Lt. Martin Blumenson, in "Special Problems in the Korean Conflict," published by Eighth Army headquarters. (Based on interviews of Col. Thomas N. Page, Surgeon, Eighth Army;
Lt.Col. Arne D. Smith, Medical Section, Eighth Army; Major Sydney L.
Fouts, Liaison Rescue Officer to Fifth Air Force; Capt. M. A. Mecca, Rescue Controller, Fifth Air Force; Capt. James E. Childers, 8193d Helicopter Unit.)
In the past, the tendency has been to move surgery as close to the patient as possible. In Korea this was undesirable because of the fluid tactical situation, the limited highway net, the rough roads, and the mountainous terrain. If they used helicopter evacuation, the hospitals could stay longer in each location and allow four or five days of postoperative care for a patient before further evacuation.
Helicopter evacuation in Korea evolved out of circumstances. A detachment of the ad Air Rescue Squadron, whose mission was to retrieve downed pilots, began to receive occasional requests from Army units to evacuate wounded from mountainous positions. Whenever its helicopters were not busy, the detachment responded. During the rapid advance of the ground troops in the fall of 1950, the helicopters were especially helpful in speeding evacuation over the lengthened routes.
In January 1951 three Army helicopter detachments arrived in Korea with the mission of evacuating seriously wounded from the front lines. Each detachment consisted of 4 helicopters, 4 pilots, and 4 mechanics. Two detachments were equipped with Bell H-13 helicopters; one had Hiller H-23s. Each craft carried only a pilot and was equipped with two baskets or pods for litter patients. Under exceptionally good flight conditions, one walking patient could be carried at the same time.
The Eighth Army surgeon placed the first two detachments to arrive under the control of the IX Corps surgeon. Since IX Corps was in the center of Korea, the helicopters were also able to serve the other corps.
The first problem that arose was the necessity of teaching the helicopter pilots what their aircraft could do in front-line evacuation. The pilots could learn only by trial and error.
The ground forces then had to learn the limitations of helicopter evacuation. In the popular conception, helicopters landed on mountain peaks, lifted straight up into the air, and operated in all types of weather. It was necessary to understand that helicopters could not fly at night, operate in bad weather, or land on sloping terrain. They needed takeoff space; they could not fly in heavy winds; they had limitations of range and altitude. They also had less lifting power in the thin, warm air of summer.
Ground troops had to understand the importance of reporting accurate coordinates to locate the patient. They had to be taught the necessity of marking the landing site with panels and of using colored smoke grenades to indicate proper location and wind direction.
Combat elements sometimes requested helicopter evacuation as a convenience. By the fall of 1951, ground units had learned to request a helicopter only for cases involving head, chest, and abdominal wounds, multiple fractures, and great loss of blood. Even then, evacuation was available only if an ambulance could not reach the patient, if a rough ambulance ride would seriously injure him, or if it was necessary to get him to a medical installation quickly. As a working premise, the local surgeon decided whether the patient needed helicopter evacuation and the helicopter detachment commander decided whether the helicopters could reach the patient.
Ground forces generally did not realize the extreme vulnerability of helicopters. Their lack of speed and inability to fly at high altitude increased the hazard of enemy ground fire. Furthermore, helicopters were extremely sensitive to damage. Lack of the gliding characteristics of a conventional plane and the increased problem of pilot control meant that almost any damage from enemy fire was fatal to the craft. Pilots did not wear parachutes because of the danger of falling into the blades if they jumped from a disabled craft. When an area was under enemy observation the patient had to be prepared for quick loading.
Because there was always a shortage of helicopters in Korea, Eighth Army ordered that these craft not be used on missions involving danger from enemy action. This did not prevent pilots from evacuating patients from units surrounded by the enemy; nor did it prevent the evacuation of casualties sustained by patrols operating forward of friendly front lines.
The first two Army helicopter detachments to arrive in Korea were attached to the 8076th Mobile Army Surgical Hospital (MASH). At that time IX Corps headquarters was at
Chungju; the hospital was forty miles to the rear. This arrangement left long distances between the helicopters and the combat lines. It then decided to dispatch the helicopters from corps headquarters. Later, all the helicopters moved into the division areas. Normally, one helicopter was stationed at each division clearing station. From there it was but a few miles to the front lines.
Certain expedients adapted the helicopters for evacuation. Plastic bags were used to keep the patients warm. Flexible tubes were fitted from the engine to heat the patients in flight. Covers for the pods were devised to keep the wind off their faces. The fact that the patients in the pods could not receive medical care while in flight remained one of the serious limitations of the helicopter, even though a mechanical device permitted them to be given plasma. The limitation on medical care and the short fuel-range of the craft make it necessary to keep helicopter flights short.
Helicopters in Korea had evacuated eight thousand casualties by 1 November 1951. Many of these men would not have survived without this transportation. The smooth ride and the rapid arrival at a clearing station or hospital possibly caused a lower rate of shock fatalities than in World War II. The treatment of head injuries was expedited because helicopters carried patients swiftly to neurosurgical teams.
The presence of helicopters in Korea helped morale. Although much experimentation in the use of helicopters for evacuation remains to be done, this "ambulance of the air" has proved its usefulness in the Korean conflict.