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8/9/2019 Dust Off Army Aeromedical Evacuation in Vietnam
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UST
O
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DUST
OFF
RMY AEROMEDICAL
EVACUATION
IN
VIETN M
y
Peter Dorland
and
Jam es Nanney
MIUTAR r INSTRVCTICtII
CENTER OF M ILIT RY HISTORY
UN ITED ST TES
RMY
WASHINGTON D c. 2008
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Library
of
Congress Catalo
ging in Publicati
on
Data
Dorland , Peter, 1946-
Dust Ofr.
Bibliography: p.
I ncludes index.
1. Vietnamese Con fli ct 196 1- 197 - Medical and sa nitary affairs. 2
V iemamese Con
fli
ct 196 1- 197 - Ae rial opera
ti
ons American. I Nan ney.
J a mes, 1945-
II.
Ce
nter
of
Military
Hi
story
U.S.)
III.
Titl
e.
OS559.44.067 1982 959.704 37 82-8858
AACR
First Prin«d 1982-
CM
H Pub 90- 28- 1
For sale by e
Superintendent
of Docwnents
U.S. Government
Printing Office
Interne
t:
bookstoce.gpo.gov Phone: toll fcee (866) 512-1800; De area (202) 512-1800
Fax: (202) 512-2104 Mail: Stop
IDee
Washington. De 20402-000 1
ISBN 978-0-16 -075478-4
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Foreword
From
th
e whealfields of the Civil
War
lo
the
jung l
es
and paddi
es
of
Vielman
,
th
e Uniled
Slales
Army has led
the world
in adapling mod ern
transport tec
hnology
to the humanilar
-ian
goa l o f saving
the liv
es o f th e
sick
and wounded. Drawing on
its first experiments
wi th
heli
co pt
e rs in
Korea , the Army in
Vietnam came
to rely al
most
entire ly
on
the
he licopler for medical evacualion, The Dusl OIT and Medevac helicop
t
er
ambu
l
ance
units
tested
and
pe
rfected for
medical u
se the
Army's
ne w hc licopler, the
UH-
I ( Huey
Iroquois)
, and developed
severa
l
new
devi
ces, especially the hoist that helped
save
tho usands of
American
and allied lives belween 1962 and 1973, The pilolS of lh
ese
heli
copter
ambu lances
disp
l
ayed
a
co
urage
and
devotion to dUly tha t
earned them
widespread
re
spect
from so
ldi
ers
in
Vi
e
tnam.
T his book c
hroni
cles th e
ea
rl y
probl
ems
of
medica l evacuatio n in
Vie tnam , recounts the valor of
seve
ral of the Du st OfT crews, and
describes th e procedures and equipment used to sp
ee
d the moveme lll
of
patient
s LO
in-theat
e r Arm y hospi tal s. Il a lso shows the effect that
lhe helico
pl
cr
had
on lradiliona l Army pro
ce
dur
es dalin
g back lO lhe
Civil War. t sho
uld
inte r
es
t anyone
co
n
cern
ed with Army medical
hi sLO ry th e Vie tnam \tV a
I
, or the problem of adm iniste ring medical
ca re in war o r in tim
es
of civilian
disasters. The
widespread
use of th
e
helico pter for rnedica l evacuation in America since the Vietnam War
testifies
O
th e
broad
er iss ues raised by this s
tud
y and of the relevance
of Arm y his tory to the civilian
commu
nity. t is grat ifying thal the
d
emand
f
or
thi s work
justifies
thi s
new
reprint.
vV as hing to n , D.C.
22 May 1984
DOUGLAS KINNARD
Brigadier Genera l, U,S,A , (ReL)
Chief of
Mi
li lary HiSlory
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Preface
During a tour wit h
The Histor
ica l Un it ,
U.S. Army
Medical
Depart
-
ment
, ForI Detr ick,
Maryland,
from 1974 101977, Pe
terG.
Do rla n
d,
then a
ca
ptain
a nd a former Dust Ofr pilot in Viet nam,
comp
l
eted
the basic
r
esearch fo
r thi s book a nd drafted a len gth y manu script. In th e li rsl seve n
months of 198 1, as a n ed itor a t the U.S. A
rm
y
Cente
r
of
Military
Hi
story
CM
H ), Washingto n,
D.C
., I co nductcd furt her resea rch o n Du st
O
,
r
eo
r
gan
ized a nd r
cd
r
artcd
ponions
or
the
orig
ina l
manu
script ,
and
added
C hapter 4 a nd the Ep ilogue.
T he
au t
ho rs
accumu
lated a store of debt s, bOlh a t Fort De trick and
Washingto n . Albert E Cowd rey, ch ie f
0
1 the
Medi
ca l Hi slO ry Branch
eM
H , supervised the project , improv ing the manusc
ri
pt s prose
and
organ
i
zation
in many places,
and saw
th at
the
revisio n received a review by
othe r
hi
sto
rian
s
at
the
Center:
Stanley L. Falk ,
George L. Mac
Garrig le, and
Jeffrey G reenhut. Col. James W . Dun n s cr iti
ca
l eye a lso
impr
oved
the
substance
of
the book . T he final ed it ing a nd prepa ration of the book for
pub lication was the work of Edith M. Boldan . Arthur S. Hard yman helped
design the cove r a nd the map.
Others
at the
Center
who respond ed
to
frequent pleas for assistance were
Charles
S impson,
Co l Ma
ry
Van Ham
,
Charles
E
ll
sworth ,
Geraldine
Ju
dk ins,
Mary
Gillett, Dwight
Oland,
Graham Cosmas, V in
cen
t Demma,
J e ffrey C la rke,
and
my coworke rs in the Ed
it
oria l Bra nch .
Without
the
help of
the
se man y peop le, Peter Dorland and I could no t
h
ave
produced this book. T he autho rs, of co urse, accept sole responsibil ity
for any e
rror
s.
Wash ington , D.C.
1
a
nu a ry 1982
J
AMES NANNEY
v
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The Authors
Peter G. Do
rl
a nd received a bachelo r s degree in biology from Amherst
College. From Apri l 197 1 to Apri l 1972 he served in V ietnam as an Army
lie ut
ena
nt flying helicopte r ambulance miss ions for Eagle Dust r of the
101s1
Airborn
e Division (Ai rm obile) . From 1974 to 1977 he worked on thi s
manu
script at Fort De tri ck, Maryla nd , f r the
Arm
y M
ed
ica l Depa rtm ent.
He then returned to
fl
ying duties, and is c
urr
ently com m
and
ing .
as
a majo r,
the 247t h Med ical De tachment
at
Fo
ri
Ir win , Ca liforn ia .
Jam es
S
Na nn ey rece ived
hi
s B.A ., M .A ., and Ph .D. degrees from
Vanderbilt U niversi ty.
Hi
s fields were Ame
ri ca
n diploma tic history
and
Ru s-
sia n histo ry. From 1974 to 1980 he worked as a research associate for the
George C. M a rsha ll R esearch
Foundat
io n, helpin g Dr . For res t C. Pogue ex
am ine the postwa r ca ree l- of Ge neral Marsha ll as Secrc tary o f S ta te and
Secr
eta
ry of
Def
ense. In 1977 -78, he took a year s leave of absence from the
Foundat
io n
10
teach Ru ssian and rece nt U.S. history at Mu
rray
Stale U nive r
s
it
y.
Mu rr
a y, Ke
ntuck
y. Si nce
Novem
be r
1980
he has b
ec
n a me
mb
er
of
the
staff o f the Ce nte r of Military
Hi
s t
ory.
He is c
urr
entl y work ing o n the up
dating
of Ameri
can l
ita
ry
lis
to
ry
VI
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hapteT
I.
II.
III.
IV .
Contents
THE EARLY YEARS
Early Medical Evacuation
Early Aeromedica l Evacuation
The Korean War .
BIRTH
OF A TRADITION
The
Struggle
Be
gins. . . . . . .
The
First Air Ambulance Unit in Vietnam . . .
Dust OffTakes
Form .
R elations with the
South Viet namese .
Ke
ll
y a nd the
Dust Off
Mystique .
A New Buildup . . . . . . . . . . . . . .. .
. . . . . .
The
Cr
isis Deepens . . . • . . .
. .
THE SYSTEM MATURES
.
age
3
4
6
1
2 1
23
24
28
30
32
38
4
43
Origins of the Air Ambulance Pla
to
on . . . . . . . . . . 44
The
Air Ambu lance Platoon Goes to W
or
k . . . 46
The
Med ica l
Company
(Air
Ambu
la nce). .
49
The 436th
Medi
ca l Company (Provisional) . 52
ATTL E
BORO
. . . . . . • .
