Chapter 9

Air Movement Missions

An air movement is the air transport of units, personnel, supplies, and equipment
involving airdrops and air landings (JP 3-17). Utility helicopters, heavy lift
helicopters, and FW aircraft conduct air movements in a DS or GS role. Air
movements are especially effective in moving forces and equipment when ground
routes are nonexistent, limited, congested, damaged, or blocked by enemy activity or
obstacles; the supported unit does not have adequate available vehicles; and time is
critical due to distances involved.

SECTION I – PLANNING
9-1. The primary difference between an air movement and an air assault is that an air assault links a specific
ground tactical plan to the aerial movement of the assault force. Air movements are planned and executed
with the same rigor and precision as air assaults because they enable the ground force commander to
sustain the tempo of operations, extend tactical reach, overcome complex terrain, and sustain operations to
maintain a position of relative advantage over the enemy.

RECEIVE THE MISSION (+*)

9-2. The battalion staff should provide the necessary orders and other additional information, to include
points of contact of supported units to allow the commander and staff to begin planning. During initial
analysis and coordination, the staff determines whether or not the mission is feasible. When the mission is
reviewed any limitations and potential complications should be minimized prior to the supporting company
receiving the mission. If meetings are required in support of the air movement, such as an initial planning
conference or AMCM, those meetings and associated timelines should be provided to the supporting unit.
The staff should also determine whether the air movement is tactical or non-tactical, which greatly
influences subsequent mission planning.
9-3. The staff sections provide mission, PZ, route, and HLZ information including grid locations,
frequencies, call signs, markings, and landing direction from OPORD. They also provide the following
information to crew executing the mission:  The intelligence section—
 Identifies threats to tactical air movement operations and disseminates reports.
 Provides assessments of the safest routes for the air movement.
 Example: CH-47 aircraft are particularly at risk due to their large signatures, especially
when transporting external loads.  The operations section—
 Provides mission, PZ, route, and HLZ information including grid locations, call signs,
markings, and landing direction.
 Provides critical mission times and a supported unit point of contact.
 Specifies the means of flight following and periodic situation reporting of activities and
locations by pre-coordinating modes of communication.
 Ensures compliance with the ACMs and advises aircrews of other potential airspace users
along projected flight routes.
 Coordinates for preplanned or on-call fires available to support operations.
 Coordinates aerial security elements as needed.
 Ensures aircrews are aware of downed aircraft procedures.
 The logistics section—

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 Arranges logistics support for extended distance missions.

 May plan throughput of fuel supplies directly to the supported unit's trains where Class III
sections can link up their FARP equipment with supplies, when in DS of a particularly large
air movement mission.
 The signal section—
 Provides frequencies for radio communications for all components.
 Pre-coordinates modes of communication.
9-4. The aviation unit staff receives information on the air movement mission through an air mission
request (AMR). This is a detailed process that must be sound and well understood from the CAB to the
company level. An example AMR format can be found in FM 3-04.

TYPES OF AIR MOVEMENTS

9-5. There are two types of air movements: non-tactical and tactical. These operations may include both
airdrops of supplies and equipment or deliberate landings at designated HLZs. The types of air movements
are as follows.
 A non-tactical air movement expedites movement and optimizes time and resources with
minimal threat of enemy activity. It emphasizes economical use of the aircraft cabin space and
the maximum use of the allowable cabin load (as determined by weight, cubic displacement, and
distance to be flown) for that aircraft type. Unit integrity or off-loading sequence is second in
priority to load efficiency when planning a non-tactical movement.
 A tactical movement facilitates accomplishment of a tactical mission with a higher potential
threat of enemy forces. The arrangement of personnel, equipment, and supplies is designed to
conform to the anticipated tactical operation of the unit.

AIR MISSION REQUESTS

9-6. Ground units at the battalion-or squadron-level and above designate a staff officer or a NCO within the
S-3 to process and manage all unit AMRs. The AMR is routed through the respective staff of the next
higher unit—normally associated with a BCT. The BAE manages and processes all AMRs submitted from
subordinate units within the BCT AO. The BAE processes the AMR up through the aviation element of the
next higher command, which could be the division staff for operations and planning or other senior
designated headquarters. The AMRs are then routed to the aviation headquarters for approval and
execution.
9-7. In certain OEs, aviation units may conduct scheduled intra-theater passenger and equipment
movements commonly known as resupply routes. These operations require extensive coordination between
the CAB and supported units. The aviation unit must balance tactical risk and efficiency in conducting
scheduled operations of this type.
9-8. During prolonged contingency operations, the AMR should be submitted as early as possible,
consistent with the type of mission request and the location. A regular AMR should be submitted by the
BAE to higher headquarters not later than 96 hours prior to mission execution.
9-9. AMRs are tasked to the aviation headquarters using a 96-hour planning cycle. The normal processing
time is a minimum of 96 hours prior to the desired date of movement. If the mission is considered to be
short notice (less than 96 hours), it is designated as a priority AMR. After the 96-hour submission cut-off,
special approval will be required from higher headquarters for the AMR.

Air Mission Request Review Process

9-10. When an AMR is submitted, a quality control check is conducted to ensure that the request sheet is
completed according to the SOP. The BAE, or the aviation element at the higher headquarters, is the filter

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for all air movements. The staff prioritizes all the AMRs that come through to best facilitate unit operations
and to maximize the use of available aircraft assets and space/lift capabilities.
9-11. If a resupply route with an established schedule is being used in the AO, aviation planners attempt to
maintain schedule integrity as much as possible. Most contingency operations will default to a resupply
route schedule to support multiple agencies and units with the available limited aircraft assets in the AO.
9-12. If aircraft assets are needed for the movement of a very important person(s) or the mission is
designated as a high priority on relatively short notice—the request may require expedited handling in the
AMR channels.

Centralized Control of Mission Requests

9-13. The senior ground commander in an AO should establish AMR submission and approval procedures
through the command’s BAE or other aviation element. This method prevents the higher headquarters from
being inundated with multiple requests, provides visibility on all AMRs, and prioritizes the requests in the
AO.
9-14. A common technique for maintaining control of AMR submissions is to use a common email account
which allows all AMRs to be submitted into one account for ease of management.

Air Movement Table and Flight Schedule

9-15. The higher headquarters publishes a daily air movement table before each mission day. If an AMR
number is not on the air movement table, the requesting unit needs to contact their BAE or aviation element
at higher headquarters to find the disposition of their request. Shifting routes, pickup, and landing times
should be considered to prevent predictability and targeting by the enemy.
9-16. During the course of ongoing operations, the AMR process can improve and be streamlined resulting
in the reduction of timeline requirements for submission and changes to the AMR. While certain OEs may
necessitate 96 hours for an AMR submission with a 12-hour publishing expectation, the timeline can shift
based on the operational tempo, availability of assets, enemy situation, and prioritization of competing
missions. Commanders and staffs must work in conjunction with ground planners at all levels to maintain
communications on the status of their AMR and the aviation assets supporting the request. Direct liaison
between a supported ground force and the supporting aviation staff, via the BAE, can alleviate problems
that might arise during the planning process.
9-17. Once the air movement table is posted, the BAE produces the mission schedule for the next day and
distributes the information on the AMR numbers being supported to the subordinate units and requesters.
9-18. The mission schedule provides the AMR number, supported unit information, supporting aviation
unit, a brief description of the mission, the pickup locations, the names of passengers, the amount of cargo
and weight, the time to report at the airfield or PZ, arrival time of the aircraft, and the estimated time of
arrival at the destination. The mission schedule also informs subordinate units and personnel about the
opportunity for space available status on a flight for additional passengers and cargo that are not on the
current AMR.

Submission of a Priority Air Mission Request

9-19. A priority AMR is submitted within the prescribed period; however, it does not meet the criteria and
timeline outlined by the higher headquarters for the normal AMR process. Priority AMRs must be
submitted as soon as possible since the time between submission and execution is reduced; however, proper
planning and coordination must be completed. While priority AMRs may cancel or delay other scheduled
flights, it is sometimes possible to support them within existing missions.
9-20. Justifications for submitting a priority AMR may include, but are not limited to the following:
 Movement of high-value detainees.
 Mission critical supply movements for force protection.

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 An emergency sustainment resupply mission to troops.

 Transport of senior command personnel.
 Transport of an incident investigating officer.
 Red Cross message and emergency leave transport.
 Very important person transport.

FIXED-WING REQUEST PROCESS AND SERVICE RESPONSIBILITIES

9-21. Military personnel and DOD civilian employees, with official business travel requirements, may
request operational support airlift (OSA) transport. Requests for OSA support must be submitted through
the appropriate authorizing official to the service validator according to service-directed procedures. The
requesting official or office shall maintain requests for a minimum of 2 years. Priority cargo and logistics
movement requirements are also submitted through the appropriate authorizing official to the service
validator. In addition to the information supplied on this form, the requestor shall be responsible for
coordinating all ground-support, customer requirements, protocol, ground transportation, lodging, baggage,
and baggage handling.

Approval Authority
9-22. DOD directives require the authorizing official to review and approve DOD senior official—flag
officer and equivalent civilian grades—aircraft support requests to ensure the proper method of
transportation is used. The authorizing official shall be senior to the traveler, unless otherwise designated,
and is normally the chief of staff of a major command and cannot be delegated below that level.

Validator
9-23. The validator receives OSA mission requests and assigns the appropriate priority urgency justification
category based on information provided by the requester and unit authorizing official. This function is
critical; the scheduling of OSA assets is based on this category. In aviation units, validators may be found at
battalion, brigade, or division. A unit may contact OSA to schedule a Soldier in the Joint Air Logistics
Information System to establish their own validator at the unit level.

Joint Operational Support Airlift Center

9-24. This element is the scheduling authority for all available continental United States OSA support
requests received through the Joint Air Logistics Information System. In scheduling requests, the Joint OSA
Center considers priority codes assigned by the service validator, the most efficient asset available to
conduct the mission, cost effectiveness, and any unique requirements associated with the request. Strict
adherence to OSA post-mission reporting procedures ensures OSA aircraft utilization is documented for
OSA annual reports to the DOD and Congress. The Joint OSA Center program analysis and system
management team is responsible for development, retrieval, and preparation of reports verifying the use of
these DOD assets.

Aviation Unit
9-25. The aviation unit providing assets and support to the OSA mission is ultimately responsible for the
safe conduct of the OSA flight. The unit communicates and resolves any safety concerns prior to executing
the OSA mission. The aviation unit is responsible for directly coordinating with the point of contact on the
request prior to flying the mission.

Mission Assignment
9-26. Mission planning and coordination is initiated when the designated units receive a mission request.
The aviation commander, a liaison, or a staff officer may be sent to the supported unit headquarters to assist
in planning. The FW unit may reconfigure or reposition in support of the upcoming operation.

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MAKE A TENTATIVE PLAN (+*)

9-27. Once the aviation company understands the specific requirements and limitations of the mission, they
begin planning using company planning cells and TLP.
Note. In addition to this reference, JP 3-17, FM 3-04, ATP 4-25.13, and ATP 4-48 guide planning
for an air movement. Company planners should also consult the Army Aviation Handbook for
crew-level procedures related to this mission.

