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Modern Medevac Mobilized

By Frank Colucci | October 1, 2004
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For combat wounded and civil disaster victims, speed really is life. The U.S. Army's UH-60Q and HH-60L medical evacuation helicopters blend the fast, long-ranged Sikorsky Black Hawk with a clinical cabin for better patient care and a hybrid "glass" cockpit for night/adverse weather operations.

National Guard UH-60Qs have flown in hurricane relief efforts, deployed to international rescue exercises, and mobilized to support active-duty units stateside. Guard and active-duty HH-60Ls have gone to war in Afghanistan and Iraq and serve peacekeeping forces in Kosovo. Today's Medevac, or Dustoff, Black Hawks are nevertheless interim air ambulances pending production of the HH-60M with better performance and truly integrated avionics around 2007. The Army has a requirement for 336 HH-60Ms and plans for 24 percent of its new and recapitalized utility helicopters to be dedicated lifesavers. The term "Dustoff," incidentally, was created 40 years ago as the call sign for a medical evacuation unit in Vietnam and still designates a combat medevac helicopter today.

The Army now has four UH-60Qs in service with the Tennessee National Guard and nine HH-60Ls with the California and West Virginia Guard, and the active-duty 507th Medical Co. (Air Ambulance) home-based at Fort Hood, Texas. The UH-60Qs were converted from UH-60As with early General Electric T700-GE-700 engines and the original Black Hawk transmission. HH-60Ls benefit from more powerful -401C engines, an uprated gearbox and heavy-duty flight controls. Both models have a partially integrated cockpit with multifunction displays beside conventional Black Hawk instruments and an Air Methods medical interior with six litter stations.


For Dustoff crews, the advanced cockpit enables pilots to map entire missions on their displays, steer around thunderstorms with their L-3 Stormscope and see thermal imagery from the forward-looking infrared turret on the Black Hawk's nose. UH-60Qs and early HH-60Ls carry FLIRSystems Star SAFIRE 1 FLIR gimbals; new HH-60Ls have the AN/AAQ-22 Star SAFIRE 2. On one night mission in Afghanistan, an HH-60L crew was asked to use its second-generation FLIR to identify a target too indistinct for the targeting flir on escorting Apaches.

The HH-60L augments Doppler/GPS navigator of the Black Hawk with TACAN, ADF, VOR/ILS navigation aids and the Personnel Locator System.

The communications suite includes HF, UHF and SINCGARS military radios, and a VHF-AM/FM/Civil set. The HH-60Ls in Afghanistan and Iraq were also equipped with a Blue Force Tracker for real-time tracking and two-way digital communications.

Back in the clinical cabin, UH-60Q and HH-60L medics on crashworthy Martin Baker crew seats have easy access to all their patients and tools at hand to provide more advanced treatment. One skilled guardsman in Operation Enduring Freedom stabilized three badly wounded Afghans on their way to a field hospital. "The versatility of the HH configuration for multiple trauma patients is a big plus," explains Maj. Peter Smart, deputy program manager for Medevac in the Aviation and Missile Command.

The active duty 507th Medical Co. of the 36th Medical Evacuation Battalion at Fort Hood received HH-60Ls in 2001 and took the new Medevac helicopter to Operation Iraqi Freedom in 2003. Months after returning to Texas, the 507th redeployed to OIF II in February 2004. The Lonestar Dustoff unit flies a mix of HH- and UH-60Ls from Al Asad Iraq and forward-operating locations in western Iraq. Though under the Army's 429th Medical Evacuation Battalion, it is attached to Marine Aircraft Group 16, 3rd Marine Air Wing in direct support of the 1st Marine Expeditionary Force.

The 126th Medical Co. (Air Ambulance) of the California Army National Guard took the new HH-60L into combat in Afghanistan. From February to September 2003, the mobilized Guardsmen flew two factory-fresh HH-60Ls, two new-but-plain UH-60Ls and two UH-60As in Operation Enduring Freedom. Company commander Maj. Bruce Balzano deployed with just 12 hours in the HH-60L cockpit. "I can't go back now," he says. "Once you embrace the technology, it allows you to fly the aircraft and be involved in the mission, and not hunt and peck for radio frequencies."

The 126th Medical Co. logged 153 medical evacuation missions in the six-month deployment--about one per flyable weather day in Afghanistan. To that total was added a long list of patient transfers, medical resupply flights and utility missions to reposition medical personnel. The first rule of the Army Medical Department is "Presence with the Soldier," and the Dustoff crews accompanied troop-carrying Chinooks and Black Hawks in the first wave of nine air assault operations. Loitering minutes from the fight, they kept medical evacuation close at hand in the hunt for Al Qaeda and Taliban remnants. Several crews were awarded Air Medals for pickups under fire.