53
The 45th Medica l
Company
. . . . . . . . . . . . . . . . . . .
55
The
Buildup
of
1967 . . . . . . . . . . . . . . . . . . . . . . 56
Ri verin e
Operations
. '
57
l l i k h .
..
The
54th and the Kelly Tradition. . . . . . . . . . . . .
. .
61
Dust
Off
Win
s It s First M
eda
l
of
H
onor.
. . . . . . . 63
Dust Off
in the
Saddle
. . . . . . . . . . . . .
..
66
THE
PILOT
AT
WORK . . . . . . .
The
UH 1 Iroquois ( Huey ) . . .
The
Hoist .
.
Evacuation ssions
Evacuat ion Problems
.
Enemy Fire . . . . . . . . . . . .
A Turn ing Point . .
•
. .
67
67
7
74
79
84
88
VII
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hapttr
v FROM TET TO STAND DO
W N
TET 1968 . . . . . .
The Drawdown Be
gin
s.
A Second Medal or Honor .
VNAF Du
st O
fr
. . . . . . . . . . . .
Cambodia . . . . . .
. . . .
A Medevac in Per il
. .
Laos.
Papa
Whi
skey . . . .
Stand
Down and
Ship Out
EP ILOGUE .
Sta
stics
Doctrine and Lessons Learned
. .
A Hi storica l Perspective . . .
BIBLIOGRAP
HICAL NOTE
. . . .
INDEX . .
MAP
. . . .
VIII
Articles
Books and St udies . . . . . . . . . . . . .
. . .
. .
. . . . . .
. . .
89
89
94
96
98
1 1
1 2
106
11 0
3
11 5
11 5
11
7
121
1
25
1
25
1
27
129
2
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DUST
OFF
ARMY
AEROMEDICAL
EVACUATION
IN VIETNAM
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~ Camp Evans
Kh. S nh
o
~ MDHA
Of}
HU
0;:;
PhU
8a;
~ p
Eagle
571d
·
lHA
Eag le
DUlt
Off
r D
Nlmg
326th Med Battalion
236th
MOHA
10lst Airborne Dlv \
(Alrm bile)
c
k
I CORPS Chu o f
54th MDHA
68th MDHA
AIR AMBULANCE UNITS
IN VIETNAM
3 December 1969
?
o
6 0
1yO
Miles
50 1 Kilometers
PlfJ iku
0
283d MOHA
Qui Nhon
498th MCHA
[[ CORPS
Air
Ambulunce
Platoon
15th Mod
Buttalion Phuoc
tat Cuv Dlv
(Airmobile)
Vinh
0
LO
;
Khfl
Cu
hi
o
7th
MDHA
lS9th ~ H
® a long Binh
Binh Thuy
Naval
Base
0
8 d
MDHA
S IGON
45th
MCHA
Soc
Trtm9
~
IV CORPS
Phan Rang
247th
MDHA
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CHAPTER I
The Early Years
The sma ll outpost in the Vietna mese delta stood a vigilan t watch.
For the past tw ent y-four hours guerr illa soldiers had ha rassed its
defe
nder
s with occas ional mortar rounds a nd small arms fire. A rad io
ca
ll
for help h
ad
brought
ghter
-bombe
rs a nd a spotte r plane to
tr
y to
dis l
odge
the
enemy
from foxholes a
nd
bunkers they
had
built
during
the night. But neither the
ae
rial
obse
rver n
or
the
men
in the outpost
cou ld detect the Commu nist soldiers in their concealed positions. At
dawn
the outpost
comma
nder
ca
lled off his a lert a nd reduced the
number
of
perimeter gua rd s. Then he led a patrol out to su rvey the
a rea.
No
soone r had they le ft their defenses than the enemy opened
fire . Two of the soldiers fell bad ly wounded a nd the rest scrambled
back to the sa fety of their perimeter dragging their casualties wit h
them.
While
the medical corp
sme
n tr
eated
the wou nded a radio
telephone operator
ca
lled their headq u
arte
rs to the east at C ia Lam.
There
w h
en
the request for m
ed
ica l
evacuatio
n came
in
th e
duty
pilot ran to hi s
wa
itin g he
li
co pter and in
minutes was
a irbo
rn
e. Hi s
opera tions officer had told him that the
pickup
zone was insecure a nd
th at gunship s
wou
ld cover
him
.
Sin
ce there were f
ew
hel ico pter am-
bu lances in the thea ter this
fli
ght wou ld be a lon g on
e:
forty- ve
minutes eac
h way. After
taking
o
ff
the pilots r
ad
ioed the gu nships
and
confirmed the time
and
place of rendezvous.
On
his
map
he trac
ed his route
out
across the
paddied
l
andscape
broken
on
ly by a n oc
casio nal v ill
age
h
am
le t o r barbed wire
camp.
Five m i
nut
es from the beseiged o
utp
ost the flight l
ea
der of the
gun ship team radioed the air ambu lance that they had him in sight
a nd were closing on him . Wh ile the
ambu
la nce pilot pla nn ed his ap
proach the gunships
made
strafing runs over the outpost to keep the
enemy
dow n.
The
outpost
commande
r
marked
his pickup zone with a
smoke gre nade
and
the a
mbulance
pilot circl
ed
down
to it fr
om
high
overh
ead
. As soon as he
landed
he shou t
ed
at the grou nd troops to
load the wounded before a mortar hit him .
Once
the patients were
secured the pilot sped out of the
area
a nd h
ea
ded towa rd Lanessan
Ho
spita l radioin g
ahead
to report his est imated time of arr iva
l
Litter
bearers from the hospital wai ted to ru sh the casua lties in to the
emergency room as soon as the helicopter touched down.
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4 D UST O FF ARM Y A ERO M EDI
CA
L EVACUAT ION I N V I ET NAM
The a rea where this mi
ss
ion took pl ace was the R ed Ri ver Delt a
in
no rthern
Vi
e tnam . Cia Lam
wa
s the airfie ld serv in g Hanoi from
across the Doumer Bridge s
pann
ing the Red
Riv
e
r.
The de lCnd ers o f
the
outpo
st we re the French in the early
19
50s
.
By the end of 1953
th
e French in Ind
oc hina we
re us
ing
e ight
ee
n medica l
evac
ua tio n
helicopters .
From
April 1950 through ea rly 1954 French a ll
ambulances evacuated about fi ve
th
ousand cas ua lti es.
In these same years the V .S. Arm y whi ch had used a few
he licopters for medical evac
uation
a t the end of World W ar II ,
empl
oye
d helicopter ambu lances
on
a large r sca le, transpo rtin g so me
17, 700 V.S. casualties of the
Kor
ean War. Several y
ear
s later in the
Vietnam War it used helicopter
ambu
lan ces to move a lmost 900 ,000
V .S.
and
a
lli
ed sick a
nd
w
ound
ed.
The
ae
rom
edica l evacua
ti
on
techniques deve lo ped
in th
ese wars opened a new era
in th
e
tr
ea tment
of emergency patients. With their ability to land on almost a ny ter
ra in , heli
co
pters ca n
save
prec ious
minut
es th at o ften m
ea
n the d if
ference betwee n life and de
ath.
T oday ma ny civilia n medical and
d isaster re lief agencies rely on helicopter ambula nces. For the pas t
thirt
y years the
V.
S. Army has played a leadin g role
in
the develop
ment of this new technology.
arly M ed ical v cuation
Although surgeons often accompanied the profe
ss
iona l a rmies of
th e e ightee nth ce ntury, th e la r
ge
c iti
ze
n armies of the
ea
rly nine
teenth century, wh
ose
batt les oftcn produ ced mass ive cas ualties,
dem
anded and received the first effective systems
of
medi
ca
l evacua
tion. Two
of
the officers o f Napoleon Bona parte, the Ba rons Domini
que J
ea
n La
rr
ey and Pie
rr
e Francois Percy, des igned light, we ll
s
prun
g c
arri
ages for swift evacuation of the wo
und
ed .
Na
poleon saw
tha t each of his di visions rece ived a n a mbulance corps of abou t 170
men, headed by a chief s
ur
geon a nd equipped with the new horse
drawn ca rri ages. O ther continenta l po wers quickly adapted the
French system to th e ir own
need
s, but th e Brilish and America n
a rmies lagged a fu
ll
ha lf ce
ntur
y in learning the medical lessons of the
Na poleonic era.
In the Seminole W ar of
18
35-42 in Florida, the
V.S.
A
rm
y
M edical D epartme
nt
ex
perimented with ho rse-draw n ambul ances
and reco
mm
ended their adoption by the A rmy. But the Depa rtment
apparentl y got no res ponse. A f
ew
years later
ex
periments
we
re re
s
um
ed , and a four-wheeled ambulance proved success ful in the West.