9-28. It is important to remember that planning for an air movement requires many of the same steps listed
for an air assault (+). Whether tactical or not, planning an air movement requires the same attention to
detail as an air assault. If an initial planning conference or AMCM is warranted, necessary personnel from
the supporting unit should attend these meetings (+*).
9-29. Several general rules apply to planning cargo operations and the use of aircraft:
 Base cargo loading on mission requirements.
 Plan to move general bulk cargo, such as boxes or crates, on 463L pallets inside or underneath
heavy lift aircraft
 When loading 463L pallets, use forklifts rated at a lifting capacity equal to or greater than the
pallet weight. Normally, all terrain and/or rough terrain forklifts capable of lifting 10,000 pounds
are used.
 Identify in advance any additional required loading aids and personnel to ensure availability at
the equipment load time. Examples are shoring, aircraft winch, and materials handling
equipment. Aircraft ground time is minimized when the unit is prepared to load and unload.
 Use shoring to prevent damage to the aircraft floor or airfield pavement.
 Do not use the book weight of items for weight and balance purposes when the actual airlift
occurs; use the actual scale weight.

MANEUVER PLANNING CELL

9-30. The first step for maneuver planners is to determine what moves by air, the types of aircraft
required for the movement, the commander's guidance, and movement priorities. Based on this
information, planners can determine and request the number of sorties by aircraft type to accomplish the
mission (+). For tactical movements, security of the aircraft, passengers, and cargo is paramount (+). For
non-tactical movements, the aircraft should be employed to maximize efficiency (+).
9-31. To ensure accurate movement planning figures, measure and weigh the equipment planned for
each load. Two methods of determining aircraft requirements are the weight and type load methods, which
are described as follows:
 The weight method is used to calculate requirements to transport large amounts of vehicles,
general cargo, and personnel. This method is based on the assumption that total weight, not
volume, is the determining factor.
 The type load method is used to calculate individual requirements for like loads. In most unit air
movements, a number of the aircraft loads can contain the same items of equipment and number
of personnel. Preparing identical type loads greatly simplifies planning and makes manifesting
easier. This method is normally used by unit-level planners.

Site Selection
9-32. In addition to the HLZ selection criteria in chapter 1, other planning considerations include but are
not limited to—
 Route selection.
 Site selection.
 Available aircraft capabilities.

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 Environmental considerations.
 Load considerations to include personnel, equipment, and loading support equipment for both
internal and external loads.
 Primary, alternate, contingency, and emergency procedures.
Note. Refer to chapter 1 of this publication, the Aviation Handbook, and unit SOPs for additional
maneuver planning cell responsibilities.

Environmental Considerations
9-33. High altitudes and hot temperatures degrade aircraft performance, reduce the usable load, and may
require a larger PZ/HLZ. Refer to TC 3-04.12 and applicable aircraft TMs for environmental and
performance planning guidelines.

Load Planning Considerations

9-34. When operating the aircraft helicopter at maximum gross weights, use the exact weight of each
occupant plus equipment. If weighing facilities are not available or if the tactical situation dictates
otherwise, estimate loads as follows:
 Combat-equipped troops: 330 pounds per individual.
 Combat-equipped paratroopers: 350 pounds per individual.
 Crew and passengers with no equipment: compute weight according to individual estimates.

Note. Consult appropriate aircraft TMs for specific cargo capacity and other technical planning
information. General planning factors must address internal or external loads (weight and size);
cargo hook capacities, numbers of troops to be transported, and any special equipment or loading
procedures required for the mission.

PROTECTION AND CONTINGENCY PLANNING CELL

9-35. Senior NCOs in the company and planning cell members work together to identify and mitigate risks
during the mission. The safety officer and/or senior NCO should assess accidental risk hazards from
the mission. Safety is an important consideration in any air movement to prevent injury to personnel
and damage to the aircraft or the transported materials. To safely conduct air movement operations,
the aircrew and support personnel must be aware of the safety hazards, such as static electricity,
turning rotor blades, rotor wash, and other operations within close proximity to the aircraft.
9-36. The protection and contingency planning cell considers the following points:
 Static electricity. When aircraft engines are running and a helicopter is hovering above the
ground, the aircraft generates and stores static electrical charges that can cause injury and spark
fires.
 Rotor wash. Helicopters and FW aircraft generate high velocity air movement from rotor blades
and propellers. Large helicopters, such as the CH-47, can generate rotor wash in excess of 120
knots. This strong wind may cause ground crew personnel difficulty in walking or standing and
its force can move unsecured items and material.
 Forklift operations. Use extreme caution when conducting forklift operations in and around the
vicinity of aircraft.
9-37. The AMSO should advise the protection and contingency planning cell on the tactical risk posed to
the unit. To that end, planners should consider—  PZ/HLZ security requirements.
 Deception routing or HLZ requirements.

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 PR considerations and coordination requirements.

OTHER PLANNING CONSIDERATIONS

9-38. The paragraphs that follow detail specific air movement considerations for the supported, supporting,
and receiving unit.
Supported Unit
9-39. It is the duty of the aviation task force to verify the supported unit is aware of their responsibilities
when conducting these operations (+) according to the multi-service helicopter sling load manual. The
supported unit responsibilities include—
 Selecting, preparing, and controlling the PZ.
 Coordinating in advance with the supporting unit.
 Rigging the loads.
 Furnishing slings, straps, clevises, and any other sling-load equipment required for the move.
 Checking for improper rigging and weight in excess of the aircraft's maximum load capabilities.
 Coordinating for backhaul of slings and rigging equipment.

9-40. External loads include bulk supplies, fuel or water drums, vehicles, trailers, materiel handling
equipment, towed artillery and other weapons systems, and ribbon bridges. The supported unit is
responsible for preparing, weighing, and rigging external loads. Supported units must avoid loading
vehicles, trailers, pallets, and other containers beyond maximum weights that have been coordinated with
the aviation unit. If the aircraft is unable to lift the load or transport it the required distance, the supported
unit must reduce the weight by removing items. This could involve partial derigging, re-rigging, and re-
inspection delays. These unexpected delays could cause the ground unit to lose aviation support if the
aircraft are scheduled for other missions.

Supporting Aviation Unit

9-41. The aviation unit makes the final determination of the load’s worthiness to fly. Aviation unit
responsibilities include—
 Providing advice and technical help to the supported unit, as required.
 Ensuring loads fall within the transporting aircraft's ACL.
 Providing assistance in the recovery and return of sling-load equipment.
 Advising the supported unit on load limitations (+).
 Advising the supported and receiving units on the suitability of selected LZs and PZs.
 Establishing coordination with the supported and receiving units.
 Coordinating with the supported and receiving units and, if able, appointing an LNO who is
familiar with the capabilities and limitations of the unit's assigned aircraft (*).
 Providing all components of the 5,000 and 10,000-pound tie-down assemblies used for securing
internal cargo for transport in the aircraft.
 Familiarizing with the security, safety, and technical peculiarities of the loads that may adversely
affect air transport.
 Arranging for the aircraft to be at the PZ on schedule (+*).

Receiving unit
9-42. It is the duty of the aviation task force to verify the receiving unit is aware of their responsibilities
when conducting these operations. The receiving unit responsibilities include—  Selecting, preparing, and
controlling the HLZ.
 Providing trained ground crews to guide the aircraft and de-rig the loads.
 Coordinating with the supporting unit for the control and return of the sling-load equipment.
 Inspecting the rigging of back loads.

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 Unloading the vehicle and cargo on the helicopter with proper equipment (such as a forklift),
subject to the approval of the PC, flight engineer, or crew chief.

SECTION II – PREPARATION
9-43. Preparation begins with the aircrew OPORD (+*). The aircrew OPORD marks the point of initiation
for the air movement mission. As with an air assault, the aircrew OPORD should have all supporting
crewmembers in attendance. The aircrew OPORD format for an air movement is exactly the same as that
for an air assault; the level of detail depends on the mission variables.
9-44. No matter the level of detail or support provided during the air movement, there should be some level
of rehearsal conducted for all mission crews (+*). The detail of the rehearsal depends on mission variables
and commander’s intent.

SECTION III – EXECUTION

9-45. Execution of an air movement mission follows the general sequence of most other aviation missions
described in part one of this publication. Listed below are unique considerations related to operating on
resupply routes or at the air terminals.

RESUPPLY ROUTES
9-46. Resupply routes are used to service forward operating bases and combat outposts with troops and
cargo. There may be several resupply routes, each delivering cargo and personnel to multiple forward
outposts.

HUB-AND-SPOKE
9-47. The hub-and-spoke method is a system of connections arranged like a wheel, in which all traffic
moves along spokes connected to a hub or a number of hubs at the center. Hub-and-spoke allows planners
to maximize the capabilities of each aircraft type and provide a safe location for transloading operations.
9-48. Advantages of hub-and-spoke routes include—
 The small number of routes leads to more efficient use of transportation resources. For example,
aircraft are more likely to fly at full capacity, and can often fly routes more than once a day.
 Complex operations, such as package sorting and accounting, can be carried out at the hub,
rather than at every node.
 Spokes are simple, and new ones can be created easily.

9-49. Disadvantages of hub-and-spoke routes include—

 Daily operations can become highly predictable, increasing susceptibility to enemy attack.
 Day-to-day operations may be relatively inflexible since the model is centralized. Changes at the
hub, or even in a single route, could have unexpected consequences throughout the network. It
may be difficult or impossible to handle occasional periods of high demand between two spokes.
 Route scheduling is complicated for the network operator. Scarce resources must be carefully
managed. Careful traffic analysis and precise timing are required to keep the hub operating
efficiently.
 The hub constitutes a bottleneck or a single point of failure in the network. Total cargo capacity
of the network is limited by the hub's capacity. Maintenance or weather delays can result in
delays throughout the network.
 Cargo must pass through the hub before reaching its destination, requiring longer journeys than
direct point-to-point trips. This trade-off may be desirable for freight, which can benefit from
sorting and consolidating operations at the hub, but not for time-critical cargo and passengers.
 Two trips are required to reach most destinations. Arriving at the hub and transitioning to the
spoke increases the duration of the mission.

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POINT-TO-POINT
9-50. In the point-to-point method, aircraft travel directly between destinations.
9-51. Advantages of the point-to-point method include—  Eliminates the
need for connections.
 Reduces mission time.
 Less prone to delays.

9-52. Disadvantages of the point-to-point method include— 

Support requirements may exceed available
assets.  Direct route to unit locations may not
be available.

AIR TERMINAL CONSIDERATIONS IN SUPPORT OF AIR

MOVEMENT
9-53. At both military and civilian airfields, the senior aviation commander or the senior civilian operator is
responsible for air terminal operations. The Army provides an arrival/departure airfield control group
(A/DACG) to control Army activities at the terminal. The A/DACG is a provisional organization designed
to assist the air mobility command and the deploying unit in receiving, processing, and loading or
unloading personnel and equipment.
9-54. The United States Air Force Tactical Airlift Control Element supervises Air Force operations at an air
terminal. The A/DACG and the tactical airlift control element should coordinate support responsibilities
prior to the start of operations. The A/DACG may also be responsible for loading and unloading aircraft
and cargo at these facilities. Deploying units coordinate with the A/DACG for their responsibilities in
processing through the terminal.

SECTION IV – SPECIFIC MISSION CONSIDERATIONS

9-55. Air movement operations can include a variety of different roles and responsibilities to meet various
needs in support of greater operations. Some of the most common include the following:
 Helicopter sling-load operations.
 Aerial mine delivery (Air Volcano) operations.
 Aerial C2 operations.
 FARP operations.
 Aerial CASEVAC operations.

