# Alaska Air National Guard Medevacs Critically ill Patient

/ Published April 2, 2024

JOINT BASE ELMENDORF-RICHARDSON, Alaska - Two Alaska Air National Guard Airmen jumped from a 176th Wing combat search and rescue aircraft into the village of Kotlik March 22 to expedite medical care for a critically ill patient and evacuate her to Joint Base Elmendorf-Richardson.

The mission began in response to a request from the Yukon-Kuskokwim Health Corporation to medevac a patient experiencing internal bleeding from Kotlik to Bethel for a higher level of medical care.

Civilian air ambulances could not support the medevac due to poor weather in the region.

The Alaska Rescue Coordination Center communicated the request to the 176th Wing search and rescue duty officer, who dispatched a 210th Rescue Squadron HH-60G Pave Hawk combat search and rescue helicopter and a 211th Rescue Squadron HC-130J Combat King CSAR fixed-wing aircraft. Both platforms carried Guardian Angel personnel recovery teams comprising combat rescue officers and enlisted pararescuemen.

For most civil search and rescue missions in Alaska, patients and distressed residents are recovered by the HH-60 due to its ability to land or deploy its rescue hoist just about anywhere. Because time was of the essence for the patient, mission planners decided to jump a GA team from the faster HC-130. 

“Our goal was to get to Kotlik as fast as possible,” said Alaska Air National Guard Master Sgt. Arnold Perea, 210th RQS HH-60 special missions aviator. “We had the C-130 go out ahead to do weather reconnaissance and see what the status was over top of Kotlik because we heard there was bad weather there. When they got there, they could see that it was clear enough for them [to jump] since they can get there quite a bit faster than us.”

Maj. James Byrne, 212th RQS combat rescue officer, and Master Sgt. Daniel Lutz, 212th RQS pararescueman, said the patient’s condition made jumping an urgent choice.

“The patient had significant internal bleeding. She was experiencing low blood pressure and had a rapid pulse,” Lutz said. “That pushed us towards launching the Herc faster than we normally would, hoping to get blood onboard sooner rather than later. We retrieved two units of blood from the hospital: one unit on the helo, one unit on the Herc. We stepped out the door with the mindset of jumping to the patient, knowing the helicopter was going to be several hours behind us.”

Village residents were waiting with snowmachines at the drop zone in a field near Kotlik, ready to bring the Guardian Angels to the village clinic.

Orbiting over the drop zone, Byrne said they had to consider ceiling, visibility and wind.

“We had the ceiling, the visibility was good enough for us to jump, and the winds were higher than what we typically jump for training, but based on the DZ location and the terrain, all of the snow out there, as a highly proficient jump team, anyone [in the 212th RQS] could have made that jump,” Byrne said. “As a crew, we assessed the situation and risk factors and determined that it was still appropriate to conduct the jump.”

Byrne and Lutz tossed wind streamers and an electronic wind drift indicator out of the aircraft door to measure the gales, but the devices’ swift disappearance in the weather rendered them useless.

The GAs turned to Maj. George Geiges, the 211th RQS combat systems officer on the HC-130 flight deck, who had all the tools necessary to calculate a good area to OK the jump.

“A crew-directed drop is one where the aircrew will pull tab data from charts and put it into the system on the aircraft,” Geiges said. “The system plots where we can release. It gives us a LAR, a launch acceptability region, meaning we can drop the jumpers anywhere in that area, and their chute maneuverability gives them the ability to steer a little bit, and that is plotted out from a wind vector.”

With the proper calculations, the GAs exited the aircraft door into the cold, gusty Alaska night.

“Once we got out, we realized the winds were pretty manageable, so we turned and ran with the wind, traveling the 1.7 miles to the drop zone,” Lutz said. “Once we neared the target area, we turned into the wind and were pushed back the remainder of the distance to the drop zone. At 1,000 feet, we disconnected our reserve static lines. If you cut away [the main parachute], the RSL pulls out your reserve. Doing this allowed us to cut away our mains on the ground and not be drug by the high winds.”

With as much as 80 pounds of medical and survival equipment strapped to their legs, the GAs pulled the release on their 15-foot lowering lines, and their gear hit the snow before they did.

“The landing itself was pretty easy,” Lutz said. “It was a slight flare [of the parachute], and we both had stand-up landings and cut away the parachutes.”

At the clinic, the GAs met with the village health aide who had been providing medical care for the ill resident.

“She was a very sick patient,” Lutz said. “You could definitely tell by her color and vitals she had been losing blood.”

Byrne said the team had more work to do before loading her on the HH-60 that had made its way through the weather to Kotlik.

“The most appropriate option was to be able to provide a medical intervention as quickly as we could versus evacuating her out as quickly as we could,” Byrne said. “We talked to a doctor in Bethel and relayed some of the information and the vitals we were seeing in real-time, and then we were given the recommendation to push blood.”

The original plan for evacuation to Bethel fell through due to many of the same circumstances that prevented civilian air ambulances from responding.

“We were trying to transload her to Bethel, but there was a band of weather between Kotlik and Bethel, so we had to divert to McGrath and do the transload to King there,” Perea said.

With the patient and the GAs onboard the HC-130, they departed McGrath for JBER, where the patient was transferred to the Anchorage Fire Department for transport to an area hospital.

Geiges said the mission was unique because of the level of teamwork required.

“We call ourselves the Rescue Triad, but in a lot of missions, one element stands out more than others, and I think this mission is a perfect example of that Rescue Triad working together. Each team was completely reliant on the others,” Geiges said. “We needed the GAs, the HC-130 and the HH-60 to get this mission done. I think it’s a great example of how that triad works here in Alaska.”

For the mission, 210th RQS, 211th RQS, 212th RQS and the AKRCC received credit for one save.