But by the outbreak of the C ivil Wa r in April 1861 the Army had ac-
'This incide
nt is rel
atcd by Va ler
ie A n d
a Frcnch Air Force medica l pilot who new in
In dochi na. in her anic le L H sa
ni
ta
ir
e en Indoch ine, I. Officier
de R
tJertlt
\ 0 1 2
pp 30-3 1
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THE E RL Y YE RS 5
quired more two-wheeled th an four-wheeled ambu lances, and even
these were in short
supp
l
y.
In 1862 a nd 1863 scarce ambulances , poorly
trained s
tr
e tch er bearers, and unruly ambu lance d
ri
vers greatly
hind
ered the M edical Department s efforts to care for the wou nded.
Ambulances were so scarce that after the first major battle of the war at
Bull Run (2 1July 186 1) many
of
the 1,000 Union wounded depended
on friends
and
rela
ti
ves to pick them up in a family ca rriage. Man y
more simply str
agg
led the twenty-five mi les
ba
ck to W as hington on
foot. Three days after the battle hundreds of wou nd
ed
st
ill
lay where
they had fa llen. The stretcher bea rers co nsisted almos t
en
tirely of
me
mb
ers of milita ry bands who had been assigned the duty. As one
historia n noted, ... sc
rubbing
blood- soaked noors
and
tables, dis
posing of
dirt
y scabby bandages and carry
in
g bleed
in
g, she
ll
-shocked
soldiers h
ad
nothing to do with music, accordin gly the impressed musi
cians ed
th
e scen
e.
At the second battle of Bull Run (29 August 1862) the large
number
of civ
ili
an drifters hired by the
Quartermaster Co
rps to drive the am
bulances simply ned the scene at the first few shots. T he
Sur
geon
General quickly rounded up about two hundred more vehicles from the
streets of Washington and accepted civi lian volunteer drivers, who proved
to be worse than the first lot. M a ny broke into the med icine cabinets on the
ambu la nces, drank the liquorsupply, then d isappeared.
Those
who made
their way to Bull
Run
were found stealing bl ankets and
ot
her provisions,
and some even took
to
rining the pockets of the d
ea
d and dying.
Over the co
ur
se of the war, however,
th
e Union system ma
rk
e
dl
y
improved, thanks to the e
ff
orts of M aj . Jonat han Letterman, Medical
Director of the Army of the Potoma
c.
Letterma n reco
mm
ended sweep
ing reform s
in th
e ambulance system and the crea
ti
on of an orde
rl
y
group of med ical clear ing stations to the immed iate rear of each bat
tl
e
fr
ont.
The
mi
ss
ion
of
the a
mbulan
ces was to bring a
ll
casualties
to
the
clearing stat ions as rapidly as po
ss
ible. The station would then sort the
casualties, a proce
ss
known
as
triage. As soon as poss
ibl
e
th
e s
ur
geons
we
nt
to
work
on the serious casualties whom
th
ey deemed savable and
se
nt th
em to hospitals
in
the rear.
Th
e most se riously wounded were
often set aside,
many
to die before they reached the operat
in
g table. The
li
ghtly wounded were treated l
ater and
retained ncar the fronl. wo
goals suffu sed Letterman s new system: to reduce the tim e between
wounding a nd lifesav ing (definitive) surgery, and to evacuate a casualty
no farther to the rea r th
an
hi
s wounds demanded. T
hi
s wou ld result in a
hi
erarchy of medical selv ices, a chain
of
evacua
ti
on
that
ca
rried
a patient
to more specia
li
zed care the fa
rther
he moved
fi ln the
front.
On 2 August 1862 Maj.
Gen.
George B. M cC lellan ordered that
Lette
rman
s plan be
placed
into effect in the
Army
of
the Potomac
.
Ambulances were to be used on ly for the
tran
sport of sick or wounded
soldiers . Stretcher-b
ea
rers and hospita l stewards were to
wear
dist inc
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DUST OFF ARMY
AEROMED CAL
EVACUAT
ON N V
ETNAM
live insi
gn
ia on their uniforms. Ambulances were to move at
t
e head
of a ll wagon trains, not the rear. On ly medical
cor
psmen were to be
a llowed to remove the wounded from the battlefield . Al
though
a m
bulances horses and harnesses were to be under divi sion con trol all
am
bulanc
e
driver
s were to be
und
er M
ed
ical
Department
control,
trained
for their work,
and
not a llowed to assume other duties such as
ass i
sting
surgeons in the field hospita ls. They were also expect
ed
to be
of
proven
good character. In March 1864
President
Lincoln
approved
a congress ional
act creat
ing a uniform
ed
Ambulance Corps, based on
Letterman s pla n , for the entire Army of the United
States
.
Alth ough the Ambulance Corps was
disbanded
at the end of the
war, it had served
remar
k
ab
ly well when it was needed . The Medical
epartment
during the war had never
overcome
seri
ous
problems in
the supply
of
medicine
and
the cons
tru
ction
of
field hospital
s
But its
numerous horse-drawn ambulances had effectively removed the
wounded from the battlefields, even during the massive conflict
at
Gettysb
urg
In
the
Spanish
-Amer ican War and
Wor
ld War I , the U.S . Army
had to relea rn many of the medical lessons of the C ivi l War. By
World W ar I ground evacuat ion of cas ua lties could be accomplished
by motor-driven ambu lances, but the increased speed was offset to
some degree by limited road access to the widely dispersed front lines
in
France and
the Low
Countr
ies.
World War
s I
and
II show
ed that
automotive transport,
while effect ive for
backhau
ls from
clearing
sta
tions to field hospitals and
evacuation
hosp itals , was of limited value
in
evacuating
cas ualties from the spot where they fell.
Early eromedical Evacuation
The
first aeromedical evacuation occurred in the Franco-Prussian
War
of
1870-71. During
the German seige of Paris, observation
balloons flew out of the city with
many
bags
of
mail, a
few
high
ranking officials, and 160 casualties . Thirty-three years l
ater
at
Kitty
Hawk,
North Carolina,
Wilbur
and Orville Wright proved that
manned, engine-powered flight in heavier-than-air craft was actua lly
possible.
In
1908 the War
Department
awarded a contract to the
Wright
Brothers for the Army s first a irpl
ane,
and in July 1909
accepted their product.
Two
enterprising Army
officers quickly noted the medica l poten
tial of such aircraft.
At
Pensacola, Florida, in the autumn of 1909,
Capt.
George H.
R . Gosman, Medical
Corps, and
Lt. Albert
L
Rhoades, Coast Artillery Corps, used their own
money
to construct a
strange- looking craft in which the pilot, who was also to be a doctor,
sat
beside
the
patient.
On
its first powered flight the plane crashed into
a tree. Lacking the funds to continue the project,
Captain
Gosman
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TH
E I
::A
RLY Y EA RS
7
went
to
W ashington
to se
ek money from the W ar Depa
rtm
ent. H e
told one conference: I clearl y see tha t thousand s of ho
ur
s and
ultima tely thousa nds of patients would be saved
thr
ough use of
a irp lanes in a
ir
evacuatio
n.
But his audience thought the
id
ea im-
pr
ac
ti
ca
l
In
May 19 12 other m
ili
tar
y av ia tors reco
mm
e
nd
ed the use
of a ir a
mbu
lances to the Secreta ry of W a r, but the W a r Dep
art
ment
still thought airplanes
un
suitable for such a mi
ss
ion .
Durin
g W orld
W ar I
Arm
y Avi
at
ion grew st
ea
d ily,
but it
s planes served as air am
bu l
an
ces only sp
ora
dica
ll
y.
As they had with gr
ound ambu
la nces, the French pioneered the
use of a irpla nes as a mbula nces. During maneuvers in 1912 a n
a irp lane helped stretcher pa rt ies on the ground locate simu lated
cas ualties.
Th
e
Fr
ench then des igned a monoplane with a box-like
structure under its fuselage for moving casual
ti
es to
field hospitals In
Octo
ber 1913 a French milita ry officer reported ,
W
e sha ll revolu
ti
onize war s
ur
gery if the aeropla ne ca n be adop ted as a means of
tra nsport f
or
the wo
und
ed .
Du
ring
World
W a r I the French d id
occas iona lly move the wo
und
ed by a irpla ne , especia lly in Nove mb
er
1915
durin
g the r
et
rea t
of
the Serbi a n
Ar
my from a combined
German,
Austrian , a nd Bulga ria n attack in Alba
ni
a. Although the type of a ir
craft used in Alb
an
ia was ad
eq
ua te in t
hi
s isol
ate
d emergency, it was
hardly fit for rout ine use on the W estern Fron t
For the rest of the war the French
Army
gave li ttle atten tion
to
aeromed i
ca
l evacu
at
ion; they had too many cas ualties and too few
air
cra
ft to be concern ed with i
t
B
ut
one F rench military
surgeon,
Dr.
