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. 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.

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.

“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.

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.”

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 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. In 2003, medical Airmen helped a Soldier wounded in an ambush in southern Afghanistan. After the forward surgical team operated, he was in the hands of CCATT Airmen aboard a C-17 to Germany.

On Aug. 7, 2015, the 455th Expeditionary Aeromedical Evacuation Squadron moved service members following an attack on a U.S. military installation in Kabul. “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 CCAT team to provide safe medical care for the patients.”

A Critical Care Air Transport team, along with Airmen from the 10th Expeditionary Aeromedical Evacuation Flight and an Extracorporeal Membrane Oxygenation team from the 59th Medical Wing all traveled 8,000 miles on a C-17 in an effort to bring a Soldier to a higher echelon of care. In mid-August, Air Mobility Command’s 618th Air Operations Center was notified of an injured Soldier in need of urgent aeromedical evacuation out of Bagram Air Base, Afghanistan. The surgical services team at Bagram performed multiple lifesaving and stabilizing surgeries. The next day, the Soldier was evacuated out of Afghanistan on the C-17 for the long journey home. During flight, the Soldier was treated around the clock by the team of Airmen. Additionally, to keep the life-saving C-17 airborne during the non-stop AE journey, a MacDill KC-135 Stratotanker crew refueled the aircraft. Although refueling during an AE flight is uncommon due to the turbulence it can cause, it was necessary to ensure the Soldier reached specialized care in the United States as quickly as possible.

“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.”

Airmen and Soldiers, along with U.S. and Japanese civilian personnel, moved two critically ill and injured patients on the C-17 from Misawa Air Base, Japan, March 22, 2017. One patient’s life-threatening conditions required flying with a CCAT team. “We brought in a CCAT 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,” said Staff Sgt. Brek Halgren, the 35th Medical Support Squadron aeromedical evacuation non-commissioned officer in charge.

Airmen and Sailors outfitted a C-17 Globemaster III with life-saving equipment to transport a 16-month-old burn victim from U.S. Naval Hospital Yokosuka, Japan, to Travis Air Force Base, California, May 13, 2017. AE and CCAT teams normally use the “VERIFY” system to transport small, infant patients, but the crew faced a unique challenge since the child was too big for the 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.

Medical Airmen, like those in the 332nd Expeditionary Aeromedical Squadron, often work quickly to get patients from far forward theaters to higher levels of care. “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. With the C-17's advanced capabilities, medical Airmen are able to ensure the comfort and safety of even the most critical patients.

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.

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.