ATTENTION IN THE TOC: This is a serious post. If you don’t like serious posts, please check back tomorrow when I will have likely written a blog post about the one time when my maintenance test pilot got in trouble for not wearing his Kevlar and body armor outside the safety of our reinforced hangar in Iraq… and was found the next morning, enjoying a smoke on the hangar’s make shift patio, wearing his Kevlar, body armor, boots… and a neon green thong. Only the thong. Seriously. That’s the cavalry for you though.
Mostly I write aviation doctrine. Mostly.
Mostly I read other branch's doctrine. Mostly.
Mostly I stick to debating Close Air Support versus my beloved Close Combat Attack. Mostly.
As a little background, I’m a scout pilot by trade, a former company commander by the grace of amazing soldiers, a one-time battle captain by sheer coincidence, and a current doctrine writer by happenstance. I’ve done all these things in combat, with the exception of doctrine writing. The forces that got me into these jobs were nothing more than right-place-right-time.
Since I’m not an assault pilot, and I didn’t really learn how to spell Air Assault until I had to help write the book about it (literally), I looked at the MEDEVAC issue from the perspective of a scout pilot. I hate it when people get all up in my cockpit with me. There you are, trying to develop the situation by scouting for gaps, flanks, and enemy weapons systems and you have a Battle Captain b*tchin’ in your ear about SITREP-this and BDA-that. I was hired to the aviation battalion battle captain job after two and half years of company command, and because I wanted to see that other side of the radio for the remaining three months of my Afghanistan rotation. I have no idea what I was thinking.
So, what happened with SPC Chazray Clark? I don’t know. I can only speculate that something went wrong regarding the launch authority and the escort requirement. According to some reports, the launch was delayed because there were no AH-64 Apache aircraft to escort the unarmed MEDEVAC aircraft to the point-of-injury as per the risk mitigation requirements for a pick up zone where enemy contact was likely. Given the nature of the risk of enemy engagements on the HLZ, you need that coverage sometimes. Even two M240B-armed UH-60s need an escort sometimes, especially when going to locations on the battlefield with a high likelihood of enemy contact. Reporter Michael Yon has ferociously championed the fight to remove the red cross from our MEDEVAC HH-60s and arm them, much in the manner of the Air Force’s combat search and rescue teams, known as Pedro. I don’t know if it will solve the problem. But I’m not a Whackhawk pilot, so I can’t cogitate on the airframe changes or weight restriction or space in the crew area. I do know that there would be some serious lag time between getting that approval to remove the cross and add the guns though, between air worthiness certificates and crew training. I tend to think that part of the problem can be solved by examining the criteria we use to examine and mitigate risk for launch. We have to ask ourselves whether or not we want to solve an aviation problem in five years, in this case once the debate on removing red crosses and replacing them with M240B door guns and gunners is completely done, or solve the issue tonight by realigning the way we fight.
So I’m throwing down the gauntlet and staking a claim in the fight. I think my beloved Battle Captain Mafia (BCM) should embrace this mission to shave those minutes off ourselves!
One of the best methods of solving the problem is addressing the warfighters directly, the crews and battle captains in the aviation force that handle the mission daily downrange. In embracing the difficulties and making honest small strides toward streamlining the launch process, we ensure the crews we send have the most accurate information and best coverage. With this, we can knock precious minutes off our clock, saving lives, limbs and eye sight. BOOYAH! When examining the issue from the platform of an aviation task force battle captain, the small fixes that can streamline the process become things that a unit can quickly add to its battle drills and daily battle rhythm.
What is the mythical “Golden Hour,” when does it start, and why is it even important to an aviation battle captain?
A battle captain is the manager of resources, of which time, people and equipment are categories. In understanding the start and stop point of the Golden Hour for MEDEVAC, we can examine the way that we efficiently prepare and launch our assets. As aviation is a limited resource on the battlefield, careful monitoring will ensure that the right resource goes to the right place at the right time, like MEDEVAC.
In this, we have to understand the “Golden Hour.”
First of all, it’s not in Doctrine. Anywhere. At all. It’s an informal concept that has taken root in the collective conscious of the Army and bloomed. Because it is not doctrinal, and the medical proponency has not blessed off on it, do yourself a favor and throw it away… especially if you’re an aviation battalion S3, battle captain, or air mission commander.
It does brief well though. Sixty minutes to ensure that an Urgent or Urgent Surgical patient is transported from the point of injury to a trauma center that can provide lifesaving procedures, typically a Level II or III Trauma facility. In fact, this is a common practice in the civilian aviation medical evacuation community: a strict adherence to time limits and time lines that ensure the timely transport of critically injured or ill patients to the resource best suited to care for them. It was studied by the medical proponency as a way to expedite the transport of urgent patients to. This is a good thing. Due to the application of strict time constraints on the transport of patients, survivability rates have increased. In the interest of being transparent, there is debate about the inflation of rates or the truth behind what air transport has accomplished in reality, but one cannot debate the importance of what air MEDEVAC crews have managed to accomplish to date!
