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TOPIC AREA: COMMAND, CONTROL, COMMUNICATION (C3) 
SUBMITTED BY: HQ AFRES/SGXO 
 
ISSUE: A requirement exists for a single WAES CONOPS coordinated and agreed upon by all 
user commands. 
 
OBSERVATION: Aeromedical evacuation has supported wartime and contingency operations under 
a variety of major commands and each command used its own concept of operations. 
 
DISCUSSION: Each contingency involving aeromedical evacuation has resulted in another 
unwritten concept of operations for aeromedical evacuation and patient regulation. The Air 
Reserve Components, the command having over 95 percent of aeromedical personnel, has worked 
with MAC over the last four or five years to attempt to standardize aeromedical evacuation 
operations. Standardization is required so proper training of the younger generation of AE 
personnel can be achieved. Aeromedical evacuation is becoming less and less a profession 
and more and more a fly by the seat of your pants operation. It seems that whomever is in 
charge sets up their own concept of how things should be accomplished and forces the 
aeromedical operations to bend to the new set of rules. It is in this environment that 
younger aeromedical evacuation members are expected to learn the aeromedical evacuation 
system. Comments are frequently heard from aeromedical evacuation personnel such as "we did 
not do it this way in Granada, or Just Cause, or Urgent Fury". U.S. Army medical personnel 
(the primary aeromedical evacuation users) have made comments-such as "Why can't the Air 
Force follow its own rules in aeromedical evacuation operations? After all, it wrote them." 
this is because there is no aeromedical evacuation system accepted by all Air Force 
commands. This is true even though HQ MAC has been designated by the Air Force as the OPR 
for aeromedical evacuation. Sometimes aeromedical evacuation personnel are told to "forget 
the command you came from. You belong to our command now and you will do it our way." It is 
essential that a single aeromedical evacuation concept of operations be developed and 
published that is binding on all DOD agencies so that proper training can be accomplished. 
It is currently impossible to provide authoritative training in a system that changes with 
each operation. 
 
IMPACT: This would eliminate the confusion of not knowing current procedures at any given 
time. Increase mission effectiveness. 
 
RECOMMENDATION: Publish an approved and in-depth concept of aeromedical evacuation 
operations in either a DOD, tri-service, or Air Force level regulation. All services and 
commands must be required to follow the concept. A centralized agency must prepare training 
materials based on the approved concept of operations and allow all personnel to become 
proficient in one standardized concept of operations. 
 

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