It's a less than ideal situation: Nurses and medical technicians secure themselves and their critical-condition patient as they feel the unwelcoming, earthquake-like shake of turbulence as their KC-135 Stratotanker avoids an unexpected storm.

Intensive care is tricky enough in a stable room, but if it isn't done immediately, they could lose a patient, a daughter could lose a father, or a husband could lose a wife.
This is the all too familiar occurrence for many of the aeromedical evacuation crews tasked with the aerial transfer of patients who need immediate medical attention from a far-away facility.

That's why Capt. Randi Ewing, 18th Operations Group Aeromedical Evacuation branch chief, said it's vital for the teams to maintain readiness by training in the air like they did May 21.

"The training provides a platform for us to train for scenarios and emergencies that we're not able to train for when we have live patients onboard," Ewing said. "We have requirements we have to accomplish every six months, but we schedule training once a week so everyone can meet their training requirements."

While working with the 909th Air Refueling Squadron, the 18th Aeromedical Evacuation Squadron frequently ensures the safe transportation of patients in the Pacific area of responsibility. With such an important mission, it's vital each member stays prepared for anything that could go wrong while airborne.

However, Ewing said certain training scenarios shouldn't be conducted while live patients are onboard the aircraft. Therefore, the team's experienced evaluators give the crew a rundown on a range of procedures and medical tactics while in a controlled environment.

"Some examples can include procedures for aircraft fire, rapid decompression and cardiac arrest," Ewing said. "It's really cool because every (mission clinical coordinator) brings different experience to the training. Some have had multiple deployments, and some have been to other bases, but they can speak to experiences, draw from them, and make the training more realistic."

Shortly after takeoff, the crews dug in as an evaluator shouted "pop!" and immediately immersed the nurses and technicians in their first scenario - rapid decompression of the aircraft.

As the crew rushed to don oxygen masks and respond to a simulated uncooperative patient, it proved that just about anything within the aircraft could lead to disastrous consequences.

While running the same scenarios from time to time can become monotonous, Ewing said that one of the biggest points in the training is the quest to improve procedures, responses and overall operations.

"Every day, we are looking for how we can do things better and more realistic," she said. "It's challenging."

Capt. Kristina Stewart, 18th AES officer in charge of aircrew training, said she feels the training is of the utmost importance.

"It's definitely beneficial," she said. "It's mandatory, but it's important to get realistic training."

Moreover, practicing in a safe environment gives the crew the opportunity to learn without putting patients at risk.

"Our goal is safe patient transport," Stewart said. "We prefer to mess up in training; it's a time to learn, make mistakes and just become better. We train on patient emergencies, aircraft emergencies and equipment setup. This way, we get to see where our strengths and weaknesses are, and we learn how to be our best."

Stewart said during the nearly three years she's been on the island, the training has improved in several ways, most notably the new implementation of a live simulated patient in lieu of a manikin.

At last, the Stratotanker's wheels touched the tarmac once more and the crew prepared to disembark.

Though the training was over, and the nurses and technicians did well, Stewart said there's always room for improvement.

"It's so important," she said. "You can get so much out of it."

- (posted on June 3, 2014) -