SLING-LOAD OPERATIONS
9-56. A sling-load operation is defined as supplies or equipment properly rigged with either one or more
slings, cargo bags, or cargo nets. The sling-load operation consists of three phases that include—
 Preparation and rigging. Loads are prepared and rigged according to appropriate multi-service
sling load TMs.
 Inspection. A Pathfinder School graduate, Sling-Load Inspector Certification Course graduate,
or an Air Assault School graduate in the rank of specialist and above is qualified to inspect and
certify each load. The individual who rigged the load cannot inspect the same load. The contents
of the load are recorded on a sling-load inspection record.
 Sling-load operations. Trained ground crews hook up loads.

9-57. The three different elements involved in a sling-load operation are the
supported unit, the aviation unit, and the receiving unit. Their
responsibilities are described below.

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9-58. The supported unit is responsible for—  Selecting, preparing, and

controlling the PZ.
 Requisitioning all the equipment needed for sling-load operations.
 Inspecting and maintaining all sling-load equipment.
 Providing trained ground crews for rigging and inspecting, filing inspection forms, controlling
aircraft, aircraft guides, hooking up loads, and clearing the aircraft for departure.
 Providing load dispositions and instructions to the aviation unit for the sling load equipment.
 Verifying the load weight (to include rigging equipment).
 Removing or re-rigging frustrated loads.

9-59. The aviation unit is responsible for (+)—

 Establishing coordination with the supported unit.
 Advising the supported unit on load limitations.
 Advising the supported units on the suitability of selected HLZs and PZs.
 Providing assistance in the recovery and return of sling-load equipment.
 Establishing safety procedures and understanding of duties and responsibilities between the
flight crew and ground crew.
9-60. The receiving unit is responsible for—
 Selecting, preparing, and controlling the HLZ.
 Providing trained ground crews to guide the aircraft and de-rig the loads.
 Coordinating for the control and return of the sling load equipment.
 Inspecting the rigging of back loads (sling-load equipment returning to PZ).

AERIAL MINE DELIVERY OPERATIONS

9-61. During shaping operations, air-emplaced minefield missions may require simultaneous insertion of
ground reconnaissance teams to mark the minefield and maintain observation of obstacles for subsequent
indirect fires or preplanned air attacks. Minefields may support operations by fixing enemy forces or
denying enemy reinforcements of an air assault objective. Shaping Volcano missions require attack or
reconnaissance aircraft security, SEAD, possible C2 aircraft support, and aircraft support to assist in
identifying enemy axis of advance and dispensing the corresponding minefield locations. For additional
information, refer to ATP 3-90.8.
9-62. During offensive operations, minefields can block enemy withdrawal during exploitation and pursuit.
Volcano minefields can protect exposed flanks by denying the enemy's use of an avenue of approach.
Following minefield self-destruction, follow-on friendly forces can employ the same avenue of approach
for parallel attacks or to bypass reconstituting units. Air Volcano mines can also block potential enemy
avenues of approach to reduce surprises during friendly movement to contact. Minefields employed during
attacks can secure an exposed flank or reduce vulnerability to counterattack. Routes away from objective
areas can be mined to eliminate counterattack and withdrawal routes. Minefields employed during
offensive operations often have shorter four-hour self-destruction times to avoid disrupting friendly
maneuver.
9-63. During defensive operations, assault units can rapidly emplace minefields in the covering force area
to delay and disrupt enemy formations. When employed to reinforce natural obstacles at chokepoints,
minefields provide opportunities for friendly counterattacks. Minefields employed during defensive
operations have long self-destruction times to delay the enemy during friendly strategic deployments.
Minefields employed during periods of temporary defense before resuming offensive operations may
employ the 48-hour self-destruct time. A key consideration for defensive employment of Volcano to pre-
plan several minefield locations based on the enemy’s predicted maneuver.

VOLCANO MINE DISPENSING SYSTEM

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9-64. The Volcano system consists of the M139 mine dispenser, four launcher racks, M87 or M87A1 mine
canisters, an electronic dispensing control unit, carrying cases, and special mounting hardware. The system
for the UH-60 is identical to the ground Volcano version except for mounting hardware. Each system can
dispense mines 35 to 70 meters from the aircraft flight path.

PLANNING CELL CONSIDERATIONS

9-65. The division or higher commander makes decisions to emplace Volcano minefields based on the
tactical situation and recommendations from division staff. While the assistant division engineer plans
Volcano employment for most shaping and decisive operations, brigade commanders can request Volcano
integration into their scheme of maneuver and may conduct the planning. Planners must develop good
triggers with the intelligence staff.
9-66. On receipt of the WARNORD (+*), the Volcano-equipped unit begins planning and aircraft
preparation. Aircrews, with battalion staff assistance, plan flight routes, SEAD/en route fire support, aerial
security, CAS, and airspace synchronization. Volcano planning uses the reverse planning sequence similar
to other air assault or air movements. The resultant OPORD must contain defined triggers based on enemy
actions. The S-2/S-3 establishes these triggers as DPs to increase aircraft readiness condition levels for
execution.
9-67. The higher headquarters staff briefs the unit on the Volcano mission. The aircrew brief includes times,
locations, routes, SEAD, aerial security, minefield marking procedures, delivery technique, and minefield
purpose. The aircrew briefing also provides crews with awareness of the commander’s intent in case they
must adjust the plan during execution. The planning staff provides a minefield sketch for the aircrews.

Maneuver Planning
9-68. Volcano-equipped UH-60 aircraft can dispense up to 960 mines in 18 seconds at 120 knots. Mines
have a self-destruct feature that can be set for various time periods. The owning aviation unit is responsible
for transporting and mounting the air Volcano. Although aviation provides the equipment, engineers
provide the mines. The unit must coordinate closely to ensure transport and delivery of mines to the upload
site.
9-69. The system can emplace four minefield types—disrupt, fix, turn, and block. Both turn and block
minefields have a probability of mine encounter exceeding 80 percent. The encounter probability for
disrupt or fix minefields with less depth and width drops to 50 percent. See tables 9-1 and 9-2, page 9-12,
for additional details.
Table 9-1. Volcano planning factors
Minefield Depth Front No. of Canisters Per Strip Total Minefields Per
Type (Meters) (Meters) Strips Per Side Canisters Load

Disrupt 140 278 1 40/20 40 4

Fix 140 278 1 40/20 40 4

Turn 340 557 2 80/40 160 1

Block 340 557 2 80/40 160 1

Table 9-2. Volcano minefield emplacement times
Disrupt/Fix Minefield Turn/Block Minefield 160 Canister Load
(Seconds) (Seconds) (Seconds)
Knots
20 27 54 108
30 18 36 72

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40 13 27 54
55 9 (Note 1) 18 39
80 6 (Note 1) 13 (Note 1) 27
120 4 (Note 1) 9 (Note 1) 18
Minefield Width (meters) 278.7 meters 557.5 meters 1,115 meters (one
(single strip) (each strip) long strip)
Passes per Minefield 1 2 (for 2 strips) (Note 2) 1
Canisters per Pass 40 80 (each strip) 160
Notes:
1: Indicate problematic airspeed/time combinations for Volcano dispensing.
2: UH-60s operating in pairs can lay turn and block minefields in one pass, firing 80 canisters each.
Disrupt And Fix Minefields
9-70. Disrupt and fix minefields use one centerline 278 meters long and 140 meters wide and deep.
Aircrews move toward the SP, maintaining the ground speed selected in the dispensing control unit. The
pilot initiates and concludes mine dispensing by pressing the cyclic launch switch. Such minefields employ
just 40 canisters per location, allowing fully loaded aircraft to dispense up to four separate disrupt and fix
minefields. See figure 9-1.

Figure 9-1. Disrupt and fix minefields

Turn and Block Minefields
9-71. These minefields have greater density and use all 160 mine canisters at one location. They are longer
and wider than disrupt and fix minefields. To achieve the greater depth requires two parallel passes by one
aircraft or one simultaneous parallel pass by two aircraft. The resulting minefield is 557 meters long and
340 meters wide and deep. See figure 9-2.

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 Air Movement Missions

Figure 9-2. Turn and block minefield

9-72. Factors of METT-TC determine whether to conduct deliberate or hasty mine dispensing. A deliberate
run might involve a preliminary "dry run" rehearsal prior to actual dispensing. It might also involve having
personnel dismount the aircraft to mark the minefield start and end point with flags or chemical lights.
Hasty dispensing involves either less time, less security, or a greater threat near the minefield location.
Hasty minefields rely on detailed pre-mission map and threat analysis and rehearsal at another location to
ensure proper functioning of a Global Positioning System (GPS). Scout personnel, which may precede the
minedispensing mission, can emplace flags or chemical lights for mission aircraft. Crew chiefs or other
aviation personnel can perform the same function concurrently, threat and time permitting. When pre-
marking is not an option, the most effective and preferred method is for planners to develop start and stop
points for the minefield and pass these coordinates to the aircrews as an eight-digit grid. Aircrews fly
precisely between the two points.

Logistics Planning
9-73. The planning staff coordinates to have mines at the arming location at least 6 hours prior to the
planned arming time. Three hours before departure time, aircraft reposition to the arming location where
the aircrew and other personnel load the canisters into dispensers (+). Once loaded, aircraft must exercise
care as to where they park so accidentally discharging mines do not threaten other aircraft, trucks, or
personnel (+).

Reporting Requirements
9-74. As soon as possible after mission completion, aircrews give the assistant division engineer an exact
dispensing time and start/end point coordinates for the minefield-dispensing strip using secure radio
communications or a secure relay and scatterable minefield warning reporting format (+). This allows the
assistant division engineer to properly mark and determine safe distances away from the minefield.
Aircrews verify assistant division engineer receipt of the entire message following mission completion.
EXECUTION CONSIDERATIONS
9-75. It is imperative flight crews emplace Volcano minefields at the correct location and time (+*); failure
to do so reduces or eliminates minefield effectiveness and increases fratricide risk. There are several
techniques to help ensure proper minefield emplacement.
 Visual identification. During retrograde or covering force operations, engineer units can clearly
mark minefield limits prior to the air-dispensing mission. Scouts may also mark the minefields.

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Chapter 9

 Azimuth/time lapse. Speed may be essential to survivability during the mine-dispensing

mission. Aircrews fly along a particular azimuth from a known SP for a predetermined time at a
predetermined high speed to deliver the correct minefield dimensions. This is an effective
method for night operations.
 Azimuth/canisters fired. This technique focuses on ensuring mine-dispensing accuracy by
tracking the number of mine canisters dispensed. At the SP along a predetermined azimuth and
slower airspeed, the pilot initiates and continues dispensing until the dispensing control unit
counter reaches the predetermined number of canisters.
 GPS. This technique is the most accurate. The aircraft navigation system can identify minefield
eight-digit start and end points. The crew flies precisely between these points. This technique is
particularly useful in desert and flat featureless terrain where map navigation/confirmation is
ineffective. If time and threat permit, aircraft can actually land at start and end points to get
accurate GPS readings, mark the minefield, and then fly the dispensing mission.

AERIAL COMMAND AND CONTROL OPERATIONS

9-76. While certain UH-60 aircraft can be configured with a dedicated C2 console, virtually any aircraft
may be used as a C2 platform. The primary consideration for aerial C2 operations is to maintain aircraft
survivability while enabling the supported commander with the necessary communications and observation
of the mission. This may require the C2 aircraft to operate in a ROZ well behind maneuvering formations,
or it may require frequent movements from one location to another for the supported commander to
observe specific actions.

