
Continued

• CENTCOM
• EUCOM
• NORTHCOM
• PACOM
• SOUTHCOM

CENTCOM NORTHCOM EUCOM PACOM
CCATT 25 22 69 70
54 58 47 73 61
65 68 67 62
Sep Oct Nov Dec Jan Feb Mar Apr May
Jun Jul Aug Sep
03 Oct 05 66 Patient Movement Requests 2
Urgent / 7 Priority BI 8 CUMULATIVE
SOUTHCOM PMRs FY04 125 Total FY 04 28,496 (BI
4,543) FY05 83
Cumulative FY 05 27,956 (BI 4,868)
Cumulative FY 06 43 (BI 14)
FY06 0 Completed Hurricane Patient Movements
Katrina 2609 Rita 1204
CCATT CRITICAL CARE AIR TRANSPORT TMs
7
AEROMEDICAL EVACUATIONCAPABILITIES

• The AE System Provides
• Integrated Control of Casualty Movement by Air
• Command and Control (C2) of Theater AE Forces and
  AE Operations
• Specialized Aircrew and Critical Care Transport
  Teams
• Operational Support Personnel
• En-Route Staging Facilities on or Near Air Fields
  for Care of In-Transit Patients
• Medical In-Flight Equipment
• Support to the Communication Network Between
  Airlift C2 Agencies

8
TODAYS TOTAL FORCE31 AE Squadrons
Active/Guard/Reserve
439 AES Westover ARB, MA
18 AES (PACAF) Kadena AB, Japan
86 AES (USAFE) Ramstein AB, GE
109 AES St. Paul, MN
914 AES Niagara Falls, NY
514 AES 714 AES McGuire, NJ
139 AES Stratton, NY
934 AES Minneapolis, MN
911 AES Pittsburgh, PA
446 AES McChord AFB, WA
142 AES New Castle, DE
932 AES Scott AFB, IL
445 AES Wright-Patt, OH
187 AES Cheyenne, WY
459 AES Andrews AFB, MD
375 AES Scott AFB, IL
167 AES Martinsburg, WV
349 AES Travis AFB, CA
43 AES Pope AFB, NC
146 AES Channel Islands, CA
156 AES Charlotte, NC
Kelly USA/FKELLY
137 AES Oklahoma City, OK
433 AES Lackland AFB, TX
452 AES March AFB, CA
118 AES Nashville TN
622 AES MacDill AFB, FL
Equipment Hub AD AES
AFRC AES ANG AES
315 AES Charleston, SC
183 AES Jackson, MS
908 AES Maxwell AFB, AL
94 AES Dobbins ARB, GA
9
Hurricane Katrina Efforts
Deployed AE Assets
Patients Evacuated
10
Hurricane Rita Efforts
Deployed AE Assets
Patients Evacuated
11
PM, AE PLAYERSJust at Scott AFB

• USTRANSCOM
• SG Surgeon General
• GPMRC Global Patient Movement Requirements Ctr
• Director of Patient Safety Program (USTC/SG)
• AMC
• A31M Mobile C2
• A33E AE Operations
• A35P Deliberate Planning
• A37TP - Training
• A37VM Stan/Eval
• A58F Concept Development

• 18 AF/TACC
• XOBN AE Barrel
• XOCA Execution Cell
• XOGC Global Channels
• XOPA Mission Support
• AMC/SG
• SGL Reserve Liaison
• SGO Clinical Operations
• SGP CCATT
• SGS Medical Equipment
• SGX Ground Medical Interface

12
AE OPERATIONSLIGHT, LEAN AND CAPABLE
Flexible for Full Spectrum Response - Peacetime,
HUMRO, DSCA
13
UNIT TYPE CODESAEROMEDICAL EVACUATION

• AE Command Squadron (8)
• Command Element, Management
• AE Crew (5)
• Flight Nurses, AE Technicians
• Inflight Care, Equipment
• AE Operations Team (8)
• Mission Support, Launch/Recovery, Crew Management
• Mobile Aeromedical Staging Facility (11)
• Staging no MDs Limited Definitive Care

14
UNIT TYPE CODESAEROMEDICAL EVACUATION

• AE Liaison Team (2)
• Flight Nurse, Medical Service Corps Officer
• Critical Care Air Transport Teams (3)
• MD, Critical Care Nurse, RT
• ABSOLUTE LINK BETWEEN PATIENT MOVEMENT AND
  AEROMEDICAL EVACUATION PLAYERS!
• Jnt Patient Movement Teams, Global PM Req Ctr
  (USTC)
• AE Planners, Mission Support, Execution (TACC)
• EMEDS, CASF, AE Equipment (AMC/SG)
• Now Strengthen Link W/ Civilian Partners

