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Graphic of Steady and ready: C-130 mainstay of medevac

C-130 Hercules: An Introduction

Since the 1960s, the C-130 Hercules has been a workhorse of the U.S. Air Force aeromedical evacuation capability. Today, it remains a reliable platform to move patients over long distances, allowing Airmen and Guardians to provide critical care in the air, aid in disaster relief missions, and bring warfighters home.

First entering service in 1956, the C-130 is a versatile aircraft, well-suited to the AE mission. Rugged and dependable enough for extensive operations in theater, it is capable of operating from short and unimproved runways. This helps push medical capabilities closer to the front lines. The C-130’s design allows the aircraft to quickly switch from a cargo and personnel transport configuration to an AE platform for up to 74 litter patients. Outfitted with electrical and oxygen systems for AE equipment, the C-130’s cabin design helps reduce the negative impact of altitude on patients.

Currently, the C-130 is used as a tactical, intra-theater AE platform and is a mainstay of today’s AE system.


The C-130 is capable of operating in challenging conditions. During this training mission from Joint Base MacGuire-Dix-Lakenhurst, New Jersey, the ground was covered in icy, slick snow, demonstrating how the aircraft’s capabilities allow for safe and rapid patient evacuation in a variety of environments.
A C-130 can be configured to strap litters to either sides of metal posts connected at the ceiling and floor of the aircraft. The aeromedical evacuation team starts by setting up the litter stanchions, then installing oxygen lines, and finally attaching equipment used during the mission, all before patients are brought aboard. Setting up these posts to accommodate for litter patients is time consuming, so aircrews have to work efficiently to configure the aircraft.
The C-130 is a pressurized aircraft that minimizes the negative effects of altitude on patients, while ensuring rapid transport to higher levels of medical care. C-130 aircraft are equipped with electrical and oxygen systems to support and accommodate specialized aeromedical evacuation equipment and enable medical Airmen to provide the necessary care to patients.
The C-130 is the primary tactical intra-theater aeromedical evacuation platform employed during contingencies and war. Critical Care Air Transport Teams, specialized teams that augment AE crews to help move critically ill or injured patients, train on the C-130 to give these CCATT doctors, nurses and respiratory therapists an opportunity to totally immerse in the care of severely injured patients.
Members of the 60th Inpatient Squadron participated in the Air Force Reserve exercise Patriot Delta, providing en route patient care and staging the medical manikins. Training opportunities like this allow aeromedical evacuation crews to gain experience in all aspects of safe and efficient patient transport, ensuring patients are transferred to the next level of care.
Students in the Flight Nurse and Aeromedical Technician Course complete 40 hours on a C-130H mockup as part of their ground training check-rides at the U.S. Air Force School of Aerospace Medicine at Wright-Patterson Air Force Base, Ohio. USAFSAM houses two C-130 mockups used in a variety of aeromedical evacuation training courses. These mockups provide realistic training to prepare aeromedical evacuation crews for emergency procedures and in-flight patient care. The addition of an electric motion platform replicates the vibration and turbulence often encountered during takeoff, landing, and en route, making the training even more realistic and enabling the aeromedical crews to rehearse in a safe and immersive environment, which will ultimately improve patient safety and survivability during medical missions.