COMMAND AND CONTROL CONSOLE CONFIGURATION

9-77. UH-60 C2 aircraft contain a command console and digital map that functions as an airborne CP,
providing communications in both secure and non-secure modes. The C2 aircraft may provide the
commander with—
 Secure communications, with frequency hopping capability.
 High frequency secure with Have Quick I and II communications.
 Satellite communication.
 High frequency-nonsecure communications.
 Joint variable messaging format.
 Upper tactical internet.
 One-station remote video terminal.

9-78. C2 equipment packages have multiple configurations. When C2 aircraft are requested, the aviation
unit must provide the ground force commander with a detailed description of the available C2 capabilities
and constraints. C2 aircraft must be accounted for during mission planning and may be required to operate
in a ROZ or along a separate air route.

FORWARD FUELING AND ARMING OPERATIONS

9-79. Air movement of a FARP allows supported aircraft to rapidly refuel, rearm, and continue assigned
missions. The primary aircraft supporting fuel and ammunition in support of FARP operations are the
UH60 Fat Hawk and the CH-47 Fat Cow. For more on FARP operations, readers should see ATP 3-04.17.
CH-47 FAT COW
9-80. The CH-47 can carry an extended range fuel system or advanced aviation forward area refueling
system equipment to provide a mobile FARP supporting deep shaping operations and other special
missions. One CH-47 can carry up to three 800-gallon fuel tanks, FARP personnel, and equipment, while
other aircraft transport internal and external ammunition loads. A Fat Hawk, on the other hand, is a UH-60
that provides fuel and/or ammunition. The UH-60 provides fuel to another aircraft from its internal or
external fuel tanks.

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UH-60 FAT HAWK

9-81. Fat Hawk or Fat Cow missions are planned using a reverse planning process similar to other air
movements or air assaults. Detailed integration with the supporting FARP personnel is crucial during this
planning to ensure aircraft weight and space limitations are not exceeded (+*). Once the Fat Hawk or Fat
Cow aircraft arrive at the FARP location, crews assist with establishing the FARP and verify safe function
of all refuel equipment as required (+).

AERIAL CASUALTY EVACUATION OPERATIONS

9-82. Army Aviation utility, heavy lift, and FW units conduct aerial CASEVAC when required. For the
Army, casualty evacuation refers to any movement of wounded, injured, or ill to and between MTFs
utilizing non-medical assets that are command directed as dedicated to, or designated in support of,
CASEVAC operations, or as an opportune lift regardless of CASEVAC designation (FM 4-02). Effective
CASEVAC complements medical evacuation (MEDEVAC) by providing additional evacuation capacity
when casualties or reaction time exceeds the capabilities of MEDEVAC assets.
9-83. As a non-medical platform CASEVAC aircraft retain legal combatant status; therefore, the use of
these assets includes the acceptance of additional risk to the patient and augmented medical personnel (who
are non-combatants) by virtue of being transported on a combatant platform that can be made the object of
attack.

REQUIRED PLANNING INFORMATION

9-84. Higher commanders issue orders to prepare the unit to conduct CASEVAC operations. In addition to
the normal five-paragraph format, CASEVAC orders should specifically include (+*)—  Type and
duration of CASEVAC support required.
 Number of aircraft required for CASEVAC support.
 Number of aircrews assigned to provide CASEVAC.
 Command post responsibilities during CASEVAC.
 Command relationships if in direct support role and any area support requirements
 Any augmentation of medical personnel if provided and sustainment support requirements for
such personnel.
 Casualty estimates for the AO.

Aerial Casualty Evacuation Types

9-85. Aerial CASEVAC is either dedicated, designated, or opportune use. The necessity for type of
CASEVAC support is established in the OPORD or command directed. CASEVAC requirements can also
be identified through the medical operations cell in the analysis of current and future operational needs.
9-86. Dedicated aerial CASEVAC consists of dedicated aircrews and aircraft identified and reserved
exclusively for the CASEVAC mission. This is the highest level of classification for aerial CASEVAC, and
is usually a specified task from higher headquarters and should be for a specific period of time. Dedicated
aerial CASEVAC may require a DS relationship with the supported maneuver forces, as well as an area
support role for forces transitioning through the AO. Additionally, dedicated aerial CASEVAC needs to be
located or stationed within response time requirements of supported forces. Dedicated CASEVAC assets
are not called on to perform any other mission. Dedicated aerial CASEVAC operations and procedures
should be similar in conduct of the AE mission approval and launch procedures found in chapter 10 and be
fully integrated into the patient movement system, to include augmentation with medical providers and
equipment as well as procedures for receipt of mission and launch approval.
9-87. Designated aerial CASEVAC assets perform other roles during the operation such as an air assault or
air movement, but are also specifically tasked with aerial CASEVAC operations as a contingency. Tasking
may be for a specific time period, a specific phase of an operation, or for a specific mission. When
designating non-medical assets for aerial CASEVAC requirements, augmentation of medical providers and

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Chapter 9

equipment should be considered, depending on availability. When planning to utilize designated aerial
CASEVAC in support of specific operations, such as an air assault, link-up procedures with air or ground
MEDEVAC assets should be established and rehearsed. Establishing link-up procedures allows for rapid
transfer of urgent casualties to MEDEVAC assets and allows aerial CASEVAC assets to return to provide
further support to the operation. Link-up procedures with MEDEVAC assets reduces lengthy evacuations
where en route care is limited or unavailable.
9-88. Opportune-use CASEVAC occurs when any available Army utility or cargo aircraft performs
CASEVAC operations. Opportune aerial CASEVAC may sometimes be necessary, but also represents the
lowest level of patient care. Lifts of opportunity are unplanned events whereby the aircraft may not be
configured to properly secure patients and en route care or equipment is not available.

Medical Care Capabilities

9-89. En route care medical providers may be personnel assigned within the aviation battalion, such as
combat lifesavers, medics, flight surgeon, or personnel received or attached to provide en route care from
within the supported brigade or within theater medical assets. Staff planners should consider requesting
augmentation of en route providers when not included in the operations plan or order for dedicated
CASEVAC operations. Considerations for each type of medical personnel are described in the following
paragraphs.
9-90. Combat lifesavers are the lowest level to provide en route care. Utilizing only combat lifesavers to
provide en route care during CASEVAC comes with elevated risks and increased outcome in overall patient
morbidity and mortality.
9-91. Combat medics from within the aviation task force may be utilized to perform en route care for aerial
CASEVAC operations. The aviation aid station is not staffed with personnel to provide medical
augmentation to CASEVAC operations. Utilization of internal combat medics could reduce overall medical
capability within the aviation footprint. Combat medic augmentation may be available from the supported
brigade or medical assets from within the theater. Requests for combat medic augmentation may be
required when not identified in the operations plan or order and requirement for support is as dedicated
CASEVAC for extended periods.
9-92. The flight surgeon or the aviation physician assistant from within the aviation task force may be
utilized to perform advanced en route care for aerial CASEVAC Operations. Utilization of the flight
surgeon or aviation physician assistant could reduce overall medical capability within the aviation
footprint. Use of the flight surgeon or aviation physician assistant for en route care should be for only short
duration CASEVAC operations.
9-93. Other providers from within the Army Health Service (AHS) may be identified to provide en route
care for specific CASEVAC missions. These providers may be specialized critical care aeromedical teams,
Institute of Surgical Research burn teams or an en route critical care nurse. These specialized providers will
be utilized for specific medical cases and coordinated to provide the specialized support needed by the
patient. These specialized teams will move with substantial amount medical equipment necessary for
movement of the patient(s).
9-94. Early integration of augmented medical providers is essential in the preparation and execution of
CASEVAC operations. Medical providers will need to be familiarized with the crew and aircraft. Medical
providers should be briefed and trained on the following:
 Schedule, crew meet-up location and procedures for mission receipt.
 Danger areas around the aircraft.
 Safety features of airframe and operation of windows, doors, seats, and seatbelts as location of
fire extinguisher, crash axe and aviation life support equipment.
 Position or station on the aircraft during flight.
 Aircraft internal communication system and standard communication procedures.
 Emergency procedures.

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 Roles and responsibilities for loading and unloading of casualties and securing requirements for
personnel, casualties and medical equipment onboard the aircraft.
 Expected roles and responsibilities on the HLZ.

PLANNING CELL CONSIDERATIONS

9-95. Company CASEVAC planning begins by understanding the overall scheme of maneuver and
CASEVAC support requirements as dictated in the operations plan or order or as directed by the
commander. Commanders tasked with CASEVAC should review the sustainment annex of the OPORD.

Maneuver Planning Cell

9-96. During CASEVAC planning, the maneuver planning cell focuses on the ground commander’s scheme
of maneuver, the threat analysis provided by the threat planning cell and the ground evacuation plan of the
supported forces. Integration in planning is facility by the medical operations cell between brigade medical
planners within the supported forces and must be conducted to communicate (+)—  Any LOA for the
CASEVAC aircraft and crews.
 Casualty collection points (CCPs) and ambulance exchange points (AXPs) that fit within the
supported commander’s ground evacuation plan. Designated AXP HLZs should be clear of
obstacles and provide protection from threats.
 Primary and alternate HLZs of supporting MTFs for approach and departure routes that are clear
of obstacles, limits overflight of structures and equipment, and provide for rapid patient
handover to MTFs.

Sustainment Planning Cell

9-97. The sustainment planning cell interacts with the maneuver and sustainment staffs during CASEVAC
planning to ensure FARPs are available and have the required amounts of fuel and ammunition to enable
CASEVAC operations (+).
9-98. The sustainment planning cell arranges Class VIII supply for support of CASEVAC operations (+). In
operations with heavy casualty estimates, Class VIII stocks may be staged at FARPs or AXPs for
immediate resupply. The medical operations cell and flight surgeon along with the assigned or attached
CASEVAC medical providers assists in identifying what Class VIII items should be readily available for
resupply.
9-99. Water, equipment and chemicals will need to be available to clean the aircraft and remove blood and
other biological contaminants that can occur during the transport of wounded, injured or ill personnel.
Commanders should establish biological clean up procedures in the unit SOP (*). At a minimum rapid
removal and flushing of human blood contaminants with water should occur between missions when time
permits.

AIRCRAFT PREPARATION AND LOAD PLANS

9-100. When assigned, dedicated, or designated CASEVAC, commanders and aircrews need to establish
aircraft configurations that are suitable for the operation (+). Dedicated CASEVAC aircraft should be
configured to maximize the greatest number of litter and ambulatory casualties while providing access to
medical providers. Designated CASEVAC aircraft need to be configured to support to combat operations or
specific mission, such as an air assault with consideration in receiving and securing litter or ambulatory
patients following insertion.
9-101. Aircrews should refer to appropriate aircraft technical manual and unit SOP for required floor
shoring material to accommodate litters and installation of litter support kits if available.
UH-60 Casualty Evacuation Load Capabilities
9-102. The UH-60 is capable of transporting both ambulatory and litter casualties. Numbers of both vary
with the aircraft’s configuration. The standard configuration is three or four litters and one ambulatory; the

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Chapter 9

maximum configuration is six litters and one ambulatory or seven ambulatory. Litters are safely secured on
the floor of the UH-60 and other aircraft using the universal litter tie-down strap to the appropriate cargo
attachment points. The UH-60 CASEVAC conversion kit provides a means to secure a litter with patient to
the floor of the aircraft. The kit aids in the ability to quickly transfer the casualty to an air or ground
ambulance for movement to an MTF. Figures 9-3 and 9-4 depict UH-60 litter CASEVAC configurations.

Note. When the standard litter is placed in the UH-60 perpendicular to the aircraft’s longitudinal axis,
the cargo doors do not close; in this position, a litter with collapsible handles must be used.