Eugene C hassaing, managed to keep the idea a live.
Wh
en he first
asked f
or
money to build air a
mbu
lances, one officer respo
nd
ed , Are
there not
eno
ugh d ead in Fra nce today without killing the wounded in
airp lanes? espi
te
such cr iticism, C hassai
ng
acquired an old
Do
rl
and
A.
R.
II figh
ter
an
d des igned a side
open
i
ng
th
at
a
ll
owed two
stretchers
to
be carried in the empty space of the
fu
se lage behind
th
e
pilot.
After
several test
fl
ights of the craft, he was perm itted to place six
such aircraft into operation.
In
Apri l 1918 two of these planes helped in
the evacuations from Flanders, but the fighting grew so intense there
that French higher authorities would
not
sanction continued use of the
planes. Late in
19
18
Dr. Chassaing
received permission to convert
sixt y four a irp lanes in Morocco into air ambu lances. and all were
used in that co untry in France's war against Riflian and Berber
tribesmen
in
the At las mountains. The French experimented with a
ir
ambulances throu ghout the interwar pe
ri
od.
By the end of World War I the U.S.
Army
had also begun
to
re
exa
mine its position on a ir ambulances. In 1920 the Army built
and
ew its l
ir
st a ircra ft de signed as
an air
a mbu la nce,
th
e
DeHavi
ll
and
DH-4A, which had space lor a pilot, two litter pat ients, a nd a medica l
a ttendant. In 1924 the
Army
let its lirst contrac ts lo r a ir ambula nces,
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8
DUST O F
F
RMY AERO M EDI
CAL
EVACUATION I N V IETNAM
and
in th
e nex t f
ew
yea rs
it
occas iona lly used its a
ir
ambulances to
p r ~
vide d i
saste
r re lief lO th e civili an community. In April 1927 afte r a tor
nado struck the sma
ll
town of Rocksprings, Texas the Arm y sent eigh
tee n
DH
-4
obse rva tion pl anes, two Douglass transport s and a Cox
Klemin
XA
-I
air
am
bul ance. T hese
pl
anes new in phys icia ns and su
p
plies to trea t 200 injured citize ns, some of whom the Cox- Klem in then
fl
ew ou t to mo rc sop
hi
sticated medical care in Sa n Antoni o.
Th
e decade a
ft
er the wa r a lso saw the development of rotary-wing
a ircra ft.
In
December 1928 the U nited States received
from Fra
nce its
first sampl e of a ro tary-w in g aircraft- the autogiro w
hi
ch used one
mo tor-drive n prope ller for forward mo
ti
on and another wi nd-d riven
pr
opeller for verti cal lift. By 1933 one U.S. manufac tur
er
had des ign
ed an
aU
g
ir
o
ambulance to ca
rr
y a pilo t and thr
ee
pa
ti
e
nt
s t
wo
rec
umb
ent in wire basket (S tokes) litters, a nd one sitt ing.
In
the
Dece
mb
er 1933 issue of the
l t
ary
Surgeon
L
t. Co
l.
G.
P. Lawrence
fo resaw
th
e mili ta ry uses of this air ambulance. S in ce
th
e aut
og
iro
could no t h
ove
r rough terrain fores ts and
swa
mps
wo
uld still re
qui re ground
evac
ua tion o f cas ualties . Bu t autogiros working from
nea rby landing areas could back haul the cas ua lties to medical sta
tions. The adva ntages see med indisputable:
AUlOg
iros not being limi ted by roads wou ld f
i.nd
more
fre
que
nt
op ponunities to open advanced landing posts than wou
ld
motor ambulances.
They could maneuver and dodge behind cover so
as to
make hits by enemy
artillery qu ite improbabl e. At nig
ht
they could potter around in the dark, un
disturbed by a
im
ed enemy fi re until they accura tely loca ted the land ing
place ou tl ined by ordi nal y elec
tri
c flas h
li
ght s in the hands of the co llect i
ng
co m
pa
ny and then land so ge
ntl
y
th
at the exact est imatio n of altitude wo
ul
d
be imm ate
ri
al.
In
1936 the Medical Field Se rvice School a t
Ca
rli
sle Ba
rr
acks, P
en
n
sylva nia tes ted
th
e medica l
evac
ua tion abilities of
th
e aut
og ir
o.
T hough the r
es
ults were pro
mi
sin
g
the Army s budgeta ry problems
pr
eve
nted fundin g a ro tary-w in g medical evacuat ion uni
t.
W orld
War
II broug
ht
the first widespread use
of fix
ed-wing a ir
c
ra
ft for milita ry medical evac
uation
. In M ay 1942 the Army M edical
Service activated the first U .S. ae romedical evacua tion unit, the 38th
Medi
cal
Air
Ambulan
ce Squadron stationed at Fort Benning,
eorgia.
Th
e war also stimulated further research on rota
ry
-wing air-
cra ft , both in Germany and the
United
S ta tes . Although Allied bomb
ing raids destroyed the fac tories that the G ermans inte
nd
ed to use for
helicopter production, research and development in the United Sta tes
pro
ceeded apace. On 20 April 1942 Ig
or
Sikorsky staged a successful
nig
ht
demonstration of his helic
opt
er. By M a rch 1943
th
e Army had
ordered thirt
y-
four Sikorsky helicopters, fifteen for the U .S. Army
Air
Forces , fifteen for the British, and four
fo
r the U .S. Navy. T hese a nd
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T H E RLY Y RS
9
la ter versions of the Sikorsky could be
qui
ckly converted to air
a
mbul
ance use by attaching litters to the sides of the a ircraft
T ests at the
Arm
y M a teriel Ce
nt
er in the s
umm
er of 1943 su
g-
gested that the helicopter could be a n effective
air
ambula nce. O n 13
Augu
st 1943 the Army Surgeon sta ted tha t he intended to fill the need
for a complete a
ir
evacuation service
in
combat zones by employ
in
g
helicopters, regardless of terra in features, as the only means of
evacuation from front lines to advanced airdomes. Further successful
tests of the litter-b
ea
ring he licopter in November 1943 s
upp
orted h is
decision . But he licopters we
re
not yet uundant and
th
e Surgeon s
plan c
ame
to nothin
g
The he
li
copter nevertheless
mana
ged to prove its va lue as a dev
ce
for rescue and medic
al
evacuation from fo
rw
a
rd
combat areas. In late
April 1944, L t Ca rt
er
H arma n, one of the first Army Air Forces
pilots
tr
a ined in helicopters a t the Sikorsky pla nt in Br idgeport, Con
necticut , flew for the 1st Air Comma
nd
o Force, U .S.
Arm
y Air
Forces, in
Indi
a.
On
23 April he took one of his unit s new li tter-
bea ring Sikorskys to pick
up
a stra
nd
ed pa rty with casualties about
twenty-fiv e kilometers west
of
M awlu ,
Burma
.
Wh
en he re
turn
ed
to
Indi
a he
had fl
o
wn
the U .S. Army s first he
li
c
opt
er medi
ca
l evacua
tion
m
ede
va
c) mission . Soon he
li
copters became
an
item in
hi
gh de
mand . M aj . Gen. George E . Stra temeye r , commander of the Eastern
Air Comma nd , re
qu
ested six of them for the rescue of five of his pilots
who had cra shed
in in
accessible areas and for similar rescue missions.
In
the spring of 1945 helicopters evacuated the sick a
nd
wounded of
the 112th R egimental C
omb
a t T eam
and
the 3
8th Inf
antry Division
from remote mounta
in
siles on
th
e island of Luzon
in th
e Philippines.
Mo
st evacuation from the fro
nt
lines in W orld War II, howeve r,
w
as
by conventional g
round ambul
ance. T he
Arm
y M edical Service
did
imp
rove its services, grea tly re
du
cing the mor
ta
lity ra tes from th ose
of W orld W ar 1 New drugs , such as penicillin and the sulfonamides,
a nd the stationing of maj or surgical facilities close to the front line,
saved
hundred
s of thousands of lives. Airplanes evacuated over 1. 5
million casualties , far more
than
in World War I , but this role was
largely limited
to
tra nsporting casualties from frontline hospita ls to
restora tive and recuperative hospitals in
th
e rea
r,
ra ther
th
an from
th
e
site of wo
undin
g to life-saving s
ur
gica l care. At
th
e e
nd
of the war Army
ae
romedical
eva
cuation still lacked a coherent system of regulations
and a standing organ izat i
ona
l base. Before it cou ld acquire th ese, Army
aviation would have to s
ur
vive the upheaval a ttending the
creat
ion of
the United Sta tes
Air
Fo rce .