AE Missions

Reserve Lt. Col. Debora Lehker, commander, 752nd Medical Squadron at March Air Reserve Base, California, talks about how challenging it can be caring for critical patients on the back of an aircraft. “In the civilian world, you have everything at your fingertips,” said Lehker. “As a [Critical Care Air Transport Team] nurse I learned to overcome that challenge when you don’t have what you need and are forced to find another way to benefit the patient at that very moment.” Aeromedical Evacuation and CCATT members are considered flight crew, meaning they must be familiar with the C-130 aircraft in addition to the medical specialty they practice. They need to know how to configure the aircraft to accommodate patient litters and know how the electricity works for the machines used to keep patients safe in flight.
The C-130 is capable of achieving larger patient loads, patient transport over longer distances, and a greater ability to care for injured members. Before moving patients, aeromedical evacuation teams, like the Airmen with the 455th Expeditionary Aeromedical Evacuation Squadron, have a lot to do to prepare the aircraft for patient transport. This involves checking and loading 800 pounds of emergency equipment and converting the C -130’s cargo hold into a flying hospital. To ensure successful patient transport, all members of an AE crew must quickly coordinate to set up the appropriate litter configuration that maximizes patient transport and can accommodate the necessary medical equipment.
“What amazes me is the capability of the C-130. In a contingency exercise, my crew and I configured the 420 square foot cargo compartment to accommodate 72 litter-bound patients,” said Capt. Matthew Decker with the 375th Aeromedical Evacuation Training Squadron. Space on a C-130 is at a premium, so aeromedical evacuation teams have to be organized when they set up their working area, which runs nearly the entire length of the aircraft’s cargo area.
When time is critical, the C-130 can quickly pick up patients, provide care in the air, and move them to higher levels of care. This is especially important when moving hospital patients ahead of a natural disaster. In September of 2008, aeromedical evacuation crews from the 908th Aeromedical Evacuation Squadron, Scott Air Force Base, Illinois, helped move vulnerable patients from Beaumont, Texas, out of the path of Hurricane Ike.
“Not many people see a hospital room when walking onto the C-130, but that’s exactly what it is for many wounded warriors returning home,” said Capt. Michael Broome, U.S. Air Force School of Aerospace Medicine. The C-130J Super Hercules allows for larger patient loads, long-distance transportation, and a greater ability to care for injured members.
Technicians and nurses from the 379th Expeditionary Aeromedical Evacuation Squadron provide a variety of aeromedical evacuation services for patients at various deployed locations across U.S. Central Command to include pain management, psychiatric, and medical emergency response. These providers are trained to quickly prepare the aircraft for patient movement. “It wouldn’t be possible to move critical patients back from the frontlines without trained aircrew medical technicians and flight nurses,” said Senior Airman Robert McCabe, 379th EAES aeromedical evacuation technician. “It’s not an easy job, but we all make the best of it. It’s worth it.”
The C-130 can configure to best care for a variety of patients and their unique needs during transport. This capability came into play when a 7-month-old patient, who was born prematurely, required transport from Dallas to San Diego. The baby was too small for the traditional litters usually used to move patients, so the Critical Care Air Transport Team with the 59th Medical Wing strapped a car seat to one litter slung between metal braces.


The need for the C-130 came from the Air Force’s Tactical Air Command during 1951 to fill a void for medium-cargo tactical transport. The C-130 is still in production today, making it the longest running military aircraft production line in history. For much of its operational history, the C-130 and its variants have been a critical aeromedical evacuation platform for the U.S. Air Force, safely moving patients long distances and allowing AE crews to deliver care in the air.
According to the Air Mobility Command Historian Office, the C-130 is the most modified aircraft in the Air Force, allowing it to meet a variety of mission requirements. This versatility makes the C-130 an important airframe for disaster response, as it can be reconfigured quickly in the field from cargo transport to aeromedical evacuations when needed. On Jan. 16, 2010, a C-130 Hercules was able to land in Haiti after the area was hit by a 7.0 earthquake, delivering critical medical personnel and supplies.
A C-130 aircraft flew to Jordan as part of Operation Fig Hill, providing disaster relief and medical support during civil strife. C-130 aircraft have always been able to navigate austere and, at times, hostile airfields to meet a wide variety of aeromedical evacuation missions.
Since the Vietnam War, the C-130 airframe gained a reputation as a reliable plane with improved capabilities for patient transport, making it a mainstay of today’s aeromedical evacuation system. In October of 1984, at least 51 people were injured and 17 were killed in a blaze that occurred at the Pines Hotel in the Philippines. At that time, More than 200 World War II veterans and their families were staying at the hotel while attending a reunion commemorating the 40th anniversary of the liberation of the Philippines. C-130 aircraft were sent to transport victims to the regional medical center at Clark Air Base, Philippines.
“Our primary mission is providing intra-theater airlift, delivering people and supplies with our fleet of C-130 Hercules directly supporting ground troops throughout Iraq, Afghanistan and Africa,” said Then-Lt. Col. Joseph Sexton, former commander of the 746th Expeditionary Airlift Squadron. The ability to rapidly respond to in the war zone gives U.S. and coalition forces a greater flexibility to preserve life in the war on terrorism.
An Air Force doctor from Elmendorf Air Force Base in Anchorage, Alaska, delivered a woman’s son during a mercy flight on March 17, 1965. The C-130’s crew, from the 5017th Operations Squadron, assisted in the delivery.

Further Reading