Figure 9-3. Interior view of UH-60 with litter patients forward of crew chief and medic

Figure 9-4. Interior view of UH-60 with litter patients aft of the medic

CH-47 Casualty Evacuation Load Capabilities

9-103. The CH-47 litter support kit consists of poles and supports only. Litters and tie-down straps must be
provided by the supported unit. The litters are provided by medical unit or MTF requesting the CASEVAC
mission. The litter support kit does not meet crashworthiness standard; patients are at greater risk in the
event of a crash or hard landing. With the litter support kit installed, the seats are replaced with 6 tiers of 4
high litters for a total of 24 litters. The two one-man seats in the rear section should remain in place for
aircrew members. The one-man seat at the left front may also be left in place for a medical attendant or
other personnel. All passengers and cargo loading are at the direction of the aircrew. CH-47 litter and
ambulatory patient capacities are provided in table 9-3 and figure 9-5, page 9-19.
Table 9-3. CH-47 litter and ambulatory casualty capability (with litter support kit)
Personnel Litter Tiers Seats (with crashworthy crew seats)
Seats Litters 4-man 1-man 3-man

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 Air Movement Missions

34 0 0 4 10
28 4 1 4 8
20 8 2 4 6
16 12 3 4 5
10 16 4 4 3
7 20 5 4 1
4 24 6 4 0

Figure 9-5. Interior view of CH-47 with installation of seats and litter platforms

CASUALTY EVACUATION REHEARSALS

9-104. In addition to PCCs and PCIs, three distinct rehearsal types will facilitate effective aerial
CASEVAC: cold-load rehearsals, combined arms rehearsals, and the evacuation request communications
exercise.

Cold-Load Rehearsals (+)

9-105. Aircrews conduct cold-load rehearsals and briefings with the supported unit’s medical personnel.
The rehearsal and briefing should cover—
 HLZ selection and requirement for point of injury response.
 Proper aircraft signaling, securing of signaling panels, deployment of smoke or use of lights, or
pyrotechnics at the HLZ.
 Safe positioning of vehicles, litter bearers and patients at the HLZ.
 Danger areas around the aircraft and crew signaling procedures to approach or depart aircraft.
 Roles, responsibilities, and procedures for loading and unloading of casualties.

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Chapter 9

Combined Arms Rehearsal (+*)

9-106. The combined arms rehearsal facilitates understanding and synchronization of— 
Type and capability of CASEVAC assets.
 Signal requirements and procedures to request evacuation.
 Expected response times upon notification of evacuation request.
 Confirmation of established CCPs and AXPs.
 Synchronization of air and ground MEDEVAC and CASEVAC assets.

Evacuation Request Communications Exercise (+*)

9-107. Units tasked with dedicated CASEVAC should conduct an evacuation request communication and
validation exercise. This exercise should include the supported unit, aviation unit CP, as well as the
supported surgeon cell and supporting MTFs. The communications exercise should rehearse— 
Requesting unit’s evacuation request procedures and request flow.
 Flow of evacuation request to the appropriate aircraft tasking authority.
 Receipt of mission in supporting CASEVAC unit’s CP and notification of aircrew.
 Exercise aircrew rapid response, flight planning and aircraft run-up procedures.
 Rehearse S-2, weather, and mission briefing procedures.
 Exercise risk level analysis and launch approval.
 Validate coordination and synchronization of air or ground evacuation assets.

EXECUTION CONSIDERATIONS
9-108. Actions required prior to assumption of duty or CASEVAC mission depend on dedicated or
designated mission type. Execution differences depend on type of mission and level of CASEVAC support
provided. In addition to the common considerations described in Part One of this publication, general
CASEVAC execution steps include the following:
 Upon notification of the evacuation request, the aircrew—

 Identifies requested unit call sign and frequency, along with requested PZ/HLZ location (+).
 Receives mechanism of injury, injury type, signs (patient vitals)/symptoms, and treatment
(also called MIST) report, if augmented with medical providers.
 Conducts final risk analysis with tasking authority and seek launch approval (*).
 Conducts appropriate link-up procedures with escort or security aircraft if required (+).
 En route to PZ, the aircrew—
 Contacts requesting unit and provide estimated time of arrival to location.
 Requests an update on the tactical situation, and verify PZ marking, location, and security. 
At the PZ, the aircrew—
 Acquires, assesses, and prepares casualties for loading.
 Secures casualties, passengers, and equipment prior to departure.
 Confirms receipt of all casualties. If casualties exceed available space, reports number of
casualties remaining at PZ (+*).
 Reports destination MTF or AXP to monitoring agency and CP for synchronization of
air/ground evacuation and medical assets.
 If en route to an AXP, the aircrew—
 Employs appropriate movement and terrain flight techniques required for threat avoidance.
 Contacts air or ground medical evacuation asset of estimated time of arrival to AXP or the
MTF, and reports estimated time of arrival at the MTF HLZ.
 Confirms HLZ location and security.

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 Air Movement Missions

 Reports patient type, number, and status information to medical evacuation platform.

BATTLEFIELD OBSCURATION
9-109. Smoke and obscurants have several uses during aerial CASEVAC operations. Some of these uses
can be beneficial to the pilot and crew in locating the patient, communicating with ground personnel, and
determining environmental conditions. Smoke can be used effectively in aerial CASEVAC operations to—
 Visually identify the landing site. Smoke generated from a smoke grenade is difficult to detect at
more than 2 to 3 miles away, but an AE crew in the vicinity should have little difficulty
identifying it. When a unit employs colored smoke to mark a landing site, the aircrew should
identify the color and confirm it with ground personnel. This marking method also minimizes
radio emissions from the supported unit.
 Conceal CASEVAC operations.
 Determine surface wind direction.

9-110. Obscurants can also be a disadvantage during CASEVAC operations, if they are employed
incorrectly. Obscurants can hide the landing site and make covert approaches unfeasible. Further, battlefield
obscurations can force aircraft to fly at higher than planned heights, increasing the risk of being acquired by
the enemy.

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Chapter 10

Aeromedical Evacuation Missions

Army Aviation provides C2 of Army medical air ambulance units conducting
intratheater AE. As a vital component of the overall AHS mission, MEDEVAC entails
the movement of patients on dedicated standardized platforms (ground and air
ambulances), medically staffed and equipped to provide en route medical care, and
links the continuum of care.

Army AE transcends tactical, operational, and strategic objectives in support of the

combatant commander’s mission. It is essential that all commanders with C2 of AE
assets understand how MEDEVAC systems integrate with each other throughout the
AO and across the levels of war.

SECTION I – PLANNING
10-1. During offensive operations, the major casualty area is normally the zone of the main attack. As
advancing operational formations extend the AO forward, supporting medical elements overtake patients.
This facilitates the acquisition of the wounded and reduces the vital time elapsed between wounding and
treatment. Basic problems confronting evacuation units include the following:
 Periodically, BCT medical companies and collocated forward surgical teams are cleared of their
patients so that they may move forward. In some scenarios, Role 3 hospitals may also have to
evacuate patients to reduce patient overflow, surgical backlogs, or to increase bed availability.
Area support medical platoons may require additional AE or aerial CASEVAC assets to support
clearing of the MTFs.
 Evacuation distance may increase as the operation continues.
 MEDEVAC have increased reliance on air ambulances, which may necessitate aerial CASEVAC
augmentation.
 10-2. During defensive operations, patient acquisition is complicated by enemy actions and the
maneuver of combat forces. The enemy attack may disrupt ground and air routes and delay evacuation of
patients to and from treatment elements.
10-3. AE support during support or consolidation operations depends on the type of operation,
anticipated duration of the operation, number and location of forces deployed, theater evacuation policy,
medical troop ceiling, and anticipated level of violence.
10-4. MEDEVAC is centrally planned with decentralized execution. Planning starts at the highest
level with the establishment of the theater evacuation policy and the medical rules of eligibility. Detailed
planning and coordination is directed across all echelons while execution authority is pushed down to the
lowest levels.
10-5. Army air ambulance units provide DS and area support within the joint operations area and
joint security area to support the overall AHS and the joint service support plan. AE conducts MEDEVAC
for both regulated and unregulated patients. At the tactical level, DS or area support assets locate, acquire,
treat, and evacuate patients from the point of injury to an appropriate MTF where the patient is stabilized,
prioritized, and prepared for further evacuation, if necessary, to a MTF capable of providing additional
required essential care.
RECEIVE THE MISSION (+*)
10-6. The battalion should provide the key planning documents described in Part One of this publication.
The staff should also provide information on the following:
 The sustainment annex of the OPORD, with particular attention to the theater evacuation policy
and medical rules of eligibility.
 Combatant commander’s scheme of maneuver.
 Allocation of AE assets to include locations for staging AE units, area support and forward
support MEDEVAC platoons to include any split-based operations.
 Established DS relationships and DS unit responsibilities to AE elements sustainment
requirements.
 Area support requirements to include locations of echelon-above-brigade, joint, and multi-
national units operating within the AO.
 Locations, frequencies, and types of MTFs to include joint and multi-national.
 Locations, frequencies, and types of ground and air evacuation assets within the AO and adjacent
AOs.
 Location of CCPs and AXPs.

10-7. AE movement techniques are based on IPB. LSCO considerations might include the following:
 Specific flight routes, altitudes, and/or times.
 Specific frequencies or transponder codes for evacuation units to identify themselves.
 Agreements for enemy/friendly wounded personnel exchange points between aggressors.
Established medical mission and launch approval procedures to include written delegation of risk
level approvals for urgent and urgent surgical missions.
 Single-ship AE, escort and security requirements to include procedures for en route security link
up, or enemy prisoner of war (EPW) in-flight security personnel.
 Casualty estimates for operations or phases of operation.
 Areas of concentrated populations at risk who may require AE support.
 Established procedures and lines of communication for MEDEVAC requests.
 Established AE flight corridors with airspace C2.
 Expedited procedures for passage of lines, airfield, and urban center transitions during
evacuations. These procedures might include—
 Identification of evacuation aircraft with casualties on board using a special call sign.
 Unique transponder codes for evacuation aircraft with casualties onboard.

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Chapter 10

 Specific flight procedures with designated altitudes and corridors for AE use only. 
Established ground evacuation routes.

DIRECT AND AREA SUPPORT RELATIONSHIP

10-8. As AE operations are complex and may cross command and service boundaries, it is essential
that the sustainment annex to the OPORD clearly delineates responsibilities, communications
interoperability and procedures, and coordination requirements. The OPORD provides the basis for
ensuring AE support is comprehensively planned, synchronized, responsive, and ensure a seamless
continuum of care. The OPORD establishes DS and area support requirements. The aviation commander,
with recommendations from the medical operations cell and the medical service corps officer, decides
requirements for split-based operations.
10-9. The medical operations cell identifies any DS and area support requirements. The medical
operations cell assists the aviation and AE commanders in analyzing response times, distance, size of AO,
concentrations of personnel at risk and proximity to supported units and make recommendations for split-
based operations. Sustainment requirements from the parent unit that must be considered, coordinated for,
or delegated to the supported units are—
 Aviation maintenance support.
 Signal and network requirements and capabilities with parent and supported unit.

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 Aeromedical Evacuation Missions

 Food services, legal, religious, and force health protection support.

 Medical equipment sustainment and Class VIII resupply.
 Refueling support requirements.

