FALLS CHURCH, Va. --
Larger, faster and flexible – a flying ICU. Since joining the U.S. Air Force fleet in 1993, the C-17 Globemaster III has significantly expanded aeromedical evacuation capabilities.
In addition to its transport and other numerous mission sets, the C-17 converts to provide aeromedical evacuation to patients in a broad variety of conditions. The aircraft has played critical roles in various contingencies, bringing warfighters to higher levels of care, bringing patients home to the U.S., and aiding in humanitarian efforts to save the lives of those impacted by natural disasters.
These photos and stories showcase the C-17’s capabilities, and highlight some important missions that use those capabilities.
“The C-17 delivers unrivaled mission and crew support, enabling medics to provide unsurpassed aeromedical evacuation to not only our nation’s wounded warriors, but to transport the critically sick, ill and injured around the globe.”
– U.S. Air Force Maj. Catherine Ortega, 43rd Aeromedical Evacuation Squadron, Pope Field, North Carolina
Because each aircraft is different, AE crewmembers begin each mission by considering the specific medical equipment and litter configurations required. One of the many benefits that many medical Airmen appreciate is the ample space in the back of the C-17, boasting 77 more feet than the C-130 and a cruise speed of 515 mph. This provides room to treat patients, especially the critically ill or injured, and ensures quick transport to higher levels of care.
Crewmembers are extensively trained on the C-17, and are able to quickly configure the aircraft to meet each specific AE mission. They assess the equipment required to care for the patients, ensure all equipment is working properly, and even plan out where patients and equipment need to be placed.
Learn more: C-17 Globemaster III (fact sheet)
The versatility of the C-17 lets it accommodate up to 74 patients at a time, both litters and ambulatory patients, meeting many AE mission requirements. Once everything is planned out, AE crewmembers work on converting the large cargo aircraft into a flying intensive care unit to enable medical Airmen to provide en route care.
“The sheer versatility of the C-17 aircraft is amazing. One moment the cargo area is filled with equipment, the next it’s filled with wounded warriors for transport to higher echelons of care. I’m honored to fly on an aircraft that has the capability to support such a multitude of capabilities." – Capt. Benjamin Allen, 43rd Aeromedical Evacuation Squadron, Pope Field
The addition of the C-17 as an AE platform played a role in improving survival rates of wounded service members, adding to a robust and ever-advancing en route care system. AE crewmembers are able to move more critical patients with the addition of the C-17.
The capabilities of the C-17 can bring a wounded service member back to the U.S. in three days or less, when it used to take 10 days. Built in attachments for central oxygen and electric systems on the C-17 also help improve survival rates for even the most critical patients.
C-17’s larger space and integrated electric and oxygen systems allow for increased patient movement. It also means more room for more life-saving medical equipment and medical Airmen to accompany critically ill and injured patients to provide necessary en route care.
Often, critical care air transport teams are required to help move these patients, augmenting existing AE crewmembers. The CCATT is a three-person, highly specialized medical team consisting of a physician who specializes in an area of critical care or emergency medicine, a critical care nurse and a respiratory therapist.
Since Sept. 11, 2001, the Air Force has primarily used the C-130 Hercules and the C-17 Globemaster to move wounded warriors to higher levels of care. Multiple AE platforms ensure the Air Force can get patients the care they need when they need it.
Then-Lt. Col. Kathleen Flarity, former commander of the 455th Expeditionary Aeromedical Evacuation Flight, explained how the C-17 is a favorite among AE crewmembers:
“Equipment and procedures are being improved continually to move wounded warriors to progressively more sophisticated levels of care in Afghanistan and ultimately, in the United States,” said Flarity. “[The C-17] is big, bright and spacious with many built-in amenities such as medical-grade oxygen and buttons patients can push to call for assistance.”
Learn more: 455th Expeditionary Aeromedical Evacuation Flight (video)
The U.S. Air Force took delivery of its first C-17 Globemaster III at Charleston Air Force Base, South Carolina, June 14, 1993. The first C-17 squadron, the 17th Airlift Squadron, became operational in January 1995. For more than 25 years, this versatile aircraft has been described as “a do-anything, go-anywhere airframe.” The C-17 allows for transport of critical patients on long flights, contributing to improved battlefield survival rates.
For example in 2003, medical Airmen helped a seriously injured Soldier wounded in an ambush in southern Afghanistan. The Solider was shot on his right side, severely damaging his kidneys, with other critical injuries to his diaphragm and lung. After the forward surgical team removed his kidney and operated on his other injuries, he was in the hands of CCATT Airmen who were responsible for ensuring he safely made it to Landstuhl Regional Medical Center in Germany. The cardiopulmonary technician aboard monitored the Soldier’s breathing and drainage from his chest tube.
On Aug. 7, 2015, an attack on a U.S. military installation in Kabul left service members injured. The 455th Expeditionary Aeromedical Evacuation Squadron was tasked with moving service members from the battlefield to receive care in Germany.
“As the medical crew director, my responsibility was overseeing the overall mission of getting the patients moved from Bagram to Ramstein,” said Maj. Jonathan Freeman, a 455th EAES flight nurse deployed from North Carolina Air National Guard’s 156th AES. “I was responsible for coordinating requirements with the C-17 aircrew, ensuring the aircraft was properly configured, and to integrate the AE team with the CCATT team to provide safe medical care for the patients.”
The C-17 has a long track record of providing humanitarian support for refugees fleeing areas of conflict and in the wake of natural disasters. These missions showcase the flexibility of the C-17 and its highly capable AE crewmembers.
