WW II Aeromedical Evacuation

Interior of an Aeromedical Evacuation C-54 Skymaster, Okinawa, July 1945
Interior of an Aeromedical Evacuation C-54 Skymaster, Okinawa, July 1945.

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Beginning of Aeromedical Evacuation in World War II

Medical personnel load a litter patient aboard a 442nd Troop Carrier Group C-47 during World War II
Medical personnel load a litter patient aboard a 442nd Troop Carrier Group C-47 during World War II.

At the beginning of World War II, Aeromedical Evacuation (AE) did not exist as established military doctrine. In fact, air evacuation of the sick and wounded was considered dangerous, medically unsound, and militarily impossible. The U.S. Army Medical Department organized evacuation around field ambulance trucks, even for long distance transport.

World War II quickly demonstrated the need to transport large numbers of casualties from distant theaters of war. However, specialized evacuation aircraft did not exist. The Army Air Forces used transport planes, reconfigured with removable litter supports for air evacuation as their secondary mission. The same aircraft that transported men and supplies to the theaters of operation were utilized as air-evacuation aircraft on their return trip. By January 1942, AAF C-47 Skytrain aircraft had transported more than 10,000 casualties from Burma, New Guinea, and Guadalcanal.

The First Aeromedical Evacuation Flight Nurses

Experience with air evacuation quickly revealed that specially trained personnel were needed to optimize casualty care during air transport. It was not possible to staff every flight with physicians, so Brig. Gen. David Grant, AAF Air Surgeon, proposed establishing a Flight Nurse Corps. Despite opposition from the Army Surgeon General, the designation Flight Nurse was created for specially trained members of the Army Nurse Corps assigned to the AAF Evacuation Service. In February 1943, the first class of Flight Nurses graduated from a four-week training course at Bowman Field, KY, that taught aeromedical physiology, aircraft-loading procedures, and survival skills.

Flight nurse duty was voluntary, requiring strenuous work and sometimes exposure to enemy fire, but the risk was justified by the reduced death rate and increased morale among the wounded.

Evolution of Aeromedical Evacuation in World War II

Regular AE routes were established, and hospitals were built along airstrips to care for the wounded who needed to remain overnight along the route. In early 1943, AE aircraft began transatlantic flights from Prestwick, Scotland, to the United States. By the end of the same year, transpacific AE flights were returning patients to the continental United States via Hawaii. In 1944 a southern Atlantic route to the United States, originating in North Africa with stopovers in the Azores and Bermuda, began operations.

At its peak, the AAF evacuated the sick and wounded at a rate of almost 100,000 per month. A one-day record of 4,704 AE patients evacuated was set in 1945. As AE crews gained experience, the risk of death during AE dropped to six patients in 100,000 by 1943. At the end of the war, the risk was down to one and one-half patients in 100,000, thus proving that AE was one of the most important medical advances in decreasing the mortality rate associated with warfare.

In his evaluation of critical factors in winning the war, General Eisenhower placed AE in a class with sulfa drugs, penicillin, blood plasma, and whole blood as a chief factor in cutting the fatality rate of battle casualties. He stated on 18 June 1945:

We evacuated almost every one of our forward hospitals by air, and it has unquestionably saved hundreds of lives, thousands of lives.

Aircraft used for Aeromedical Evacuation during World War II

The aircraft used for AE during WW II included:

  • C-46 Commando
  • C-47 Skytrain
  • C-54 Skymaster
  • C-64 Norseman
  • C-87 Liberator Express

In addition, bombers and tankers moved patients from forward battle zones during WW II tactical AE.

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