Watercraft as Overwater Ambulance Exchange Points to Enhance Aeromedical Evacuation

TL;DR

Problem: long-range aeromedical evacuation in noncontiguous maritime theaters suffers from limited reach and complex multi-platform coordination. Approach: a watercraft-based overwater AXP concept is demonstrated during MEDEVAC Projects Week using a semi-Markov decision process, hoist stabilization, BATDOK, Starlink, and ATAK to move a manikin between two HH-60Ms and a moving vessel. Contributions: the first live demonstration of watercraft as an overwater AXP, integration of four enabling technologies, and proposals for maritime evacuation chains, transfer opportunity zones, and dedicated overwater AXPs, plus civilian applications. Significance: expands dynamic MEDEVAC reach across island chains and informs civilian disaster-response planning through multi-agent coordination.

Abstract

Ambulance exchange points are preidentified sites where patients are transferred between evacuation platforms while en route to enhanced medical care. We propose a new capability for maritime medical evacuation, which involves co-opting underway watercraft as overwater ambulance exchange points to transfer patients between medical evacuation aircraft. We partner with the United States Army's 25th Combat Aviation Brigade to demonstrate the use of an Army watercraft as an overwater ambulance exchange point. A manikin is transferred between two HH-60 Medical Evacuation Black Hawk helicopters conducting hoist operations over Army Logistics Support Vessel 3, which is traveling south of Honolulu, Hawaii. The demonstration is enabled by a decision support system for dispatching aircraft, hoist stabilization technology, commercial satellite internet, military geospatial infrastructure applications, and digital medical documentation tools, the benefits of which are all discussed. Three extensions of the overwater ambulance exchange point are introduced and civilian applications are considered.

Figures (7)

• Figure 1: An HH-60M Medical Evacuation Black Hawk helicopter hoists a stabilized litter patient to Army Logistics Support Vessel 7, docked in Pearl Harbor. $\copyright$ Charlie Clark 2023
• Figure 2: An Army critical care flight paramedic, hoisted down from an HH-60M Medical Evacuation Black Hawk helicopter alongside his mock patient in a SKEDCO, walks the main deck of Logistics Support Vessel 7. $\copyright$ Charlie Clark 2023
• Figure 3: An Army crew chief spots Logistics Support Vessel 3 from the cabin of an HH-60M Medical Evacuation Black Hawk helicopter. Logistics Support Vessel 3 would later that day depart Pearl Harbor for the open ocean. It would there serve as an ambulance exchange point for a mock patient transfer demonstration between two HH-60M helicopters. $\copyright$ Charlie Clark 2023
• Figure 4: The Load Stability System stabilizes a packaged manikin being evacuated from the point of injury. Hoist stabilization allows aircrews to hoist litter patient without using a tagline. This in turn enables hoist operations for litter patients in small confined areas such as Army watercraft.
• Figure 5: Battlefield Assisted Trauma Distribution Kit systems were provided to the five units participating in the patient transfer process: with the ground medic at the point of injury, with the flight paramedic on the first HH-60M, with the combat medic on LSV-3, with the flight paramedic on the second HH-60M, and with the medical provider at Tripler Army Hospital.