With three detachments operating from Bagram, Kandahar and Firebase Salerno, the 126th was stretched thin over Afghanistan. The unit deployed with just 41 people and stood round-the-clock alerts with two pilots, one medic and one crew chief per aircraft. With only one spare pilot in-country, Balzano said, "Unless I gave you a day off, you didn't have a day when you weren't first-off or second-off for Medevac for the entire time you were there."

Pilots flew 120 to 140 hours in six months, more than twice their peacetime flying allocation. Balzano flew 10.5 hours one day in the full range of daylight and night vision goggle (NVG) conditions. "You have to just reach back, put the goggles on your head and keep going," he said. Unlike active-duty units, the 12th now requires that all pilots be fully NVG qualified.

The 126th also brought with it highly experienced Emergency Medical Technicians mobilized from their peacetime jobs. "Our biggest contribution over there was our medics," Balzano said. "The wounded we treated got care far above that available from the active units." The HH-60L interior also gave the medics a better working environment than that found in bare UH-60s. The unpopular UH-60 casualty carousel rotates for patient loading and locks in flight. The medic on board has only limited access to patients on the other side. In contrast, the HH-60L provides in-flight access to six litter patients, six seated patients, or a combination of three litter and three ambulatory patients. The HH-60Ls of the 126th carried five or six casualties on only a few occasions.

Though the air defense threat in Afghanistan was limited to individual guns, rocket-propelled grenades and, potentially, shoulder-fired surface-to-air missiles, small-arms threat zones covered the entire country. "You avoid the villages where you can and stay over uninhabited areas," Balzano said. The HH-60Ls were equipped with the same infrared exhaust suppressors, flare dispensers and IR jammers worn by UH-60s. U.S. Army Medevac helicopters operate unarmed.

Flying was also extremely challenging in an environment where the base altitude is 5,000 ft. "It just gets worse from there," Balzano said. "Everything goes up. Everything is a mountain flight." Fortunately, the California Guard crews perform about a dozen rescues a year in the Sierra Nevada Mountains back home, and some pilots are graduates of the High Altitude Army Training Site in Colorado. Afghan mountain weather ranged from snowed on the first day in-country to high winds and dust storms in the summer. "It was strange to have those altitudes with dust," observed Balzano.

Also surprising, high ambient temperatures did not decline rapidly at high mountain elevations. HH-60Ls are about 2,000 lb. heavier than "slick" Black Hawks, and to accompany Chinooks at the high-density altitudes around Tora Bora, the 126th used its UH-60Ls stripped of their heavy litter carousels.

Aircraft of the 126th logged around 150 flight hours a month each in OEF, about two-and-a-half times the operational tempo in stateside training. With a diligent in-country supply system, the unit sustained Operational Readiness rates around 90 percent, even with its sophisticated new Dustoff helicopter.

The Tennessee National Guard flies the only UH-60Qs in service. Detachment 1 of the 146th Medical Co. (Air Ambulance) started as the Combat Enhanced Capability Aviation Team or CECAT (Medical) with the first YUH-60Q1 demonstrator in 1992. A lighter, less-costly production Q-model configuration was approved by the Department of the Army in 1994 and integrated by Sikorsky in 1997.

The Tennessee CECAT used its four UH-60Qs to promote and refine the Medevac Black Hawk in the Army and to handle state emergencies. A baby was delivered aboard one of the aircraft during Hurricane Floyd in 1999. UH-60Qs made two rescues in the Smokey Mountains. A deployment to Romania for Operation Rescue Eagle in 2000 introduced the Medevac Black Hawk to multinational forces.

The current 146th Medical Co. was formed in 2002 and divided between Tennessee and West Virginia, with its headquarters element in West Virginia. The UH-60Q detachment in Knoxville, Tenn. will ultimately relocate to Smyrna with all other Black Hawks in the Tennessee Guard. It was called to a year of active duty separately in 2003 in support of Operation Noble Eagle to provide Medevac support for the Florida Ranger Camp in Eglin, Fla. and the Mountain Ranger Camp in Dahlonega, Ga. By August 2004, the four aircraft had accumulated some 2,750 flight hr..

Like the HH-60L, the air-conditioned medical interior of the UH-60Q relieves some environmental stress on patients and its On-Board Oxygen Generating System eliminates clumsy oxygen bottles. Unlike the internal hoist used on Medevac UH-60As, the Breeze-Eastern external hoist on the UH-60Q takes up no patient space.

