Medical exercise strengthens total force Published May 20, 2022 By Capt Traci Howells 136th Airlift Wing SAN ANTONIO, Texas -- The Texas Air National Guard’s 136th Airlift Wing provided vital airlift in support of a full spectrum aeromedical evacuation readiness exercise here, April 14, 2022. The Validated Assessment Program for Operational Readiness (VAPOR) exercise brought together total-force aerial and medical personnel based in Texas, including active duty’s 59th Medical Wing, Joint Base San-Antonio-Lackland, and fellow Texas ANG unit, the 147th Attack Wing, out of Houston, Texas. Together, they practiced the process of transporting patients to the 136th AW’s C-130J Super Hercules. “The aeromedical environment is stressful; it is a unique environment, and you have to learn how to adapt to the airplane,” said Col. David Alexander, Texas Air National Guard Headquarters Air Surgeon. “You get dehydrated and exhausted, and there is airplane noise and vibration. The more you exercise in the actual environment, the better prepared you are.” Brig. Gen. Mark Gaul, ANG Assistant to Deputy Surgeon General of the Air Force and Col. Ken Egerstrom, ANG Director of Medical Services, attended to observe and provide feedback on the Total Force training. The VAPOR exercise was designed to replicate the continuum of patient care when aeromedical evacuation is required, from point of injury to arrival at hardened facility. The addition of airlift allows for more realistic-based training scenarios. During the flight, integrated TXANG and active duty critical care air transport teams (CCATT) ran patient care scenarios in the air. The CCATTs are highly specialized and uniquely skilled three-person medical teams that augment standard aeromedical evacuation crewmembers, and turn an aircraft into a flying intensive care unit. Alexander explained the advantage of integrating ANG and active duty members during training exercises, and noted that getting into the aircraft with mixed crews is a real-world scenario is a strong possibility. “As long as you’ve got common language, common protocol, common procedures, you can integrate,” he said. “By building that relationship on the front end, you can keep and continue that on the back end,” he said. “The more familiarity you have, the more commonality you have, especially in the airborne environment.” Maj. Rich Mitchell, 181st Operations Squadron, and aircraft commander, said the exercise was just as essential for the aircrew, who are flying on relatively new aircraft with the wing’s recent conversion to the C-130J. “Some of the crewmembers have done aeromeds over years of flying, but the CCAT flying adds another layer of pressure and a sense of urgency,” he said. The aircraft experienced an unexpected malfunction during start, and the aircrew had the opportunity to train on the systems alongside CCAT members, he added. “It was supposed to be a relatively straightforward flight, but the situation that day led to aircrew training, too,” Mitchell said. “Overall, it turned into a real world training and experience we can also use on our future missions.” The goal of VAPOR is to close the gap between formal training and the training needed to execute the mission in the field, said Col. Daniel Rodriguez, 136th Medical Group commander. “With VAPOR, we are running scenarios continuously on a more frequent basis, keeping the training valid and sustained throughout the course of their career,” he said. “This way, when they are called on, they are ready to go and the team is ready to respond.” The 136th AW is already home to an En Route Patient Staging System (ERPSS), which includes equipment and medical personnel specially trained to stage and prepare patients for military air transport. The wing is currently in the process of standing up the ANG’s newest aeromedical evacuation squadron, which will expand the medical evacuation capabilities of the wing.