Direct Support Relationships

10-10. The air ambulance company may employ an area support or a forward support MEDEVAC platoon
in an area support role when area coverage of multiple units and AOs is required. A forward support
medical platoon is traditionally employed as DS to a BCT. In an area support role, AE provides MEDEVAC
to and between MTFs for all units assigned or transitioning within the assigned AO. A forward support
medical platoon in a DS support role to a BCT still has a medical evacuation area support requirement to
units not assigned but transitioning through the BCT’s AO.
10-11. Coordination with directly-supported units should begin as soon the DS role is identified.
Commanders of units providing DS may further assign support relationships between their subordinate
units and elements of the supported unit after coordination and agreement with the supported commander.
The senior medical service corps officer, with assistance from the medical operations cell, advises
supported commands on utilization of AE assets and requirements for support when forward support
MEDEVAC platoons are under a DS relationship. A liaison from within the aviation battalion should be
provided to coordinate with, and advise, the supported command on all aviation capabilities to include AE.

Area Support Relationships

10-12. Area support roles are clearly delineated through the OPORD and sustainment annex. The medical
operations cell assists the AE elements in area support roles in identifying mission requirements for both
regulated and unregulated patient movement within the AO. Clear priorities in the utilization of AE asset
and synchronization between air and ground evacuation should be established with the MEDEVAC tasking
authority in the AO.

HIGHER, ADJACENT, AND SUPPORTED UNITS

10-13. AE leaders need to evaluate the AHS plan in relation to higher, adjacent, and supported units. The
medical operations cell assists the forward support MEDEVAC platoon in developing the medical COP.
The medical COP should be updated regularly with established battle-rhythm to maintain medical
situational awareness. The medical COP information provided to the forward support medical platoon by
the medical operations cell includes location, type, and status of MTFs, forward surgical teams, and
forward resucitative surgical teams within the AO, to include echelons above brigade and adjacent AOs.
 Evacuation unit locations within the higher, adjacent, and supported units.
 Call signs and frequencies of MTFs and evacuation assets within the AO.
 Supported unit CCPs and AXPs, to include manned, unmanned, planned, or established.

AEROMEDICAL EVACUATION CORRIDORS AND ROUTE PLANNING

10-14. Specialized AE flight corridors may be established within the theater, division, or corps AOs.
Established AE routes may offer protection to air ambulances depending on the enemy’s adherence to
international agreements. The medical operations cell assists in identifying altitude requirements, special
restrictions, and procedures to utilize established AE corridors with the controlling airspace C2 agency. AE
corridors provide specialized routes, altitudes, and expedited procedures that provide—  Deconfliction
with and avoid interference of indirect fires.
 Avoidance of congested areas and/or built-up airspace.

10-15. AE route planning within the close area is according to the unit tactical SOP and the
commander’s guidance, with advice from the medical operations cell and the senior medical service corps
officer.
MEDICAL MISSION APPROVAL AUTHORITY

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10-16. Medical mission authority begins at the theater-level through the creation of the theater
evacuation policy and the medical rules of eligibility documents by appropriate medical officers. Once
approved, these documents are published through the orders process and become the foundation for what
constitutes a valid medical mission. For AE missions, the medical mission approval authority is
accomplished by verifying the details of the MEDEVAC request with the policy contained in the theater
evacuation policy and/or medical rules of eligibility. Once confirmed that the mission request falls within
the established theater guidance, the request becomes an approved medical mission. AR 95-1 and AR 40-3
specify what constitutes an authorized medical mission for AE. The medical operations cell assists in
establishing procedures to validate the MEDEVAC request.

RISK APPROVAL AND LAUNCH AUTHORITY

10-17. Brigade commanders are authorized to delegate launch approval authority to subordinate
commanders for certain missions according to AR 95-1 and AR 40-3. General support aviation battalion
and ABTF commanders should request delegation of high risk launch approval authority for urgent and
urgent surgical evacuation requests. Field grade air ambulance commanders should request delegation of
moderate risk launch approval authority for urgent and urgent surgical evacuation requests. Delegation of
risks should be documented. Procedures are in place to maintain 24-hour access to the appropriate approval
authority.
10-18. Commanders may incorporate authorization procedures which account for single-ship AE
missions, as well as en route linkup with escort or security aircraft, when tactically feasible. Single-ship AE
operations should occur in permissive, non-contested areas of the AO to conserve aviation assets. The
medical operations cell ensures unit SOPs clearly establish single-ship AE parameters.
10-19. It is essential for commanders to have documented procedures in place when pre-authorizing
AE missions. AE launch approval procedures must delineate between appropriate approval levels for
different priorities of AE requests and establish pre-briefed, pre-approved launch procedures for moderate
risk and below urgent and urgent surgical MEDEVAC requests. The medical operations cell ensures unit
SOPs clearly establish mission approval procedures and incorporate pre-briefed, pre-approved parameters
to avoid delay in launch approval.

MAKE A TENTATIVE PLAN (+*)

Note. In addition to this reference, JP 4-02, FM 3-04, FM 4-02, ATP 4-02.2, and ATP 4-02.3
guide planning for AE. Company planners should also consult the Army Aviation Handbook, for
crewlevel procedures related to this mission.

10-20. Company AE planning begins with the receipt of orders from the staff and continues through
preparation to execution. Coordination and early integration with supported units when in a DS role
facilitate necessary planning and synchronization. As evacuation is centrally planned, with decentralized
execution, SOPs effectively establishes command guidance for mission execution and assures consistency
across splitbased formations.
10-21. Commanders must identify immediate AE support requirements to include possible AE support
during forward staging and movement (*). Immediate support requirements effect time available for
planning and preparation.

ESTABLISH STANDARD OPERATING PROCEDURES

10-22. Air ambulance unit commanders establish and publish SOPs covering critical support, mission
preparation, mission execution, and administrative procedures for the unit. The AE SOP should establish
the following:

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 Aeromedical Evacuation Missions

 Aeromedical flight operation procedures, manning, and reporting requirements.

 Duty crew assumption procedures.
 Daily AE asset maintenance, manning, logistics, and operational readiness reporting
requirements.
 Aircrew endurance policy, tracking requirements, and extension procedures specific to AE
operations.
 Mission receipt, notification, reporting, launching, tracking, and recording requirements and
procedures.
 Aircrew duty brief requirements.
 Hoist operations.
 Controlled medication security, inventory, and reporting procedures.
 Medical equipment inspection and maintenance requirements.
 Standard medical equipment load plan.
 Standard medical operating guidelines and clinical practice guidelines for patient treatment.
 Patient medical documentation and patient care reporting requirements.

AEROMEDICAL ALLOCATION PLANNING

10-23. AE support plans must remain flexible throughout all phases of operations. During lower-
intensity operations, forward support MEDEVAC platoons conduct 24-hour operations with a first-up
aircraft/crew, a second up aircraft/crew, and a third aircraft available as a spare. All other crews are in rest
periods until their next duty cycle and crew rotation. Although this availability and posturing may be
sufficient to meet lower casualty rates, LSCO generate significantly higher casualty rates and AE planners
must adjust accordingly.
10-24. AE commanders and forward support MEDEVAC platoon leaders need to plan asset
availability and support based on casualty estimates for each phase of an operation (+). If casualty numbers
exceed available evacuation assets, additional MEDEVAC assets will need to be identified and
implemented into the planning process. Reinforcements to areas that have an expected high concentration
of casualties are required.
10-25. Forward support MEDEVAC platoons need to adjust crew availability, fighter management,
and maintenance plans to maximize availability (*). During LSCO, the MEDEVAC assets must be flexible
enough to provide support with all assigned aircraft and personnel throughout the entire operation.
10-26. Casualty flow rates could exceed duty crew flight hour restrictions. Crews assigned 24-hour
duty have limited time to meet reset rest periods. Commanders should be prepared for alternating day and
night crews on 12-to 14-hour overlapping shifts to maintain 24-hour support.
10-27. The AE commander, forward support MEDEVAC platoon leader, and medical operations cell
must consistently monitor casualty estimates during the planning phase of operations and specific mission
for each supported unit (*). When casualty estimates are expected to exceed available AE assets,
commanders and the medical operations cell must inform the supported unit’s medical planners, the
aviation commander, and the medical command (DS). This recognition is essential in identifying the—
 Requirement for aviation dedicating or designating aerial CASEVAC in support of AE
operations.
 Relocating AE assets to reinforce areas by theater medical planners.
 Relocating of MTFs or forward surgical teams to support operations.
 Reinforcement of forward ground ambulances to support maneuver elements.
 Brigades enhancing CASEVAC plans.

THREAT PLANNING CELL

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10-28. The area support and forward support MEDEVAC platoon AMSO coordinates with the
general support aviation battalion/ABTF S-2/S-3 and the supported unit S-2/S-3 to provide threat analysis
of the supported AO. The AMSO focuses on understanding the order of battle, enemy capability and assets
and scheme of maneuver of the supported forces. Knowledge of the order of battle and scheme of
maneuver also facilitates planning by providing the maneuver planning cell with information about how
much standoff is required to avoid enemy air defense systems during AE operations.
MANEUVER PLANNING CELL
10-29. During AE planning, the AHS planners focus on the ground commander’s scheme of
maneuver, the threat analysis provided by the AMSO and the ground evacuation plan of the supported
forces. Integration in planning is facilitated by the AE commander or forward support MEDEVAC platoon
leader and the medical operations cell between brigade medical planners within the supported forces and
must be conducted to communicate—
 Any AE aircraft LOA due to enemy threat. AE should coordinate AXPs with ground evacuation
and supported units that are located prior to the LOA. These AXPs are in addition to other AXPs
identified in the ground ambulance scheme of maneuver and should be located as far forward as
possible.
 CCPs and AXPs that fit within the supported unit’s ground evacuation plan. Designated AXP
HLZs should be clear of obstacles and provide protection from threats.
 Analyze primary and alternate HLZs of supporting MTFs for approach and departure routes that
are clear of obstacles, limit overflight of structures and equipment, and provide for rapid patient
handover to MTFs (+).
10-30. Maneuver planners should also take environmental considerations into account when developing the
AE maneuver plan. Specific points include—
 Jungle operations. Jungle combat operations are usually characterized by ambushes and
unconventional warfare-type operations. The security threat caused by infiltrators requires lines
of communication be patrolled often and convoys be escorted. Forward-positioning assets
improves response times, minimizes road movements, and allows AHS elements to take
advantage of the security offered by combat units. Some of the difficulties to consider for AE in
a jungle environment are reduced radio range, few suitable HLZs, and increased reliance on hoist
operations.
 Desert operations. Common mistakes made by units when establishing the HLZ include locating
the helipad near the patient handling area (causing dangerous over flight of the facility or the
rotorwash and dust cloud to encompass the facility), marking HLZs with obstacles the pose
hazards to the aircraft, and situating HLZs in confined areas or on ground vehicle routes.
 Cold weather operations. Arctic warfare is usually characterized by extended lines of
communication that increase evacuation distances and times. Patient evacuation may have to be
sustained for longer periods due to terrain delays and the lack of direct routes of evacuation.
Patients with hypothermia require timely evacuation and monitoring throughout the evacuation
process.

SUSTAINMENT PLANNING CELL

10-31. The area support medical platoon supply sergeant and forward support MEDEVAC platoon
sergeant arrange Class VIII supply for support of AE operations (+). In operations with heavy casualty
estimates, Class VIII stocks may be staged at FARPs or AXPs for immediate resupply. The medical
operations cell and flight surgeon, along with the assigned medical providers, assist in identifying what
Class VIII items should be readily available for resupply.
10-32. Proper decontamination of the airframe is extremely important. Water, equipment, and
chemicals need to be available to clean the aircraft and remove blood and other biological contaminants
that can occur during the transport of wounded, injured, or ill personnel. Refer to FM 3-11 for aircraft
decontamination procedures. Commanders should establish biological clean up procedures in the unit SOP.

