Reservists save lives on the fly Published April 12, 2013 By Airman 1st Class Madelyn McCullough 446th Airlift Wing Public Affairs MCCHORD FIELD, Wash. -- The C-17 Globemaster III ramp drops and 20 Reservists rush on to transform the plane into an air hospital. They work together to latch in place the metal frames that will hold litters carrying supplies and patients. As stretchers full of defibrillators, bandages, and fluids are loaded into the plane, leaders yell "Prepare to lift!" followed by the echo of their team. Other Airmen point them in the right direction to deposit their loads, while others sort through wires and begin unpacking supply kits. Once all the equipment is on the plane, the C-17 ramp lifts and latches. Patients are loaded onto their beds where flight nurses brief and secure them and finally, the plane is ready for takeoff. Some call it organized chaos, but to the 446th Aeromedical Evacuation Squadron, it's training. Once a month, on the Sunday of the primary UTA, Reservists from the 446th AES embark on a four-hour flight. Usually, training consists of two five-member crews per flight. On April 7, budget constraints forced the squadron to put 20 crew members onto one flight. The two 10-member crews worked with different patients and scenarios, but had to share the same space. Even so, these aeromedical Airmen didn't let the cramped quarters stop them from training. About an hour into the flight, Capt. Steven Smith, a 446th AES flight nurse and training evaluator, acted out a patient dropping to his knees and vomiting blood. He laid there until a team-in-training rushed over to help him. Evaluators watched the exercise to make sure the flight nurses and medical technicians correctly followed procedures. "We have air scenarios that emphasize different medical areas," said Capt. Richard Payne, a 446th AES flight nurse and training evaluator. "The crews are getting familiarization practicing medical procedures on an aircraft." "I learn to take care of very sick and injured people in a different environment with limited resources," said Capt. Mutita Hornsberger, a 446th AES flight nurse who was being evaluated. Seeing that the 446th AES spent nearly 6,800 hours in the air on more than 2,500 missions in 2012, adjusting to the aircraft conditions is a must. When a flight nurse dropped the key to the narcotics box during this training flight, Master Sgt. Larry Jones, a 446th AES medical technician and training evaluator, took the opportunity to add a new scenario to the training plan. He pretended to be a patient who found the key, snuck into the narcotics and overdosed. Crews responded by giving him the antidote. Jones mimicked the aggressive side effect of the drug and the team had to struggle to bind him to a litter. "We try to make training realistic for events that would happen out in the system," Jones said. Other scenarios include fires, door seals breaking, smoke, electrical outages, or leaks, Smith said. The Airmen have to figure out how to respond to and fix the problems. "When training, we do the worst possible scenarios so when we are deployed those situations can be anticipated and prevented," Hornsberger said. Although they prepare for the worst, not every flight will have multiple catastrophes. Most will, however, allow very little free time. "A real patient has needs," Smith said. "They need food or help eating because they could have a broken arm. They might need help going to the bathroom. They have to take medications and they need help if they can't take their own. In a situation with 40-plus patients, three flight nurses and four medical technicians, it can be incredibly busy." In demanding situations like that, training allows for a quick response and a successful mission. "This training is absolutely necessary," Hornsberger said. "It's part of the AE mission to take care of wounded military while at war. While not at war, it's our mission to train and be ready."