Top Training for our Military Medics

F/S Russell Clarke

CPL Gillespie with patient AC Haywood. AK-07-0329-18-tn.jpg.

The Air Force’s Aviation Medicine Unit (AMU) conducted a Forward Aeromedical Evacuation (Fwd AME) course at RNZAF Base Auckland from 10 June to 11 July 2007. The intensive tri-Service annual course is for senior medics and aims to qualify them and to get them used to working in an operational environment.

It teaches medics about Fwd AME in an operational environment which can be defined as the movement of battlefield casualties (people who have suffered high velocity trauma) to a field hospital (usually rearward of battlefield) for emergency treatment or surgery.

Fwd AME was first developed during the Korean War but really came into its own during the Vietnam War. It is a unique and challenging environment for medics to work in. They are on their own, it’s a tight space, and it’s very noisy and hard to operate in. It is no exaggeration to say that this is the hardest and most challenging medical course run in the NZDF. Medics are challenged and tested, pushed to the limits to make sure they have got what it takes to be a Fwd AME medic. You have to think fast, outside the box, work well under pressure and carry out advanced life-saving medical techniques quickly and efficiently. You may never get the time to test your skills under pressure.

CPL Beauvais with instructor and assessor in an Iroquois. AK-07-0329-08-tn.jpg.

The Fwd AME course replaces the old Search and Rescue (SAR) Medics course that was designed in the late 70s early 80s. This course was designed to look after lost trampers or people who had accidents while in the mountains. Back then there were no rescue helicopters and the RNZAF’s No. 3 Squadron provided Nation Search and Rescue support to the NZ police. No. 3 Squadron still provides this support to the NZ Police when requested, but since East Timor the focus has changed and we needed to update the SAR course and provide more operational helicopter training for medics. The course was updated and re-named the Fwd AME course, although all the SAR course objectives are still completed within the new Fwd AME course as we still provide SAR Medics for national SAR duties with No. 3 Squadron.

The Fwd AME course also covers dealing with the high velocity trauma and ballistics a medic could face during an operational deployment. MAJ Tate provided instruction in this area and gave the course the latest treatment and guidelines that are coming out of current war zones around the world. A Fwd AME medic needs to be multi-skilled to deal with both military type trauma and civilian trauma so the course also covers obstetric, paediatric and geriatric emergencies.

The course also went to the Auckland University pathology lab and had a trauma doctor show the students over a human cadaver and human anatomy and physiology. They completed a day visit to the Westpac Rescue Helicopter in Auckland and spoke to paramedics who have worked in this environment for a long time and were given practical advice on treating and transporting patients via a helicopter.

CPL Purdie with patient AC Whyte. AK-07-0329-16-tn.jpg.

The advanced trauma skills were taught by two St John Ambulance Special Emergency Response Team (SERT) Advanced Paramedics. These guys are highly skilled paramedics who are on-call for St Johns to treat patients in tactical environments and armed offenders call-outs with the NZ Police. They really put the medics through their paces when it came to dealing with trauma in a pressure situation.

Terminal testing was conducted during a simulated exercise, the medics rapidly stabilised and prepared a patient for flight in a helicopter. Then they loaded and monitored the patient during a short flight. They also had to complete an oral test where they were given a simulated situation and had to answer questions from a medical panel. Instructors were Senior Fwd AME Medics, Chief Paramedic Westpac Rescue Helicopter Service, and SERT Advanced Paramedics for St Johns and Major Tate from NZ Army.

The course aims to provide medics, nurses and doctors with the necessary skills to work solo with advanced emergency care skills in a forward aero-medical evacuation/ search and rescue environment.

The course prerequisites are: winch person’s course, approved emergency care course, helicopter underwater escape training (HUET) and a survival course and is open to Medics, Nursing Officers and Medical Officers.

The annually run course for up to six tri-Service students covers obstetrics, documentation, in-flight monitoring, stressors of flight, trauma training, surgical emergencies, as well as environmental and thermal conditions.

For the Air Force the course represents keeping an eye on the present with a view to the future. We currently only have six qualified Fwd AME medics with only two able to deploy at this present time. With the new NH-90 helicopters coming on-line we need a minimum of ten Fwd AME medics trained and ready to deploy in support of this new helicopter.

Winch training is one of the most difficult tasks in terms of the welfare of the patient. That means keeping control of the patient and the situation and getting inside the helicopter with a patient in the Stokes litter.

Medic winch training from an Iroquois at Raumai. OH-07-0428-04-tn.jpg.

The Westpac helicopters may have the added luxuries of warmth and more up-to-date gear but at the end of the day we use the same equipment. Only the stretchers are different – we use the NATO military stretcher. We can also carry more stretchers (six compared to Westpac’s two) and have a better, longer winch on our helicopters. We actually have more room to operate in.

We work in isolated situations and overseas where we may not know where the nearest hospital to evacuate to will be.

The RNZAF’s Iroquois are used for search and rescue/civil defence, humanitarian aid, aero-medical evacuations both operationally and in NZ.

Various FWD AME medics have deployed to East Timor, the Solomon Islands and on other operations.

The trauma training conducted by the Specialist Emergency Response Team (SERT) Paramedics was most valuable and greatly appreciated.