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 Aeromedical Evacuation Missions

At a minimum, rapid removal and flushing of human blood contaminants with water should occur between
missions when time permits.

SECTION II – PREPARATION
10-33. Commanders use available time prior to the assumption of AE operations to initiate movement,
sustainment, and network preparations, and conduct rehearsals.
INITIATE MOVEMENT (+*)
10-34. The commander should initiate preparations for movement immediately after allocating location
assignment amongst the forward support MEDEVAC platoons as required by the OPORD (+*). Forward
support MEDEVAC platoon leaders initiate flight operations functions and manage implementation of
plans and programs. Forward support MEDEVAC platoon leaders can began coordination with supported
units for reception of the forward support MEDEVAC platoon in split-based operations, as follows:
 Verifying remote site and supporting unit’s location with unit headquarters (+).
 Coordinating movement clearances and security with higher headquarters and direct supported
unit’s headquarters.
 Coordinating air movement tables with the supporting aviation units’ operations element.
 Coordinating with the supporting operations element airspace C2 as required.
 Confirming or coordinating anticipated support requirements at the remote site with unit
headquarters.
 Creating aircraft load plans to include additional personnel and equipment.
 Coordinating any air movement request or ground convoy requirements needed to
forwardposition forward support MEDEVAC platoon personnel and equipment.

INITIATE SUSTAINMENT PREPARATION

10-35. AE commanders and forward support MEDEVAC platoon leaders should initiate sustainment plans
as coordinated with higher unit sustainment planners and confirm sustainment responsibility established
with supported units. Special considerations for split-based or remote-site locations include— 
Integration of any attached maintenance or sustainment personnel.
 Coordination for medical equipment maintenance and calibration.
 Coordination for Class VIII resupply.
 Confirm aviation fuel support with higher headquarters operations logistics or supporting
element.

INITIATE NETWORK PREPARATION (+)

10-36. Forward support medical platoon leaders initiate network preparation for the CP at split-based
operations or remote sites. Whenever possible, forward support medical platoon CPs monitor operations on
Blue Force Tracker, digital chat rooms, secure LOS/non-LOS radios, secure phone, and any other tracking
means assigned to the unit or acquired/directed for mission success. Appropriate equipment with required
COMSEC per the OPORD and SOP must be established and operational within the CP to facilitate flight
operations and mission execution. Flight operations must confirm—  Communications with parent and
supported units.
 Communication with mission tasking and launch approval authority.
 Communication with aircraft.

CONDUCT REHEARSALS (+*)

10-37. AE rehearsal types are the same as described for aerial CASEVAC (see chapter 9). The mission
variables dictate the type of rehearsal the commander selects; however, units should strive to conduct the
most detailed rehearsal possible.

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SECTION III – EXECUTION

10-38. Actions required of AE commanders and forward support MEDEVAC platoon leaders prior to
assumption of duty include establishing duty and aircraft schedules according to units SOP. Units should
have an established battle rhythm to meet 24-hour support requirements. Flight operations must be
established and maintain current COP and medical COP. Aviation risk assessment worksheets should be
briefed and approved. PCCs and PCIs should occur before rehearsals and communications exercises. Parent
unit and medical C2 should be notified of current AE status and reporting procedures established.

ASSUME DUTY REQUIREMENTS

10-39. AE commanders have assumption of duty procedures in the unit SOP. Oncoming duty crews must
receive a daily duty assumption brief prior to assumption of duties (+). The time, location, and method of
receiving the brief is designated and coordinated as part of the daily battle rhythm. At a minimum, the duty
assumption brief contains the following:
 Overview of preceding 24-hours of operations for the assigned operational area.
 S-2 brief to include significant friendly and enemy activity and threat outlook.
 Weather outlook by staff weather officer.
 S-3 or battle captain brief missions, review of operations leading up to and forecasted from brief
time for both air and ground, daily SPINS, airspace control order, and air tasking order.
 Review and verification of duty risk assessment worksheet and pre-briefed, pre-approved risk
level of moderate for urgent and urgent surgical medical evacuation requests.
 The medical operations cell should brief the current medical COP, MTF, and ground evacuation
status, and casualty estimates for upcoming operations.
 Review duty crew EPAs.
 AMC briefing requirements per SOP.  Any planned COMSEC changeovers.

FLIGHT OPERATIONS REPORTING REQUIREMENTS

10-40. Flight operations maintain daily logs and send the following daily reports to AE unit headquarters,
aviation operations, and the medical operations cell—  Aircrew and aircraft status.
 Mission tracking reports for the preceding 24-hour period.
 COMSEC status.
 Sensitive items status.
 Fuel status.

10-41. Flight operations coordinate, monitor, report, and assist forward support MEDEVAC platoon leaders
in maintaining—
 COP and medical COP.
 Threat reports.
 SPINS, airspace control order, and air tasking order.
 Notices to airmen.
 Weather forecasts.
 Aircrew endurance.
 Flight plan submittal management and airspace C2 coordination.

10-42. Following the duty-assumption brief, crews report to the aircraft to preflight, set up aircraft to
the established mission ready standard, conduct crew briefs, and run up and conduct aircraft checks
according to the SOP. Crews will confirm PCCs and PCIs of medical equipment have been completed (+).
The forward support MEDEVAC platoon establishes signals to clearly indicate when the oncoming crew
has assumed the mission. This is meant to ensure there is no confusion or delay in the event an urgent or
urgent surgical medical evacuation request is received during crew change.
COMMON OPERATIONAL PICTURE AND MEDICAL COMMON OPERATIONAL PICTURE

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MONITORING
10-43. Forward support MEDEVAC platoons monitor operations at the lowest level possible. They
will understand the task organization of the supported AO including all supported units and their daily
mission sets. Forward support MEDEVAC platoon leaders communicate with all medical officers in the
supported AO and continually develop the health service support (HSS) plan with the ground force and
aviation task force. Understanding the tactical situation on the ground is imperative to mission success and
the timely and efficient evacuation of patients.
10-44. The forward support MEDEVAC platoon leaders need to regularly update the COP and
medical COP information maintained in flight operations (*). They—
 Coordinate with support units, ground evacuation, medical planners, and the task force medical
operations cell when movement of AXPs is necessary based on operations and threat assessment.
 Advise the supported unit on locations of CCPs based on operations and threat assessment.
 Inform aircrews of any change to CCP or AXP locations.
 Update the battle captain, medical operations cell, supported units, and medical planners on
weather forecast that may prohibit or delay launch.

AEROMEDICAL EVACUATION MISSION REQUEST

10-45. Flight operations monitor all evacuation requests systems. When an AE request is received, flight
operations—
 Copy all lines of the MEDEVAC request received and any MIST report received. MIST reports
provide are additional medical information that may be received with the request.
 Notify aircrew and provide mission details along with written 9-line evacuation request and
MIST report, if received.
 Report mission receipt to parent headquarters and medical operations cell.
 Assist aircrew with airspace C2; flight plan; receipt of launch approval as required; and aerial
security information, as required.

MISSION EXECUTION COMMUNICATION AND SEQUENCING

10-46. Execution of an AE mission follows the same general process as described for an aerial CASEVAC
mission (see chapter 9). However, since AE aircraft have dedicated medical care providers, the following
additional steps apply:
 En route to the AXP or MTF, critical care flight paramedics (+)—
 Provide en route care per current standard medical operating guidelines and clinical practice
guidelines or medical direction.
 Report patient type, number, and status information to pilots.
 Initiate and/or annotate en route treatment on DD Form 1380 (Tactical Combat Casualty
Care [TCCC] Card) or DA Form 4700 (Medical Record-Supplemental Medical Data) for
each casualty, as required.
 Upon arrival at the AXP or MTF, critical care flight paramedics—
 Assist with unloading of casualties and loading to air or ground ambulance or MTF. 
Conduct patient handover according to SOP.

FLIGHT OPERATIONS MISSION TRACKING AND REPORTING REQUIREMENTS

10-47. Flight operations maintain an analog and digital tracking system for AE mission execution. At a
minimum, the following data is captured and displayed at all times (+):
 Mission number with time assigned.
 Time MEDEVAC request submitted, if known.

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Chapter 10

 Time mission received by forward support MEDEVAC platoon.

 Time launch approval received if required.
 Wheels up time/launch.
 Wheels down time/landing and patient location.
 Wheels up time/launch from patient location.
 Wheels down time/landing at MTF/AXP.
 Wheels up from/launch at MTF/AXP.
 Wheels down/return to base.
 Crew flight time for mission.
 Crew accumulated flight time for duty day.
 Time crew entered rest period.
 Time crew will be reset if no other mission received.
10-48. Flight operations report crew status and tracking to parent headquarters, ABTF CP, and the medical
operations cell according to SOP.

SECTION IV – SPECIFIC MISSION CONSIDERATIONS

10-49. Overall mission requirements vary based on mission equipment required, security escort support,
and additional patient care needs. Units should anticipate how common types of missions may place
additional demands on aircrew coordination and sequencing, and require training or rehearsals with
external support elements.

HOIST OPERATIONS
10-50. Hoist operations place greater demand on aircrew coordination and sequencing. Pilots must consider
time on station fuel requirements when analyzing fuel consumption (+). Hasty analysis and decision
processes must occur upon arriving to the hoist location. Identifying potential HLZs, confined HLZs, or
utilizing limited slope landing or low hover techniques may be preferable to conducting hoist operations.
Enemy threat, terrain, rotor wash affect, and aircraft hover power are considerations to conducting dynamic
versus static hoist insertions and extractions. Hoist operations should be conducted according to aircraft
and mission training support products and unit SOPs (+).

ESCORT REQUIREMENTS FOR ENEMY PRISONERS OF WAR

10-51. The requesting unit must provide security of EPWs. Escorts should have detainment records or be
able to provide information on the capture and detainment of the EPWs. Escorts remain with the EPWs at
the MTF. EPWs should be thoroughly searched and restrained prior to loading the aircraft. Security escorts
should be positioned in the aircraft where they can effectively maintain observation and control of all
EPWs (+). Treatment of EPWs is according to international standards and agreements as described in ATP
4-02.2. Medical care provided is the same standard for all casualties within the critical care flight
paramedic standard medical operating guidelines (+).

HELICOPTER LANDING ZONE IDENTIFICATION TECHNIQUES

WHEN SUPPORTED BY SECURITY ESCORTS
10-52. When AE Aircraft have security escorts, they should allow security aircraft to conduct
reconnaissance of the HLZ for security threats, conduct suppression or elimination of any threats as
necessary, and direct AE approach to the HLZ (+). Attack or reconnaissance aircraft should continue to
provide aerial security in conjunction with AE aircraft, in unsecured AXPs and point-of-injury HLZ’s.