The National Security Act of 1947 established the Uni ted States
Air Force as a sepa rate military arm a
nd
a t the same
tim
e stripped the
Army of most of its aircraft, l
ea
ving it only abo
ut
two hundred light
pla nes a
nd
helicopters. T he genera l mi
ss
ion of Army av iation was
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THE EARLY YE RS
11
Teachers College.
On
3
August he and
Capt.
Oscar
N.
Tibbetts,
the
squadron s
commander, met at the college
and examined one of
the
H-5 s. A Stokes litter fit into the compartment of the H-5 very well,
but
the handles
of
the
standard Army
litter
had
to
be cut
off.
With
two
patients and Colonel Dovell on
board,
the H -5 lifted off, easily
cleared the surrounding telephone poles and buildings, and returned
for a perfect landin
g
Colonel Dovell asked to see a long flight, so the
pilot flew
him and the two patients out to the 8054th Evacuation
Hospital
at
Pusan, 100 kilometers away.
On
10 August,
at Co
lonel
Dovell s request, Lt.
Gen.
Earle E .
Partridge,
commander
of
the Fifth
Air Force,
authorized th
e use
of
these ancl.other Air Force helicopters
for frontline evacuations. The Air Force
~
i n u e to evacuate the
Army s frontline casualties until the
end
of
the year, allowing the
Army
time to organize and ship to
Korea
its own helicopter detachments.
Late in the year the Army deployed four helicopter detachments
to
Korea. These
units, each
authorized
four
H-13
Sioux helicopters,
conta
ined
no
medical personnel, but were
under
the operational con-
trol
of
the
EUSAK
Surgeon.
Each
was
attached
to a
separate
mobile
surg
ical hospital, with a
primary
mission
of aeromed
ical evacuation.
The
crewmembers
drew their rations
and quarters
from the MASH,
and
their aircraft
parts
and
service from wherever they cou ld be
found. The
2d
Helicopter Detachment became operational
on
1
January
1951; the
3d,
later in January;
and
the 4th, in
March.
The
1st Helicopter Detachment, which arrived in February,
never
became
operationa
l because
commanders
transferred all
of
its aircraft to
other
nonmedical units. At the height
of
the Korean conflict the three
operational helicopter
detachments
controlled only eleven aircraft.
But by the end
of
the war they had
evacuated
about 17,700 casualties,
supplemented
by a considerable number
of
medevac missions per-
formed by nonmedical helicopters organic to division light
air
sections
and helicopters of
Army
cargo
transportation
companies . Marine and
Air Force helicopters had also made a sizable number
of
frontline
evacuations .
The
independence
and
therefore the value
of
the air
ambulance
units increased after the introduction
of
detailed standard
operating
procedures.
Typical of
those
adopted
by the
detachments
was the list
that
Lt. Col. Carl
T.
Dubuy, commander
of
the 1st Mobile Army
Surgical Hospital,
drew up
in early
February
1951. Evacuation re-
quests were to be made only for
patients
with serious wounds, or
where surface transport would seriously worsen a casualty s injuries.
The helicopters would be used strictly for medical evacuation
and
reconnaissance and would not be used for command administrative
or tactical missions. Each request for a helicopter was to include a
clear
and
careful
reading of
the coordinates
of
the pickup site. The
ground
commander was to try to find the lowest pickup site around,
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DUST OFF
ARMY
AEROMEDICAL
EV CU TION IN VIETNAM
to ease the
strain on
the minimally
powered
H -13 helicopters
that
performed the
bulk of
medical evacuations in Korea. A request was
not
to be
made
for a
landing
zone subject to hostile fire ; if trouble did
develop, the men on the ground were to wave off the helicopter.
Dubuy recommended
the
use of colored panels to form a cross to
mark the pickup site, and he also favored some indicator of wind
direction and velocity, such
as
grass fire. He suggested that if the
helicopter flew past the pickup zone without recognizing it, the
soldiers on the
ground
should fire flares
or
smoke grenades to attract
the pilot s
attention. (The
aircraft h
ad
no radios.)
Co
lonel
Dubuy
sent
these reco
mmended
procedures
to
the
commanding
general
of
the 7th
Inf
antry
Division, which the 1st
Mobi
le
Army
Surgical Hospital then
suppo
rted,
but
the
division afforded the list
on
ly a
haphazard
distribution.
n January 1951 all four pilots of the 2d Helicopter Detachment
took part in a mission that, although it violated the precept that
helicopters would not be flown within
rang
e of enemy weapons, saved
several lives. On the
morning of
3
January, Capt.
Albert
C.
Sebourn
of the 2d
Detachment
received
an urgent
request for
air
evac
uation
from a
unit at
a schoolhouse s
urround
ed by a large
Ch inese
Communist
force near C hoksong-ni. The
unit
was a Special
Activities
Group
(SAG), an elite, battalion-size
organization
of a ir
borne and ranger-qualified soldiers. Their on ly defensive perimeter
was the
border
of the one acre schoolyard. A
MASH doctor
had
been
asking for a ride in a helicopter. Sebourn put him in the right
seat
and
then fl
ew to the coordinates of the request. After l
and
ing in the
schoolyard,
Sebourn shut
down the helicopter. As soon as he and the
doctor
climbed out, a
mortar
round
l
anded near
the right side
of
the
helicopter, damaging it but not injuring anyone. Both men
ran
into
the schoolhouse, where the
commander of
the
SAG unit
explained
that he had numerous casualties and wanted the helicopter to
bring
in
ammunition
on its
return
flights from the hospital. When Sebourn
tried to
restart
his aircraft, he found that the battery was dead; he and
the doctor stayed
at
the school overnight.
When Sebourn
did not
return
to the 2d Detachment s base after
several hours ,
Capt. Joseph
W.
Hely
checked back through Eighth
Army
channels.
The
request
had
been
quite old
when
the 2d Detach
ment
received it : it
had
been
routed
through
Tokyo.
Eighth
Army
asked
Hely wheth
er
he would fly ammunition out to the beleaguered
force, and he assented. With
ammunition
in both his aircraft s litt
er
pods, he tried to
fly
out, but heavy snowfall made him postpone the
flight until the weather improved.
Next
morning, when he reachea
the area, he noticed tracers from enemy machine g
un
s trying to shoot
him down . He spiraled down into the schoolyard,
unloaded
the
am
munition, gave the battery in Sebourn s helicopter a boost,
and
then
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14 DUST OFF: ARMY AEROMEDICAL EVACUATION IN
VIETNAM
of helicopters to specific combat units for evacuation missions direct
support).
For
instance , the 3d
Infan
try Division, with an indorsement
from I Corps requested its own air ambulance; I Corps wanted to
g
iv
e each division its own a ir ambulance.
But EUSAK
headquarters
denied the
request
because there were not enough he
li
copters to pro-
vide such individualized coverage, and the current area and standby
coverage was working adequate l
y
Many
other
problems in this new system proved intractable.
The
most serious came from the constant need to repair the helicopter.
T he sluggishn ess of the Air Force, the Army s aviat ion procurement
agency, in meeting Army av iat ion s su
pp
ly needs created a backlog of
requests fo r helicopter parts and components. Just as American in-
dustry at
the
start of World
War
II was
unable
to
fill
a
ll
the Army s re-
quests for airplanes, so at the start of the Korean War it was not
geared for he
licopter
production. T he fine tol
erances
required
because
of
the
many
rot
at
ing
and
revolving parts in a helicopter,
and
the limit
ed
commercial potential for the craft, made American aircraft
manufacturers re lu ctant to devote their resources to such a chancy in-
vestment. When production did increase, a serious problem arose in
transporting the vast qu
ant
ities of war materiel from the States to
Korea . All of these problems adversely affected the supply of spare
par
ts, fuel,
and
even a ircraft. By late 1952 the eleven a ir
ambulance
helicopters in
Korea
had
to compete
with
about
635 oth
er
Army
nonmedical helicopters for whatever resources the American aircraft
industry could provide.
Parts shortages in the field accounted for the loss of
much
valuable
flyin g time in all Army aviat ion units in Korea, more so than any
other problem.
In
a three month period in 1952 the 8193d Army Un it
lost
abo
ut one-third of its potential a ircraft days because of parts short-
ages.
This
resulted in
li
ves lost because the
unit
was
un
ab
le to respond
to a
ll
evacuat ion requests.