15
COMMAND AND CONTROLNETWORK
XOPA
16
JTF-Katrina Wiring Diagram(reflects original
chart posted from HQ JTF-Katrina, 8 Sep 05)
PETERSON AFB
PFO (Director FEMA)
NORTHCOM ADM KEATING
FORT GILLEM
CAMP SHELBY
BATON ROUGE
JTF KATRINA LTG HONORÉ
JTF KATRINA (FWD) MG COLGLAZIER
DCO MS
JTF- KATRINA SOUTHERN LOUISIANA BG GRAHAM
DCO LA
LCC MS Maj Gen CROSS
LCC LA MG LANDRENEAU
SJFHQ-N BG MOULTON
TF ALL AMERICAN MG CALDWELL
TF AVIATION COL SHANNAHAN
13 COSCOM (TLC) BG TERRY
PAD
38 IN (-) MG VADNAIS
35 IN (-) MG MASON
AVN Assets
TF KILKENNY (MCC) RDML KILKENNY
1 AETF (ACC) Maj Gen MAYES
TF ODELL (SPMAGTF) MajGen ODELL
2
1 CAV
82
SEA ECHELON RDML BOOKERT
SHORE ECHELON RDML TURCOTTE
FWD (ACCE) Maj Gen MORROW
TF AVN
BG CAMBELL
17
AOC Structure (Tyndall AFB)
NORTHCOM
NORAD
CSAF
ADM Keating
COMACC
JTF-Katrina CC
LTG Honore
JFACC
COMAFFOR
CONR/CC
1 AF/CC
1 AETF/CC
MGen Mayes
ACCE
Chief of Staff A1 A9 A2 SE A3 PA A4
JA A5 SG A6 HO A7 HC A8 IG
AOC DIRECTOR
DIRSPACEFOR, SOLE, JPRC, etc
DIRMOBFOR
2 x DDM4s
Strategy Div
Combat Plans Div
ISR Div
Combat Ops
Air Mobility Div
18
NEW MISSIONDODs Role as Homeland Responder

• Integrated Ops
• Staging
• Pt Prep
• Inter-Agency
• Orchestrate, not own the mission
• Bring the right operational expertise
• General Moseley, A/TA, 28 Oct 2005

19
SPECIAL NEEDSDiagnoses/Populations/Equipment
20
LESSON -- RESPONSECOMMAND/CONTROL/COMMUNICATION

• C2 Command and Control
• USNORTHCOM Planning Mtg DODD 6010.22
• Defines DoD roles and responsibilities and
  activation procedures
• Communication
• Early Dialogue
• Identify Requirements
• Validated
• Vetted
• UTC Capability or just manpower
• Comm Equip

21
LESSON RESPONSEPLANNING AND TIMELY EXECUTION

• Phased Approach
• UTCs Employed to Meet Requirement
• Airlift Requirement For Total Ops
• REMEMBER Support Role
• Early Planning
• Local and National Tabletop Exercises
• Coordination on USNORTHCOM Plans
• Cost of Homeland Readiness
• Quick Reaction Assets
• Think Multi-Modal
• Early!

22
Lessons for the DSCA PartnershipIn the Works

• Patient Tracking
• Manifesting and Records Continue as Issues
• Equipment
• Special Needs
• Return of Litters (and Straps)
• Patient Preparation
• Identification
• Medications
• Supplies
• i.e., Ostomy, Peds

23
SUMMARY

• Aeromedical Evacuation Mission
• A Subset of Patient Movement
• Aeromedical Evacuation Unit Type Codes
• Blocks of Capability and How We Employ Them
• Command and Control of Assets
• Defense Support to Civil Authorities New
  Mission
• Lessons Learned
• Real Progress Made
• The Spotlight is Already Focused

24
AEROMEDICAL EVACUATIONMeeting the Mission
Everyday

• Next To Moving The President, There Is No Other
  Special Mission More Important Than AE

25
BACK UP SLIDES
26
TANKER/AIRLIFT CONTROL CENTERAeromedical
Evacuation Mission Support

• AE Global Mobility planner for USTRANSCOM AMC
  supported exercises, contingencies, crisis,
  Non-combatant Evacuations, and humanitarian
  events
• Focal Point for all CJCS approved AE Requirements
• WARNORD/PLANORD/OPORD/EXORDs
• Mission Assignments, Request for Forces
• Source, task, rapidly deploy AE UTCs
• AE C2, MASF, AELT, AE Crews, CCATTs, etc
• AE Equipment, Communications, Re-supply, etc
• Central coordinating division among AMC/TACC AE
  functionals, COCOM medical planners, and other
  Federal agencies to determine, validate, and size
  AMC (or AMC gained) AE forces and equipment
• Develop implementation/execution plans
• Coordinate site operating AE support logistics
• Input to Common Medical Operations Plan