Aerial MEDEVAC begins in a completely different place from where you would typically imagine: the senior medical advisor to the commander. In the case of Afghanistan, this is at CJTF. In order to preserve the medical evacuation assets, which are owned by the Army’s Medical Service branch, the employment of an air or ground evacuation asset to a MEDEVAC rests with the senior medical advisor. They are best suited to know the nature of the injury, the type of support and equipment needed during transport, and how long the injury has before it worsens. These are medical considerations that drive the selection of either air or ground methods to remove an injured soldier from the field of battle.
In other words, the choice to use a helicopter to accomplish a specific mission is a doctor’s choice. From that point, the 9-line is given to an aviation force to the fill requirement.
From that moment, when the approval message is received by the supporting aviation force, the clock starts ticking to fill the order. The current standard for notification, approval, and launch of MEDEVAC aircrews (and their escorts) is 15 minutes. This is all delegated and tracked digitally by the way, so it’s all broadcasting in real-time in everyone’s TOC. Because this whole process has been made digital through the convenience of modern things like mIRC and CPOF (or CPORN, command post of right now, if you’re so inclined and slightly cav-ish), we all share the same situation understanding across the TOCs. Whether you’re the IBCT Battle Captain or the CAB Battle Captain or the aviation battalion task force battle captain, everyone knows when the clock starts because we all see it in the chat windows. So, long before approvals are granted or leadership is being hunted down for launch authorization, the digital spider web of the BCM is hard at work getting crews spun up and coordinating for escort assets, if they were needed.
Launch Approval versus Mission Approval
The approval to launch an air asset rests with the senior aviation commander based on the level of aviation related risk. This is critical to highlight: mission approval authority and launch approval authority is not the same person. They don’t even have the same background. The ability to launch an aviation asset for an assignment has several critical considerations, which may be enemy threat, rules of engagement, weather, fighter management, escort requirements, and the overall tactical situation. These are things critical to consider for any aviation mission, let alone the launch of a MEDEVAC aircraft. Because these considerations cross the spectrum of aviation risk, the choice to launch the asset is given to the aviation commander, who understands these factors intrinsically. Furthermore, the staff of the aviation task force will have the optimum planning tools available to both identify and mitigate those aviation specific risks, which can include Air Force weather observation teams, aviation specific intelligence tracking and development, flight mission planning tools and software, and armed escort aircraft.
So, as the mission approval authority has the decision to use an air medical evacuation asset, the launch approval authority has the decision of whether it is safe and proper to launch the air asset. In sharing these decisions, the asset is both guarded and protected for use at the right time and place without risking the crew or loss of the airframe.
An Aviation Battle Captain’s Approach to MEDEVAC and Managing Assets throughout the Mission Period
In Afghanistan, aviation battle captains have a plethora of digital assets at their disposal to monitor the process of announcing and commencing the process of air MEDEVAC. Digital battle nets enable immediate posting, transmission, and acknowledgement of missions. This is followed up with standardized reporting to know when a launch has been approved, executed, arrived at the point of pick up, departed the point of pick up and arrived to their destination treatment facility. These digital announcements are critical to situational awareness for both aviation leadership and ground forces, anxious to know the status of their in-bound medical asset.
Part of being a battle captain is knowing how to manage resources in the immediate fight. While future operations and current operations fall under the purview of the S3 in total, and there is a high degree of interaction between these two cells within one shop, the there is a distinct difference between them. One plans for the future. One plans for the next couple of hours. So, how can the battle captain plan for MEDEVAC readiness when the fight varies? If I could offer the aviation BCM some nuggets, it would be this:
Preparing for the worst: Getting yourself postured as a battle captain to do MEDEVAC
1. Examination of the ground force CONOPS daily. As the links between fellow battle captains cross unit boundaries in the digital world, frequent contact with the battle captains in the BCT and battalion tactical operations centers offers insight into the missions currently underway and those planned for the future. This information, when synthesized properly, becomes a window into knowing which patrols or missions are likely in end up in contact with enemy forces and lead to the launch of a MEDEVAC (or even a quick reaction force of attack reconnaissance aircraft), especially when paired with the constant stream of intelligence from an aggressive and proactive S2.