The
8193d commander
Capt.
Emil R.
Day
requested that a fifth helicopter be assigned to each of the
MASH
helico
pter
detachme
nt
s,
but
thi s was not done.
In
a
ll
ocating
parts the
Air
Force favored its own
fi
g
ht
ers
and
b
ombers
over the
Army helicopters. Supply personnel in the States seemed to have little
awareness of the cost in human life of
returning
supply requests for
editorial changes, ex
pl
anations of excess requirements, and
proper
item descriptions H arry S Pack, in
an eva
lu
at
ion of the
pr
oblems of
helicopter evacuation
in
Korea, aptly criticized
th
e support system:
The
basic concept of the employment
of
the helicopter
in
the Army . is
it
s increased speed over other fo
rm
s of transport currently
in
use
in th
e
mov
eme
nt
of
per
so
nnel and materie
l.
Therefore,
it is
only logical
th
at the en-
tire helicop ter program, including maintenance a
nd
supply procedures,
should follow Ihe same philosophy
of
speed and mobi l
it
y 1 ensure receiv ing
maximum value from the helicopter.
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6
UST OFF ARMY
AEROMEDICAL EVACUAT
ION I N V I
ETNAM
into the Stokes li tter. Some pat ien ts with cert ain types o f casts splints
and
dressings cou ld no t be
mo
ved by helicoptcr at a ll becau se of the con
fined spa ce
of
the Stokes litter.
Th
e pilots a nd mecha ni
cs
imp rovised
hea ting for the
in
side
of
these li tte rs by fabrica ting manifold shro uds
and
dueling
warm
a ir
ofT
the
man if
o lds i
nto
the litte rs.
Ev
en so
th
e patie
nt
s
had to be covered with mount a in slee ping bags
or
plas
ti
c bags. If the
manifold h
ea
l
were
used
on
o nc li
tt
er o
nl
y,
exc
ess
wa
rm a ir esca ped ncar
th e hose conn
ec
tion; but
i heat
were tu rned o n both litters
th
ere was not
enou gh lo r ei ther.
The
problem pa rt ly stemmed from the plast ic cover; it
lay direc tly on the pat ient and did not a llow the hea t to circul
ate
properl y
So the de
ta
chment s worked with a maintenance
com
pany and a Bell A ir
craft technical rep resentat ive constructing a three quarte r le ng th cover
of
la b ric-covered
tub
ing tha t could bejoined to the
or
igin al h
ea
d cover.
t
served
as
a windbreak a
nd
gave spa ce
for th
e heat to cir
7
ulatc over
th
e
patient s low
er
body.
InJuly
19
51 a new litter mount , manufac
tur
ed by Bell Aircraft for
the H - 13, reached Korea . These greatly improved mounts accom
moda ted a sta nda rd Arm y field litter ,
elimin
a ting the need to tra nsfe r
a pa tient to a Stokes li tter be l
or
e placing him in the pod. Un fortunately
the cov
ers
that Be ll man uf
ac
tured for the new mount we re usua lly
torn up by the slipstrea m a fter j ust
thirt
y days
of
use . T he
d
etachm
e
nt
s i
mprovi
se
d a
ca
n
vas
cover
from
pup
te nt she lter halves;
when used with the zipp
er
a nd s
nap
s
fr
om the Be ll cover , it
pr
oved rar
s
uper
i
or
to the original in that it had a long service li fe a nd kept water
from see pin g throu gh onto the patient. T he men
of
the detachment s
used their own money a nd
Kor
ean labo r to pr
od
uce a n ample supply
of cove rs.
Even with the improved pods, the ex ternal mounting a nd the
abse nce of a med ica l corpsman o n the a ircraft produced ano ther di
f-
fi
cult
y
P
il
ots b
ega
n to notice
that
many
of
the casualties needed
tra nsfusion s before being moved to a m
ob
ile surgi
ca
l hos pi ta
l
n cold
weathe r an in-
fli
ght transfusio n with the flu ids stored
outs
ide the a ir
cra ft risked deepenin g the pa
ti
ent s shock as the fluid tempe ra
tur
e
dropped. At lirst the pilots would wait the th irt y or forty-five
minut
es
necessary ror a trans
fu
sion before depa rting with a patient. T hen L t
Col J a mes
M. Brown,
commander of
the 8063d
Mob ile Surgical
Hospita
l, dev ised a method for en route tran sfu sions of plas ma 01
whole blood. A bott le of blood or plasma was a ttached to the inside
wall
of
the cockpit with in reach
of
the pilot. Needles a nd plas ma
would be a rra nged before
departure
,
an
d
during fli
g
ht
the pilot could
mon
itor the fluid
flo
w
thr
ough the
tub
es extending to the litter
pod
s .
A rubber bu lb could be used to regula te
pr
essure to the bottle. T
hi
s
modifi
cat
ion was a
ppro
ved for a ll medica l helicopters in the thea ter,
a nd Bell Aircrart also i
ncorporat
ed it in a ll its D-model
air
craft.
Since the E ighth A rmy possessed on ly thirty-two H -13 s by
May
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THE EARLY Y EA RS
17
195 1, use
of
the valuable cra ft had
to
be closely monitored a nd
res tricted . A
re
curring probl em was that ground
co
mmand ers
sometimes reques ted helicopters morc as a co nveni ence than as a
necess
it
y To preve nt thi s, the EUSAK Surge on on 23 June 195 1
dissemin ated a stateme
nt
th
at
th
e role
of
hel icopter evacuat ion was
onl y
to
prov ide immediate evacuation of nontranspo
rt
able and
critica ll y ill or
injur
ed pa tient s who needed surgica l or medical care
not ava
il
abl e a t forwa
rd
medica l facilities .
Thi
s statement was given
wider distribution
than
had Colonel Dubuy s in Februa ry and it
noticeabl y reduced the
numb
er of unnecessary mi ss ions.
T he detac hments o Tered their service to a
ll
of the fi ghting units in
volved in the United Na tions effon in Korea . At first glance it seemed
tha t the language
ba
rrier would make ma ny of these mi
ss
ions
ft
r
em
el
y
difficult. But the lack of air-ground communica tions helpe8 in thi s
respec t for it precluded any a
tt
empt whatsoever at oral o ~ m u n
tion betwee n pilots and ground commanders.
Mo
st pilots found tha t
universal sign
lan
guage us
ua ll
y sufficed to
tr
ansmit any informa tion
necessary to complete
an
evacuation.
In
Septe
mb
er 195 1 one of the
pilots received a request to pick up two
wound
ed men from a T
urki
sh
brigade.
Th
e pilot recalled :
When I
got
to the spot des ignated I couldn t find anybody. I was c
ircl in
g around
when
a
Turkish observa tion
pl
ane buzzed me. He led me to a wooded area
on a moullla in top where
th
e T urks had dug in . T he
tr
ees were too high to
perm it a landing.
t
looked pretty hopeless because couldn t communicate
with them. Fina
ll
y, we ill in close until
th
e roto r blades of
th
e he
li
copter
bru shed the tops of the trees. T he T urks go t the
pi
tch. They chop ped down
enough of the trees so that co uld land on a
rid
ge. sa l down a
nd
the
C hinese began tossi ng mortar shells
a t
me. But go t the two wounded
Tur
ks
out.
Enemy ground res istance to a
ir
ambul ances in Korea never
became a severe problem , as it did later in V ietnam. Few landing
zones
we
re subj ect to enemy sma
ll
a
rm
s fire but many we re within
ra nge
of
enemy anille.
·y
and morta r
s
Although the pilots genera
ll
y
stayed out of landing zones under enemy fire, several had more
th
an
one encounter with C
ommuni
st weapons. At on po
in
t
ea
rly
in
th e
war a compa ny of the 7th Infa ntry Division was
fi
ghting in the area
known as the Iron Tria ngle. In assaulting an enemy-held slope, two ori ts
soldiers were seriously wo
und
ed by the C hinese. A requ es t for an a ir
ambu lance quic
kl
y made its way to the 4th Helicopter Detachment ,
stationed with the 8076th M obile Surgical H ospital a t C hunchon.
C BS correspond ent
Rob
ert Pierpoint was there and had rece ived per
mi
ss
ion to ny with the detachm ent. Three minutes a fter the ca ll came
in , a pilot and Pie rpoint new north toward the pic
kup
site. T he m
en
on the g
round
put out col
ored
panels
to
ma rk a land ing zone on a
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8
UST OFF
ARMY AER
OMED
ICAL
EVACUATI
ON I N V I
ETNAM
n
earby padd
y, whil e others tried to bring the cas ualties down from the
hill. Thirty minutes after the ca ll went out , the helicopter landed at
the marked pos ition. T he pilot and Pierpoint got out. Ju st as the litter
bearers made it down the hill , C hinese
mortar
s from across the va lley
opened up on the
padd
y
A
mortar
r
ound
came
in, hit
about
thirty
fe
et
from the helicop t
er
tail, and sen t the Americans scra mblin g up the hill.
