WW I Aeromedical Evacuation

World War I Aero-Squadron. By later standards, early aircraft were limited, but their roles in modern warfare were already being established, including Aeromedical Evacuation (AE).

Aeromedical Evacuation in World War I

Curtiss JN-4 "Jenny" bi-plane whose rear cockpit was used for the first U.S. Army Aeromedical Evacuation.

Although the French Army and others had experimented earlier, it was not until 1918, the last year of WW I, that the US Army first recognized the value of air transport of wounded soldiers. In that year at Gerstner Field, LA, Major Nelson E. Driver and Captain William C. Ocker converted a Curtiss JN-4 "Jenny" bi-plane -- the primary Army trainer in WW I -- into an air-ambulance. They modified the open rear cockpit to accommodate a standard Army stretcher, holding one patient in a semi-reclined position. Crude as it was, the modification allowed the US Army to transport patients by airplane for the first time in February 1918, the beginning of Aeromedical Evacuation (AE). This success led to an order directing all military airfields to have at least one air ambulance for the duration of the war. During the next several years, ambulance aircraft were used by the U.S. Army on an emergency basis only, despite repeated urging by Army Medical Department officers for the routine use of transport airplanes for evacuating casualties in the event of war.

World War I also produced the first flight surgeons. The US Army Medical Corps used airplanes primarily to transport flight surgeons to the site of airplane accidents to assist in the ground transportation of casualties.

Development of Medical Evacuation after World War I

The success of the Jenny air ambulances during World War I paved the way for the further development of air evacuation, with several other types of aircraft converted successfully for this purpose. In 1920 the DeHavilland DH-4 aircraft modification allowed it to carry a medical attendant and two side-by-side patients in the fuselage. Shortly thereafter, the Cox-Klemmin aircraft became the first plane built specifically as an air ambulance, carrying two patients and a medical attendant enclosed within the fuselage. The building of the Curtiss Eagle in 1921 allowed the transport of four patients on litters and six ambulatory patients. Unfortunately, in its first year of service, an Eagle crashed during an electrical storm, killing seven people.

Despite the crash setback, aeromedical transportation continued to progress. In 1922 the US Army converted the largest single-engine airplane built at the time, the Fokker F-IV, into an air ambulance designated the A-2. In the same year, a US Army physician, Col Albert E. Truby, listed the potential uses of the airplane ambulances as follows:

• Transportation of medical officers to the site of crashes and evacuation of casualties from the crash back to hospitals.
• Transportation of patients from isolated stations to larger hospitals, where they could receive better treatment.
• In time of war, transportation of the seriously wounded from the front to hospitals in the rear.
• Transportation of medical supplies in emergencies.

Origin of Flight Nurses

Before long, others began to recognize the need for air transportation of patients and the special training that would be required for medical attendants. Mary Beard, registered nurse (RN) and director of the American Red Cross Nursing Service in 1930, stated:

No one of our nursing organizations, no leading school of nursing, nor any other professional group, has taken up this subject seriously and definitely tried to promote the organization of a group of nurses who understand conditions surrounding patients when they are traveling by air.

Visionary Lauretta M. Schimmoler, RN and pilot, created the Aerial Nurse Corps of America in 1936. Although the organization struggled for years and never gained official recognition by the military or the Red Cross, they proved the concept and are today recognized as the original flight nurses, the model for the USAF Flight Nurse Corps. Early in WW II, the flight nurse specialty was established and training provided by the Army Air Corps.

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