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 Aeromedical Evacuation Missions

CRITICAL CARE PATIENTS AND REGULATED PATIENT

TRANSFERS
10-53. Critical care patients are post-resuscitation patients requiring specialized equipment and care.
Patients are usually on a ventilator and have medication, fluid, and blood infusions, as well as require
specific medical monitoring. Lengthy delays occur at HLZs for patient receipt and handover.
10-54. Regulated patient movement requests are synchronized, time-sensitive patient movements usually
requiring special medical equipment and extensive en route critical care. Regulated patient movements are
usually augmented with an en route critical care nurse or advanced medical providers from within the MTF,
if available. Request for movement may have several hours of notification or could require immediate
response.
10-55. En route critical care nurses are the preferred provider to augment care on air ambulances because of
their capabilities when transporting complex polytrauma patients and/or hemodynamically fragile patients
following damage control surgery and resuscitation procedures. En route critical care nurses are an
extremely low density position within the Army and allocation in the theater is mission-and availability-
dependent.
10-56. The area support medical platoon in the echelon above brigade is generally responsible for the
movement of Priority 1 regulated patients between MTFs or MTFs and the aeromedical staging facility.
Additional forward support medical platoons may be assigned in the theater, division, or corps area to
support the movement of regulated patients. AE elements assigned in these areas have area support
requirement to move unregulated patients from points of injury or Role 1 MTFs in the AO.
10-57. Critical care flight paramedics utilize critical care patient transfer checklists and procedures
provided in the standard medical operating guidelines to prepare patient for transport and record receipt of
patient and medical direction.

MILITARY WORKING DOGS

10-58. Evacuation of wounded, injured, and ill military working dogs and handlers creates distinct
challenges for AE providers. Considerations for AE of military working dogs include the following:
 All military working dogs should be muzzled for transportation.
 Handlers should escort all injured working dogs during evacuation. When both the handler and
the working dog are injured, priority of care is the handler.
 Working dogs should be transported to a theater facility identified with veterinary capabilities,
when able.
 Treatment of military working dogs is according to the standard medical operating guidelines
and the clinical practice guidelines.
 Treatment of military working dogs is documented on approved forms.

EMERGENT BLOOD AND CLASS VIII RESUPPLY REQUESTS

10-59. AE is authorized within the mission set to conduct emergency movement of Class VIII, blood and
blood products. Mission requests for movement of emergent medical supplies can be received as an AMR
or as a 9-line MEDEVAC request. Urgent requests for resupply of blood, blood products and Class VIII
should be treated and launched as any urgent/urgent surgical request without delay.

AEROMEDICAL EVACUATION IN CHEMICAL, BIOLOGICAL,

RADIOLOGICAL, AND NUCLEAR ENVIRONMENTS
10-60. Evacuation of patients must continue even in a contaminated environment. The commander needs to
recognize resource constraints and plan and train to overcome deficiencies. The AHS commander should
have a comprehensive plan which is rehearsed on a periodic basis to ensure the timely evacuation and

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Chapter 10

treatment of CBRN casualties. The number of casualties and their medical conditions, type of contaminant,
size of the land area contaminated, expected duration of the operation, risk assessment and the acceptable
level of risk, and the number of AHS assets (medical personnel, medical units, and evacuation vehicles and
aircraft) initially contaminated determines the quantity and type of uncontaminated AHS resources, if any,
introduced into the contaminated environment to ensure timely medical treatment and evacuation occur.
Refer to the appropriate equipment technical manual or ATP 3-11.32/MCWP 10-10E.8/NTTP
311.37/AFTTP 3-2.46 for equipment decontamination procedures. Refer to ATP 4-02.7/MCRP
4-11.1F/NTTP 4-02.7/AFTTP 3-42.3 for additional information on AHS operation in a CBRN environment.
10-61. The commander must take into consideration the number of assets he or she is willing to commit
during evacuation operations in a CBRN environment. Since the combination of evacuation methods is
nearly endless, the commander has greater flexibility in tailoring an evacuation plan to meet his/her
particular tactical situation in a CBRN environment. The following are important considerations for
evacuating patients from contaminated environments:
 In using personnel to physically carry the patient, the commander must realize the inherent
physical stress involved. Cumbersome mission-oriented protective posture gear needed in a
contaminated environment (added to climate, increased workloads, and fatigue) greatly reduces
the effectiveness of unit personnel.
 If the commander must send evacuation personnel into a radiological contaminated area, he or
she must establish operational exposure guidance for the MEDEVAC operation. Radiation
exposure records are maintained by the unit CBRN NCO and are made available to the
commander, staff, and surgeon. Based on operational exposure guidance, the commander decides
which MEDEVAC assets to send into the contaminated environment.
 Operating MEDEVAC platforms while wearing mission-oriented protective posture gear reduces
visibility and hearing which degrades situational awareness and can cause injury or accident.
Commanders should incorporate CBRN scenarios into training plans to familiarize personnel
with these limitations and techniques to mitigate the reduction in effectiveness such as gear-
imposed increased evacuation distances and times. Establishing an ambulance shuttle system of
CCPs and AXPs is useful. Augmentation from higher roles of AHS support may also be required
to meet the extended evacuation needs.
10-62. Commanders should make every effort to limit the number of contaminated evacuation assets
while still maintaining a timely and effective medical treatment and evacuation operation. Factors to
consider for reducing the impact contaminates have on evacuation assets include the following.

CONTAMINATED AND UNCONTAMINATED EVACUATION ASSETS

10-63. It is expected that a certain number of both ground and air ambulances will become
contaminated; therefore, the commander can segregate these to have the smallest overall impact on
available assets and the greatest possibility for continuing patient evacuations. The commander should
optimize the use of contaminated resources, medical or nonmedical, which are already contaminated before
employing additional (uncontaminated) resources. Once a vehicle or aircraft has entered a contaminated
area, it is highly unlikely it will be able to be spared long enough to undergo a complete decontamination.
This depends upon the contaminant, the tempo of the battle, and the resources available. Contaminated
vehicles (air and ground) have restricted use and are confined to a contaminated environment.
10-64. Introducing uncontaminated aircraft into a contaminated area should be avoided, whenever
possible. Ground ambulances should be used instead of air ambulances as long as their use does not
adversely affect the patients’ medical condition. Ground ambulances are more plentiful and easier to
decontaminate; however, this does not preclude using aircraft in a contaminated environment or for the
evacuation of contaminated patients.

AIR AMBULANCE OPERATIONS

10-12 ATP 3-04.1 7 May 2020

 Aeromedical Evacuation Missions

10-65. The relative positions of the contaminated area, location of patients, and threat air defense
systems determine if and where air assets are to be used. Aviation and medical commanders may choose to
restrict one or more air ambulances to the contaminated areas and use ground vehicles to cross the line
separating contaminated and clean areas. The ground ambulance can proceed to the receiving MTF with a
patient decontamination station. The patient can then be transferred to a clean ground or air ambulance if
further evacuation is required. The routes used by ground vehicles to cross between contaminated and clean
areas are considered contaminated routes and should not be crossed by clean vehicles. The effects of wind
and time upon contaminants must also be considered. Hasty decontamination of aircraft and crews should
be accomplished to minimize exposure.
10-66. The rotor wash of helicopters must always be kept in mind when evacuating contaminated
casualties. The intense winds disturb the contaminants in the area and aggravate the condition by further
spreading the contaminants. A helicopter must not land too close to a decontamination station because any
trace of contaminants in the rotor wash compromises decontamination procedures or contaminates the
aircraft.

7 May 2020 ATP 3-04.1 10-13

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PART FOUR

Expeditionary Operations
Successful execution of aviation operations in expeditionary environments requires
leaders to bring an expeditionary mindset. This approach focuses on maximizing
mobility and survivability, while retaining redundancy of critical systems.
Expeditionary operations require rapid deployment of either pure or a task-organized
force via land, air, and/or sea into austere or immature theaters with the requisite
mobility, lethality, protection, and C2 capability to operate as part of the joint
interagency intergovernmental and multinational team to conduct unified land
operations. Aviation units must be prepared to conduct the full range of decisive
action operations in their new AO in the shortest time possible. They must be
prepared to operate with limited sustainment at high operational tempos. Additionally,
units must be prepared to frequently move on the battlefield, both for survivability and
to maintain operational reach for the supported commander. Being expeditionary
ultimately means being able to fight outnumbered with limited resources, while
enabling success for the commander.
Specific factors related to expeditionary operations are defined in ADP 3-0.
Expeditionary aviation operations are discussed in FM 3-04.
 Glossary

SECTION I – ACRONYMS AND ABBREVIATIONS

A/DACG arrival/departure airfield control group
AAA anti-aircraft artillery
AAR after action review
AATF air assault task force
AATFC air assault task force commander
AB attack battalion
ABTF aviation battalion task force
AC attack company
ACA airspace coordination area
ACM airspace coordination measure
ACS air cavalry squadron
ACT air cavalry troop
ADA air defense artillery
ADAM air defense airspace management
AE aeromedical evacuation
AHB assault helicopter battalion
AHS Army Health Service
ALO air liaison officer
AMC air mission commander
AMCM air mission coordination meeting
AMR air mission request
AMSO aviation mission survivability officer
AO area of operations
ASE aircraft survivability equipment
AWT attack weapons team
AXP ambulance exchange point
BAE brigade aviation element
BCT brigade combat team
BDA battle damage assessment
BHL battle handover line
BHO battle handover
BRASSCRAFO background, range, altitude of the target, sun or full moon, shadow,
concealment, rotor wash, area to maneuver, fields of fire, obstacles
C2 command and control
CAB combat aviation brigade
CAS close air support
CASEVAC casualty evacuation

CBRN chemical, biological, radiological, and nuclear

CCIR commander’s critical information requirement
 CCP casualty collection point
COA course of action
COMSEC communications security
COP common operational picture
CP command post
D3SOE denied, degraded, or disrupted space operational environment
DOD Department of Defense
DS direct support
EA engagement area
EMCON emission control
EPA evasion plan of action
EPW enemy prisoner of war
EW electronic warfare
FARP forward arming and refueling point
FCR fire control radar
FLOT forward line of own troops
FRAGORD fragmentary order
FRIES fast-rope insertion and extraction system
FSO fire support officer
FW fixed-wing
GCS ground control station
GPS Global Positioning System
GS general support
HA holding area
HLZ helicopter landing zone
HSS health service support
HVT high-value target
IPB intelligence preparation of the battlefield
IR infrared
ISOPREP isolated personnel report
JTAC joint tactical air controller
LD line of departure
LNO liaison officer
LOA limit of advance
LOS line of sight
LSCO large-scale combat operation
MANPADS man-portable air defense system
MDMP military decision-making process
MEDEVAC medical evacuation

METT-TC mission, enemy, terrain and weather, troops and support available, time
available, civil considerations
MTF medical treatment facility
MUM-T manned unmanned teaming
NAI named area of interest
NCO noncommissioned officer
NOE nap-of-the-earth
NORMA nature of the target, obstacles, range to target, maneuvering area, altitude
above target area
OE operational environment
OP observation post
OPCON operational control
OPORD operation order
OPSEC operations security
OSA operational support airlift
PAA position area for artillery
PACE primary, alternate, contingency, and emergency
PC pilot in command
PCC precombat check
PCI precombat inspection
PIR priority intelligence requirement
PL phase line
PR personnel recovery
PZ pickup zone
PZCO pickup zone control officer
QRF quick reaction force
RF radio frequency
RFI radio frequency interferometer
ROE rules of engagement
ROZ restricted operations zone
RP release point
RW rotary-wing
S-2 intelligence staff officer
S-3 operations staff officer
SCAR strike coordination and reconnaissance
SEAD suppression of enemy air defenses
SOP standard operating procedure
SP start point
SPIES special purpose insertion extraction system
SPINS special instructions
SWT Scout weapons team
T&EO training and evaluation outline
TAA tactical assembly area
TAI target area of interest
TLP troop leading procedures
TRP target reference point
 UAS unmanned aircraft system
WARNORD warning order