2. “Watching” the fight; “Knowing” the critical points. During the course of a deployment, as familiarization grows with both an area of operations and the coalition ground forces, critical points in a mission will unfold on the digital network to the people who pay attention to them. This is best accomplished at times by simply opening the right windows on military internet relay chat (mIRC), Command Post of the Future (CPOF) or even Blue Force Tracker (BFT) and watching. The key is to know what windows to open, who to talk with, and what to look for. In planning the day’s operations, review of CONOPs and discussion with the future operations cell will gives perspective on who should be chatted up digitally on the mIRC net. The first place the digital transmission of the 9-Line will be seen prior to the division or CJTF mission approval authority will likely be in the mIRC window of the battalion in contact. This garners a battle captain the ability to alert crews, gather critical information (such as weather or threat situation), posture attack aircraft as escorts, and start planning for launch authority notification, if needed. Once the rose is pinned to the unit to launch, the battle captain will already have the crews briefed and on their way to the aircraft. This saves valuable minutes in the launch process and provides time to react to changes. It is vastly easier to turn an asset off than it is to turn it on.
3. Alerting the Boss. There are times when the risk associated with launching an asset will exceed the approval authority of the aviation battle captain, and the leadership will need to be notified for approval. By watching chatter on nets and monitoring the fight as it develops, a battle captain can posture themselves to know how to quickly reach out to the right launch approval authority at the right time. This saves valuable time in the debate of knowing what risks may be associated with sending an asset into an area, especially considering the threat situation. This enables the commander to have the critical situational understanding he or she needs to put the right assets on the job. This also limits stalls in response time due escort requirements, premature launches, and “territorial” debates about missions. The more information that a battle captain can give to both the ground and air commander will ensure that tactical trust is present. When there is tactical trust in the ability of an aviation battle captain, the commander will also trust their judgment and suggested solutions to problems during the launch sequence.
4. Communicating with the Flight before the Flight happens. Prior planning prevents piss poor performance. Daily mission briefs need to be made available and given to any and all aircrews that are preparing to fill mission sets for the day: attack reconnaissance pilots (which includes unmanned aircraft systems crews), ring route or air movement crews, and the MEDEVAC teams on call. Every aircrew needs to know what a battle captain has been watching and discussing with the ground forces via the digital networks, and any additional information that a battle captain can give quick reaction force personnel helps them to stage themselves in a position to launch or dynamically retask to assist ground forces. The link between the MEDEVAC crew on shift and their escort needs to be made in order to ensure that battle drills, limitations and considerations are shared.
5. Dealing with the launch restrictions. Inevitably there are limitations to the use and application of any air assets on the battlefield. Air ambulances are no different in this matter. Between an aviation commander’s years of experience and intuition and the planning conducted by his or her staff, limitations are balanced with the need to safely meet mission. Restrictions aren’t bad unless they aren’t reexamined for poignancy every now and then. As a battlefield changes during the course of a deployment, and the need for security increases or decreases. Consequently, the needs of the unarmed air ambulance to have a standard UH-60 chase aircraft or attack escort for launch will also change. As an example, if an AH-64 is necessitated to escort an air ambulance to a point-of-injury pick up, units will determine whether weapon sight systems for the attack escort must be completely optimized prior to departure from the FOB or allow for optimization in flight. This is a trade-off for the commander. Does he allow for immediate take-off and system optimization in flight, risking the inability of the attack escort to provide immediate suppression of enemy fire once the berm is crossed? Or does he wait for optimization, allowing precious minutes to tick by on a soldier’s life? These are difficult considerations that are managed by frequent and careful examination of both the risks and the mitigation measures in place.
6. How to instruct the ground force on using their asset. Whether serving a ground force commander in a direct support or general support relationship, air ground integration goes beyond just sharing the ground force scheme of maneuver or the effects of the AGM-114R from an AH-64D. The ability of a battle captain to articulate limitations to the ground force staff about air MEDEVAC is every bit as critical as discussing weapons effects. Much of this is air ground integrations is accomplished through a competent and proactive brigade aviation element prior to leaving the home station. Even with comprehensive air ground integration, the highly charged and emotional atmosphere of an urgently needed MEDEVAC can cause rifts in the shared understanding that ground and aviation units have. Having a well thought and well crafted plan ready for the ground force commander is every bit as vital as having one ready for the aviation commander. This is where a battle captain can preserve an asset from being misused prior to it even being needed or requested.
SPC Clark was a tragic loss. I don’t know what happened. I can’t help but wonder that, if he’d been injured during my watch as a battle captain, maybe things might have been different. I wonder if I would have planned my asset allocation differently . I wonder if I would have recognized a fight brewing, posturing both MEDEVAC and escort assets in a better fashion. I wonder if I would have had a better solution to the delays for my commander.
Mostly I just wonder. Mostly.
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