The UH-6Qs are nevertheless prototype aircraft more sophisticated and tougher to support than vanilla Black Hawks. Tennessee aircraft are now operating with one multifunction display as the utility helicopter program office fields new displays common to the Q- and L-model Medevac Black Hawks.

The HH-60Ls of the West Virginia detachment of the 146th Medical Co. are now deployed in Kosovo. A crew from the 146th received the 2004 Kossler Award from the American Helicopter Society for rescuing an elderly woman and two children from rising floodwaters. One of the West Virginia aircraft also brought rescued POW Jessica Lynch back to her hometown.

The cockpits of the UH-60Q and HH-60L are essentially identical except for the flir hand-controller installed in later L-models. The UH-60Q pilots train on the same 2B38 flight simulator used for other Black Hawks, but CDU (Communications Display Unit) Trainer software on personal computers teaches "switchology" unique to the UH-60Q. The Aircrew Training Program of the 146th also provides 10 hr. of static aircraft familiarization. FLIRSystems instructors teach Medevac pilots how to get the most out of their night-vision sensor.

To prepare active-duty and Guard medics for both the UH-60Q and HH-60L, the Army School of Aviation Medicine at Fort Rucker, Ala. has a Medical Suite Trainer built by DEI Services Corp. The fully functional medical cabin was built around an actual interior kit and includes the external rescue hoist and External Stores Support System with outboard fuel tanks to provide loading practice.

The Army plans to "recapitalize" its aging utility helicopter fleet with a mix of remanufactured and new-build UH-60Ms that will recapture lost performance and trim operating and support (O&S) costs. Part of that fleet upgrade will be a new HH-60M with the dynamics and digital cockpit of the M-Model Black Hawk, and a refined medical interior much like that in the UH-60Q and HH-60L. Current plans sustain HH-60L production through 2005. The first HH-60M prototype will be turned over to the Army in early 2006, and Low-Rate-Initial Production of the HH-60M starts in fiscal 2007. Even with an MH-60M full-rate production decision, the Army will probably retain about 30 HH-60Ls in inventory.

The first two UH-60M prototypes with broad-chord composite main rotors, T700-GE-701D engines and integrated avionics are flying. Even with no immediate increase in allowable gross weight, the UH-60M promises a significant payload-range improvement over early Black Hawks. The Army estimates the UH-60M will carry about 1,000 lb. more than the UH-60A and around 470 lb. more than the UH-60L in hot and high conditions. Improved performance will be appreciated in the heavier Medevac aircraft. "The Afghanistan scenarios are going to be better supported with the additional power in the M," said Smart at AMCOM.

The UH-60M will also receive a Hamilton Sundstrand dual digital flight control computer that borrows heavily from Seahawk hardware and architecture. The new computer with advanced flight control laws will provide better stability and an automatic hover hold function especially useful for hoist rescues at night.

The medical Mission Equipment Package specification for the HH-60M has been approved. Though Air Methods is not yet under contract for the M-Model, medical interior design work is underway with feedback from Medevac users. Crashworthy Martin Baker attendant seats have already been qualified on the HH-60L and a fixed medical cabinet has given way to a modular medical storage bag. An advanced medical oxygen system will double pressure and volume to meet medical protocols for trauma patients. Changes to make the tilting/elevating litter support system and cabin lighting more maintainable are under study.

The HH-60M is also expected to provide an even better communications capability. The AN/ARC-222 multiband radio in the HH-60L already covers some low-frequency civil bands, but according to Smart, "What we really need is a multiband radio that covers everything up to 960 MHz." The interim solution must also be military specified and qualified. Eventually, the Joint Tactical Radio System will cover the full range of frequencies for military and civil communications. The Digital Battlefield gave the HH-60L a requirement for the Improved Data Modem. The IDM, or Blue Force Tracker, on the HH-60M may someday transmit patient information to waiting hospitals en-route.

The UH-60M was initially to use a modest digital cockpit integrated by Sikorsky based on experience with Black Hawks outfitted for the Turkish Land Forces. The cancellation of the Comanche armed reconnaissance helicopter has suddenly funded common cockpits for the CH-47F and UH-60M. The Rockwell Collins Common Avionics Architecture System (CAAS) developed for Special Operations helicopters will also give the HH-60M an integrated crew station readily supported in the broader Army fleet.

The CAAS common cockpit has five 6X8 inch multifunction displays. Primary flight symbology, thermal and radar imagery, digital maps and aircraft systems information can be posted on any display, and each portrait panel can be split to maximize and customize information. The Army expects avionics suites for the UH-60M and HH-60M will be identical except for the flir on the Medevac helicopter. Cockpit design is complete; and with further refinement, the MH-60M will give the Army Medical Department a fast, powerful ambulance for mercy missions to come.

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