T he company co
mmander
ca lled an arti
ll
ery ba ttalion 6,000 yards to the
r
ea
r and had
th
em knock out
th
e C hinese mortar pos
iti
ons.
T he pilots, Pierpoint,
and
the Iill
er bearers
re
turn
ed to
th
e
helicopter and
lo
aded the cas ualties. Not waiting to check for damage
the pilot climbed int o the
smo
ke-filled cockpit. H e cou ld hardl y see
the
in
struments but as soon as Pierpoint jumped in they made a
max
imum
power
takeoff. T hey l
anded at
the hospital
at
2120, r
eading
their a ircraft instruments with a flashlight one of the men
at
the paddy
had g
iven
them.
In another respec
t
Korea was worse than Vietnam: the am-
bulan
ce crews
some
times
had
to contend with
enemy
aircraft.
Although
the
U.S.
Air
For
ce destroyed most
of th
e
North Korean
air
craf
t ea
rl
y in the con
fli
ct, the entrance of the Chinese Communists into
the war in December 1950 brought fast and powerful enemy jet
fighters to Korea. A few medical helicopters did encount
er
fire from
North Korean
Yak fighters,
but
the
Americans outmaneuvered
the
faster jets and escaped damage.
Apa rt
fr
om
frontline
evacuat
ions a ir
amb
ulan
ce
de tachments
also flew a few
other
medica l
support
missions. By the second year
of
the
war
they routinely
transported
whole blood to the mobile surgical
hospitals. This proved valuable because the whole blood tend
ed
to
break
down
pr
ema
turely or clot when
carr
i
ed
by surface vehicles over
the rough
Korean
roads. The faster means of transport also allowed
blood storage
and
refrigeration to be
centra
li
zed
rather than
dispersed
close to the front.
The
helicopters backhauled some critical patients
from the mobile surgi
ca
l hospitals to a ir
str
ips for
further
evacuation to
one of the general hospitals
inJapan.
Sometimes they even backhauled
patients to hospita l ships
along
the coast,
such
as
th
e Navy s hospital
ship onso
lation
a
nd th
e Danish
Jutlandia
which were
equ ipp
ed for
helicopter landings Since fixed-wing ca rgo pl
anes
ew a ll
casua
lties
bound for Japan , the hospital ships remained anchored as floating
hospitals off Korea rath
er
than act as ferries.
Most
de
tachm
e
nt
pilots also tried to make
th
e life
of
th
e frontline
soldiers as tolerable as they could. Besides medical supplies a
nd
am
munition
the pilots often took beer ice cream and
so
das to the front.
T he sight
of
the helico
pter
coming in for a l
anding
in the blist
ering
Korean
s
ummer
with the pilot wearing only his boots, a red
ba
seba
ll
cap,
a
nd
swimming trunks,
and
then unloading these otherwise unobtainable
luxuries , did mu
ch to boost the morale
of
the co
mbat
soldier
s
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TJ I
RLY YE RS
19
Apart from yielding a great deal
of
practical experience, the
Kor
ean
War
furthered aeromedical evacuation by convincing the Army
that the helicopter ambu lances deserved a permanent organizat ion.
When the war broke out, the Army M edical Service
commanded
neither
helicopters
nor
pilots,
and
its l
eaders
were not
committed
to further-
ing
aeromed
ical evacuation.
In Kor
ea the Eighth Army soon acqu ired
virtually complete operational control
of
the helicopt
er
detachments
charged with a mission
of
medical evacuation.
But
the Surgeon
General
want
ed to have the
detachments made
organic to the Medical
Service, to have an organi za
ti
on within the Office of the Surgeon
General capable
of
dir
ecting and admi niste ring the av ia tion
resources, and to have medical personnel rather than av iators
fr
om
other
branches
of
the
Army
piloting the a ir
cra
ft.
The Surgeon General achieved his first goal with the publi cation
on 20 August 1952
of
TO E 8-500A , which provided for an a ir am
bulance detachment
of
seven officers,
tw
e
nt
y-one dnlisted men, and
five utility h
el
icopters. T he first such u nit was the 53d Medical
Detachment
(He li
cop t
er Ambu
lance),
act
ivated
at
Brooke
Army
Medical en ter, Fort Sam Houston, San Antonio, Texas, on 15
October 1952. In
Kor
ea, mea nwhile, th e a mbulance units were
tra nsfered from the adm ini
strat
ive command
of th
e Eighth
Army
F
li
ght
Detachment
to that of the Eighth
Army
Su
rgeon.
By the end
of
the war the
Su
rgeon Ge neral also succeeded in
achiev
in
g hi s seco
nd
goal of crea
tin
g a special aviat ion section
in
his
office. O n 30
Jun
e 1952 the C hief
of Staff
of the Army directed the
C hairman
of
the Materiel Review Board to eva luate the Army
hel icopter program. In accordance with the Boa rd s recommend ation,
the C
hi
ef of Staff on 17 October 1952 directed the assistant c
hi
efs of
staff a nd the va
ri
ous
Army
branch c
hi
efs to set up their ow n agencies
to
supervise and coordinate aviation within each o
ffi
ce.
The
Surgeon
Gene ra l's Office was charged with coo rdination of a ll
pl
anning
operations, personnel staffin g, and supply
of
Army av iat ion used in
the Medical Service. On 6 November the office estab lished the Army
Aviation Section within
th
e Hospita
li
zation and Operations
Br
anch,
Medical Pl
ans
a nd
Op
erat ions Division .
On
the
adv
ice of the new
sect ion , the S
ur
geon General reco mmended that
...
a
ll
a ircra
li
des igned, developed ,
or
accepted for the
Army (regard
less
of
its in -
tended primary use) be chosen with a view toward potential use as air
ambulances to accommodate a maximum number
of
standard litters .
This advice was followed in 1955 when the Army held a des ign com-
petition for a new multipurpose utility helicopter. The winner of the
competition, the Bell Aircraft Corporation's prototype
of
the U H-1
Iroquois ( Huey ), even tually beca me the Army's standard am-
bulance
helicopter in the Vietnam War.
During
the
Kor
ea n
War
the
Surgeon Genera
l also tried to place
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20
DUST
OFF
ARMY AEROMEDICAL EVACUAT ON N V
ETNAM
M edi
ca
l Service Corps (MSC) pilots in the cockpits of the
Army
s a ir
ambulan
ces,
But he did not succeed until shortly a fter the armistice
in 195 3, From ea rl y 1951 on , the Surgeon Genera l had advocated
tra ining some
MSC
officers as av iators, and in the spring
of
1952 the
regul
at
ions gove
rnin
g
Army
av
iati
on
were
ame
nded to a
ll
ow
MSC
personn el to become pilots, A
qu
ota
of
twenty-
fi
ve
MSC
officers,
most ly second lieutenants, was set for night
tra
ini
ng
in
October.
None
of the current MSC officers h
ad
ever been helicopter pilots,
alth
oug
h a few had had some av iat ion tra in ing, By ea rly July, fifty
three applicat ions f
or
the slots had been received,
but
on ly seve
nteen
applica
nt
s were
qua
li fied, E ight
MSC
officers began night training in
October, a nd one washed out before graduation , The ot her seven
gr
aduat
ed on 28
February
19
53,
In
September
the
Surgeo
n
Genera
l
s
office requested
and
received a standin g
quota of
ten
MSC
officers per
month for attendance
at
the Army Av iat ion Sch901
at Fort
Si ll ,
Ok
la homa, By 1 October the Medica l Service h
ad
twent y-fo
ur
officer
pilots and
soo
n r
ece
i
ved fi
ve more
by
transf
er
from other branches.
No
ne had nown in
Korea
before the a rmi st ice in Jul
y,
After the Korean
War
the Surgeon Genera l s Office app lied itself
to assessing the potent ial of helicopter ambulances in future connicts,
In part icular, Lt.
Col. Sp
urgeon H, Neel,Jr., in a
number of
medical
and av iation
journa
ls, pub
li
cized and promoted the Army s a
ir
am-
bulances. T he Korean expe
rience
he rea
li
zed, cou ld no t serve as an
infa llible guide to the use
of
he
li
copters
in other
types
of
wars and dif
ferent geographica
l regions,
but
it certa inly showed
that
helicopters
h
ad made
possible at l
east
a modificat ion of the first links in Letter
man s chain
of evacua ti
o
n.
