A Kaman HH-43F Huskie lowers A1C William Hart Pitsenbarger, USAF, Pararescue Crew Member, Detachment 6, 38th Aerospace Rescue and Recovery Squadron into a burning minefield to extract a wounded ARVN soldier, Bien-Hoa Air Base, Vietnam, 7 March 1966. On 11 April 1966, 21-year-old Pitsenbarger was killed while defending wounded comrades. He was awarded the Air Force Cross, later upgraded to the Medal of Honor, for his actions.
During the Vietnam War (early 1960s through 1975) there was a much fuller exploitation of the helicopter for Aeromedical Evacuation (AE). Combat search and rescue helicopters retrieved aviators who were shot down. Helicopters in support of U.S. Marines and Army forces picked up the wounded soon after injury, and quickly transported them to definitive treatment facilities. Helicopter AE was considered a significant factor in the decreased mortality from wounds in Vietnam. During World War II, about four percent of the casualties reaching medical treatment facilities died. During the Korean War, this was reduced to two percent. The Vietnam conflict demonstrated fatality rates of one percent for casualties arriving at medical treatment facilities.
South Vietnam was a country of mountains, jungles, and marshy plains, with few passable roads or serviceable railroads. The allied forces waged a frontless war against a seldom seen enemy. Even more than in Korea, helicopter evacuation proved to be both valuable and dangerous. The physical problems of terrain and Vietnam's tropical climate were exacerbated by the Viet Cong's guerilla tactics that had no respect for the red crosses on the doors of the air ambulance helicopters.
In these conditions the modern techniques of AE developed and matured. The physical obstacles of mountain, jungle, and floodplain could be overcome only by helicopters. The frontless nature of the war also made the helicopter necessary for medical evacuation. Air ambulance units found ever wider employment as the helicopter -- used both as a fighting machine and as a transport vehicle -- came to dominate many phases of the Vietnam War.
Use of MedEvac Helicopters in Vietnam
In late April 1962, the 57th Medical Detachment (Helicopter Ambulance) arrived in Vietnam with five UH-1 "Hueys," remaining there for the next eleven years. The first MedEvac took place on 12 May 1962, an Army Captain acting as an ARVN advisor. In the early 1960s there was little structure or doctrine for AE that fit the needs of Vietnam. The command structure evolved over the course of the war from Helicopter Ambulance detachments under the operational control of nonmedical aviation units to dedicated air ambulance companies with platoons field-sited far from their company HQ, and other organizational forms, nothing fully satisfactory for all circumstances.
The term "Dustoff" was coined in Vietnam, when it was chosen in 1963 from a code book as the call sign for the 57th Medical Detachment. It evoked a Huey taking off from the dry and dusty Vietnam countryside and came to represent all MedEvac helicopter operations. 57th Medical Detachment has the honor of being known as "The Original Dustoff".
Air ambulances transported most of the sick, injured, and wounded soldiers and Marines who required rapid movement to a medical facility, and also many Vietnamese civilian and military casualties. Casualty proportions varied over the course of the war. Before 1965 about 90 percent of the patients were Vietnamese. After the U.S. buildup began in 1965, the figure dropped to only 21 percent for 1966. As the United States started to turn over more of the fighting to the South Vietnamese in the late 1960s, the Vietnamese number rose again until it reached 62 percent in 1970.
Although only about 15 percent of the cases treated by all Army medical personnel in the war were wounded in action, it seems that the percentage of wounded among the air ambulance patients was much higher, between 30 and 35 percent, since the ambulances gave first priority to patients in immediate danger of loss of life or limb, a condition most closely associated with combat wounds. Up to 120,000 of the U.S. Army wounded in action admitted to some medical facility -- 90 percent of the total -- were probably carried on the helicopters. This is about one third of the some 390,000 Army patients that the air ambulances carried to a medical facility.
Casualty Statistics of Air Ambulance Crews
Statistics confirm that air ambulance pilots and crewmen were at risk of being injured, wounded, or killed during their one-year tour. About 1,400 Army commissioned and warrant officers served as air ambulance pilots in the war, one of the most dangerous types of aviation in Vietnam. About forty aviators (both commanders and pilots) were killed by hostile fire or crashes induced by hostile fire. Another 180 were wounded or injured as a result of hostile fire. Another forty-eight were killed and about two hundred injured as a result of non-hostile crashes, many at night and in bad weather while on evacuation missions.
These totals mean that slightly more than one-third of the aviators became casualties in their work, and the crew chiefs and medical corpsmen who accompanied them suffered similarly. Furthermore, helicopter ambulance missions in the Vietnam War were lost to hostile fire at a rate 3.3 times higher than other aviation missions. Even compared to the loss rate for non-medical helicopters on combat missions, the ambulance loss was 1.5 times higher. Warrant officer aviators, who occasionally arrived in South Vietnam without medical training or an assignment to a unit, were sometimes warned that air ambulance work was a good way to get killed.
Air Ambulance Personnel Rescue Hoist
Use of the MedEvac helicopters in Vietnam was beset by a problem of landing zones. In the jungle and steep terrain it was often impossible to land the helicopter, a situation that required wounded to be moved to the nearest feasible landing site. This required a large draw of peresonnel to carry the wounded and extended the time and agony of the casualties. A solution was found in the form of the Personnel Rescue Hoist, developed and improved to a reliable model by mid-1966.
The hoist was a winch mounted on a support anchored to the floor and roof of the helicopter cabin, usually just inside the right side door behind the pilot's seat. When the door was open, the hoist could be rotated on its support to position the cable and pulleys outside the aircraft, clear of the skids, so that the cable could be lowered to and raised from the ground. After a UH-1 was outfitted with the necessary electrical system, the aircraft crew could quickly install or remove the hoist. On a hoist mission, while the aircraft hovered, the medical corpsman or crew chief would use the hoist cable to lower a litter or harness to casualties below. The crew chief would sometimes lower a medical corpsman with the device. Then the hoist would raise both the medic and the casualty to the helicopter. The standard hoist eventually installed on the UH-1D/H could lift up to 600 pounds in one load and could lower a harness or litter about 250 feet below the aircraft.
MedEvac Helicopters Used During the Vietnam War
The primary MedEvac Helicopter in Vietnam was the UH-1 Huey, models UH1-D and UH-1H, but others on this list served in the MedEvac role as well as other duties.
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