Medical Airmen from Ramstein Air Base, Germany, supported Operation Shining Hope, which provided humanitarian aid to Kosovar refugees in the spring of 1999. This mission displayed advances in the Air Force's deployed medical capabilities. The first four AE missions out of Tirana, Albania, were on C-17 Globmaster IIIs, demonstrating the C-17's effectiveness and flexibility.
Ahead of Hurricane Maria in 2017, Reserve Airmen from the 45th Aeromedical Evacuation Squadron worked to configure a C-17 to accommodate the heavy stream of patients requiring evacuation. The team evacuated patients with a wide range of medical concerns from the U.S. Virgin Islands and St. Croix, saving American lives while giving the AE crew valuable deployed experience.
Once AE crewmembers know the disposition of the patients they will be moving, they can quickly configure a C-17 to accommodate the patients and any life-saving equipment required for the flight.
Learn more: Arctic Eagles board C-17 for Hurricane Florence relief efforts (video)
Learn more: Aeromedical Evacuation Offload Six Injured Children during Fuego Relief (video)
The C-17 offers an improved patient experience. The C-17 has more space, improved lighting, built-in stanchions, working heat and air conditioning, and even the ability to serve warm coffee to patients and crewmembers, all of which ensure that patients stay more comfortable during flight.
“The C-17 is one of the most highly capable aeromedical evacuation aircraft. It brings the ease, comfort and readiness to our AE fight and mission.”
– Capt. Lauren Kalani, 18th Aeromedical Evacuation Squadron Clinical Quality Element
“In 2012 when an IED had went off, we were able to land in Bagram Airfield and move those affected quickly, and safely and get them to Landstuhl [Regional Medical Center] for advanced care," said Maj. Steven Radaker, detachment commander with the 18th Aeormedical Evacuation Squadron. "We were able set these patients minds at ease after such a traumatic event. The 18th AES, along with the C-17 aircrew, showed these patients that they can depend on us getting to them quickly and providing the critical care they need.“
In May of 2010, the 375th Aeromedical Staging Flight received their largest influx of patients since February of that year, accepting 49 wounded warriors over the course of two missions. The ASF transfers more than 1,500 patients a year. The larger capacity and availability of the C-17 makes large missions like these possible.
After completing the final flight of the Southern Hemisphere winter Antarctic season, the 304th Expeditionary Air Squadron was alerted there was a medical emergency at the National Science Foundation’s McMurdo Station, Aug. 25, 2018. The crew worked quickly in negative 65.2 Fahrenheit conditions to safely evacuate one critically ill patient and another needing medical care.
Not only did this mission highlight the agility and flexibility of the Joint Task Force-Support Forces Antarctica, it also showcased the C-17’s ability to be called on at any moment, and to land despite challenging conditions.
“AE missions are rewarding missions because it affords us the opportunity to serve military members and their families,” said Capt. Kai Yamashiro, 21st AS aircraft commander for this particular C-17 mission. “Without our ability to coordinate and work side by side with each other, this mission wouldn’t be feasible. Our teams work and train hard every day to be able to provide operational support for our fellow Airmen and their families in times of need.”
U.S. Airmen and Soldiers with Joint Base San Antonio, Texas, Kadena Air Base and Masawa Air Base, Japan, and March Air Force Base, California, along with U.S. and Japanese civilian personnel, teamed up to provide extensive medical support to move two critically ill and injured patients the from Misawa Air Base, Japan, March 22, 2017.
Two C-17 Globemaster IIIs each transported a critical patient, one to Tripler Army Medical Center in Honolulu, Hawaii, and one to Brooke Army Medical Center at Fort Sam Houston, Texas.
One patient’s life-threatening conditions required AE crewmembers to be augmented by CCATT. “Normal missions fly with three to five medical personnel,” said Staff Sgt. Brek Halgren, the 35th Medical Support Squadron aeromedical evacuation non-commissioned officer in charge. “We brought in a CCATT team from Kadena Air Base, Japan, an Extracorporeal Membrane Oxygenation team from Brooke Army Medical Center at Fort Sam Houston, Texas, and a few other specialties to assist in the patient in critical condition.”
Learn more: Misawa's Largest Aeromedical Evacuation (video)
Airmen and Sailors worked together to outfit a C-17 Globemaster III with life-saving equipment at Kadena AB, to transport a 16-month-old burn victim from U.S. Naval Hospital Yokosuka, Japan, to Travis Air Force Base, California, May 13, 2017.
Traditionally, AE and CCAT teams use a system known as “VERIFY” to transport small, infant patients. The crew faced a unique challenge since the child was too big for the existing onboard system and too small for a regular bed.
The solution was to secure a “Giraffe” omnibed system, traditionally used in neo-natal ICUs. This was the first time this system was used on the C-17, requiring extensive planning to ensure it would keep the child secure and safe during the 10-hour flight.
Medical Airmen, like those in the 332nd Expeditionary Aeromedical Squadron, often have to work quickly to get patients from far forward theaters to higher levels of care. This often requires medics to quickly move patients from one aircraft immediately on board the C-17.
“It can be as quick as ‘tail to tail’ for some of our clinically wounded – where a plane comes in from a (forward operating base), we unload them into an ambulance and move them to another plane on the runway to take off to Germany,” said Maj. Julianna Olson, the 332nd Expeditionary Aeromedical Squadron clinical nurse.
The medical Airmen that make up AE and CCAT teams are flexible enough to provide life-saving care on any aircraft. With the C-17's advanced capabilities, these medical Airmen are able to ensure the comfort and safety of even the most critical patients.