A s
up
erior
communi
ca
ti
ons syste m wou ld
a llow a well-equ ipped and well -sta ffed ambu lance to land at or near
the site of the
wounding making
much grou nd evacuat ion un-
necessary,
f
the patient s
cond
ition could
be
stabilized
brien
y,
it
might prove helpful
to
use the speed
of
the he
li
copter
to
evacuate the pa
ti
ent farther to the rear, to more
co
mplete med ical fac ilities
th
an those
provided at a rudimentary div isi
on
clear
in
g station. T
ri
age might be ca r-
ried out belter at a hospital than in the field, But the Korean
War and
the concurrent French struggle in Indochina had afforded on ly
limited , imperfect tests of helicopter medical evacuation, T he poten
tial was obv ious, but not fu lly proven.
2At
th is time the Army Medical
Se
rvice consisted of six cor ps: Medic
al
, De ntal . Veterinary,
A
rm
y Nurse, v\ omen s Medical Specialists. ;md the Mcdical Service Corps,
wh
ich provided iI
va
ri
cty of admini stnll ivc and teehniCil1 services.
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CHAPTER
II
Birth
Of
A Tradition
The
lay
of
the la nd
and
the guerrill a
nature
of
Viet Co
ng
war
f
are
n
South
Vietnam demanded
that th e America n forces stationed th ere
from the
ea rl
y 1960s thr
oug
h
Mar
ch 1973 again use the medical
he
li
copter.
In
a country of mountains,
jungles
and marshy
pl
a
in
s, with
few passa
bl
e roads and servicea
bl
e ra ilroads the a
lli
ed for I s waged a
fro
nt
less wa r against a se
ld
om seen enem
y
Even morc thaT}
in
Korea,
helicopter evacuation
pr
oved to be both va lua
bl
e and
dang
erou
s
South
Vietnam
consists of
thr
ee
major geograph
ic fCatures. A
coastal pla
in
, varying
in
width
fr
om
fift
een to fo rty kil ometers, ex tends
al
ong mo
st of the 1 400 kilom
ete
rs of the coas
t Th
is plain a
but
s the
second fea tur
th e
so
uth easte rn edge of the Annamite Mounta in
Chain,
know n in
South
Vi e
tnam
as the
Central
Hi g
hland
s w
hi
ch
run
from the n
ort
he
rn
border
al
ong
the old Demilitarized Z
on
e so
uth
to
within eighty
ki
l
ometers of
Sa igon .
Th
e
Centra
l
High
lands
are
most ly
steep-sloped sha rp -crested mounta ins vary
in
g in height from 5,000
to
8,000
feet covered with ta ngled jungles a nd
broken
by ma ny na r
row passes. I he
so
uthe
rn
third
of th
e cou ntry co nsists almost entirely
of an
arab
le del ta.
Th
ese three geographica l
fe
a
tur
es helped shape the fo
ur
milita ry
zones of South Vietnam . The northern
zo
ne, or I Corps Zone, w
hi
ch
ra n from the Demilita
ri
zed
Zone
down
to
Ko
ntum
a
nd
Binh
Dinh
prov
in
ces,
co
nsisted almost entirely of high mounta in s and dense
jungle
s
At
seve
ral points th e
Annamit
es cut the narrow coastal pla
in
and exte nd to the South C hina Sea. Il Corps Zone
ran
from I
Co
rps
Zone so
uth
to the so
uth
ern
fo
othills of the Central Hi g
hl
a nds about
one
hundr
ed
kil
ometers north
of
Saigon.
t
consisted
of
a long stretch
of
the coas tal plain the
hi
ghest portion of the
Cen
tra l Hig
hl
and s and
the
Kontum
and D a
rl
ac Plateaus . Corps Zo ne ran from II Co
rp
s
Zone
so
uthwe
st
to
a line fort y kilomete rs below the
ca
pital
Sa
igon.
This was an intermediate geographic reg ion
co
nta in ing the southe rn
fo
o thills o f th e Ce
ntr
a l Hi g
hland
s; a few la rge
dry
pla ins; some thick
triple-ca nopy
jungle
a long the Ca
mb
odia n bo rder; a nd the northe rn
stretches
of
the
delta
fo
rm
ed by the M e
kong Riv
er to the so
uth
.
IV
Corps
Zone cons isted almost entirely
of
thi s delta, which has no forests
exce
pt f
or
den
se
mangrove swa
mp
s at th e
southernmos
t tip and
forested a reas
ju
st north a nd so
uth
east of Saigon. Seld
om
more tha n
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22
D UST OFF RMY EROMEDIC L EV CU T I ON I N V IETN M
twenty
fe
c t ab
ove
sea leve l
th
e de lta is covered wi
th
rice fie lds
sepa ra ted by ea rthen dikes.
Durin
g the rainy season the paddies a re
marshy
making
heli
cop
ter landings and vehicular
troo
p
tr
ansport ex
tr
eme
ly difficult. Hamlets
strad
dle the rivers a
nd
cana
ls,
an
d la rger
villages (up
to
10 ,000 people) and cities lie at the junctions
of
the
waterways. Bamboo brakes and tropica l trees grow a round the
vi llages and usua lly ex tend from 50 to 300 meters back on either side
of the canal or hamlet.
The entire cou ntry lies below the Trop ic
of
Cancer, between the
8th and 17th para
ll
els. T he climate is genera
ll
y hot and humid the
yea r round. In winter the country lies
und
er a high pr
ess
ure system
th at causes a dry season in the south. In the summer however ra in s
fidl heav
il
y,
varying
from
torr
ential
do
w
npour
s to st
eady
mists.
The
no
rth
ern reg ion
of
South Vietnam has the most ~ ave rag ing 128
inches, whi le the Sa igon region averages 80 inci}es.
In
the northern
region a nd the
Centr
al
Hi
ghlands, where most 6rthe ghting by
U.S.
tr
oops
during
the war occurred, dense fog and low clouds often
grounded a
ll
a ir
craf
t About ten times a year, usually between July
a
nd November,
typhoons blow in from the South C hina Sea, soaking
South
Vietnam
with heavy rains and las hing
it
with fierce wind
s
Although the climate a nd terrain exacerbated the technical problems
of
medical evacu
at
ion by helicopter in South Vietnam, the a ir am
bulance pilots who worked there worried as much
or
more about the
dangers that stemmed from the enemy s frequent use
of
guerrilla tactics.
T he Viet Cong were w ily, elusive, and intensely motivated.
They
usually had no respect f
or
the red crosses on the doors
of
the a ir am
bula nce helicopter
s
Likely to be a nnihila t
ed
in a la rge-scale, head-o n
clash with the
imm
ense fire
power
of American
tr
oops, they usua
ll
y
struck only in raids a
nd amb
ushes of
American and
Sou th Viet
namese
patrols
To
perform the
ir
missions
the a
ir
ambu
l
ance
pilots
o ften had to ny into areas subjec t to intense
enemy
sma
ll
arms fire.
Later in the war the p ilots en
countered
more formidable obstacles,
such as Russ ian- and Chinese-made ground-la-air missi les.
No air
ambu
lance pilot could depend on a ground commander s assurance
that a pickup zone was secure.
Mortar and sma
ll arms fire often
found a
zone just
as the helicopter touched down. Enemy soldiers
were known to patiently hide for h
ours around an
ambushed patrol,
looking for the inevit
ab
le rescue helicopter.
In these conditions the modern techniques
of
aeromedica l evacua
tion developed a nd matured. T he obstacles
of
mountain, jungle, and
floodplain could be overcome only by helicopters. T he frontless
nature of the war also made necessary the helicopte r for medical
evacua ti
on
A
ir
ambu lance units found
ever
w
i
er employment as the
helicopter- used both as a
fi
ght ing
machine
and as a transport
ve hi le
came
to dominate
many
phases
of
the war.
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BI RTH OF TR D I T ION
23
e Struggle egins
In 1961 President John F. Kennedy took the first of a number of
measures that over the next four years drew the
United
States deep
into the stormy pol
it
i
cs
of
Southeast Asia.
In
May
,
Kennedy
publicly
r
epeated
a pledge, first made by President
Dw
ight D. Eisenhower in
1954,
ofU
.S. support for the
government
of the Republic of Viet
nam
.
Kennedy
had the Department of
State
adopt a less
demandin
g
diplomacy in its deal ings with the troubled r
eg
ime of
President
Ngo
D inh Diem. The
department tr
ied to coax Diem into mak ing urgentl y
nee
ded
politica l, economic,
and
mi
li
tary reforms, but he dallied,
and
the Viet Cong summer campaign of 1961 further weakened his
te