The rotor blades of the MEDEVAC helicopters never stopped spinning as the Army Reserve Aviation Command’s UH/HH-60 Black Hawks climbed to new heights and led the third iteration of the fast-paced joint operation known as Mountain Medic 2023 last week.

Soaring against the backdrop of the Rocky Mountains, the exercise aimed at improving and reenforcing medical evacuation operations and skill sets while pushing its medics, pilots and aircrews nonstop in austere environments set for large-scale combat operations.

“We had a lot of opportunity to get after training in the mountains, do hoist operations, work in a degraded environment and really hit those MEDEVAC training objectives that we care about at the company level,” said ARAC training officer, Lt. Col. Jennifer Housholder, Mountain Medic officer in charge. “Medical care is inherently a joint endeavor, and MEDEVAC and aeromedical operations have unique and specific requirements that need emphasis.”

Led and planned by the ARAC, Mountain Medic brought together assets from the Army, Army Reserve, Air Force, Air Force Reserve and Space Force to exercise in a joint, multi-component and multi-domain environment. Born in 2020 when exercise Global Medic was cancelled due to the COVID-19 pandemic, Mountain Medic aims toward lower-level MEDEVAC training objectives.

“This was an opportunity to really design an exercise that was geared at that forward support MEDEVAC platoon, that company-level training,” Housholder said.

Air Force Reserve medical personnel with the 302nd Airlift Wing set up tents in the field and treated patients brought in by Army Reserve casualty evacuation (CASEVAC) and MEDEVAC helicopters while the Army’s 10th Group Special Forces (Airborne) assisted on-ground with a quick reaction force. It was many of the airmen’s first experience in a simulated combat operation environment.

“Most of these Airmen are medics or technicians in a hospital or clinic, so we need them to be multi-capable Airmen where they learn how to set up tents, guard the perimeters, onload and offload (helicopters), and process patients in just a few tents like this,” said Chief Master Sgt. Kimberly Lord, 302nd Airwing Command Chief. “They’ve learned more today in the first two hours than I expected them to learn the entire week, so I’m proud of them.”

Along with the Army Reserve CASEVAC and MEDEVAC Black Hawks, flight paramedics, air crews and medical teams practiced loading patients and supplies onto Air Force C-130 Hercules airplanes. The “Tail-to-Tail” training scenario helped the joint service crews move and communicate while transferring the care of a casualty from one aircraft to another.

“We’re essentially a short-range asset,” said Army Reserve Staff Sgt. Daniel DiVincenzo, a critical care flight paramedic with 5-159th General Support Aviation Battalion, 244th Expeditionary Combat Aviation Brigade, ARAC.

During the Tail-to-Tail scenario, DiVincenzo and his team care for patients on HH-60 MEDEVAC Black Hawks for a limited amount of time before landing and transferring them to a C-130, as Air Force fixed wing is necessary for long distance casualty transport.

“We work with the Air Force to move that patient to a higher echelon of care that is further beyond the forward line of troops—to return them to the greatest position of health they can possibly get to,” said DiVincenzo.

Meanwhile, incorporating the Space Force helped forward the multi-domain mission planning process. Different squadron elements from Peterson Space Force Base were invited at the beginning of the exercise to give classes and address GPS and satellite communications and the potential for a negative change in environment.

“Space Force is essential to developing and reinforcing capabilities that enable air, land, and sea warfighting functions; this includes capabilities that effectively protect and defend those space assets critical to operations conducted by the (military),” said Housholder. “Given that a near peer-to-peer combat scenario will likely result in degradation or full denial of critical capabilities afforded by Space Force, aviation units need a realistic training environment.”

Exercise participants operated throughout Colorado Springs, Fort Carson’s range, south to Pueblo Memorial Airport and northeast to Peterson Space Force Base. Pilots and aircrew were able to practice flying and airlifting patients from and through mountainous terrain back to a safe location.

Medical teams worked with live roll players, medical mannequins, military working dogs and cadavers. The exercise culminated with a mass casualty event that brought the training together across all medical and aviation services and components.

“In addition to conducting treatment in-flight, medical personnel had opportunities for hands on training with cadavers, patient hand-off, and to glean best practices from each other to improve individual unit level care and readiness,” said Housholder.

With all the exercises executed by the ARAC, this has been the best according to DiVincenzo, who expressed the importance of this exercise and his overall role as a flight paramedic.

“The most rewarding thing for me has been seeing three new flight paramedics out there learning and just killing it and hearing the Air Force telling us we’re doing a phenomenal job,” he said. “From a medical standpoint, just knowing you’re sending someone home to their mother, father, son, brother, daughter—that’s absolutely the most rewarding. The legacy of dust-off—it’s not one person that was saved, it was a family.”

Housholder hopes to see Mountain Medic continue even as she eyes retirement later this year.

“I’d like to see it grow,” she said. “This is a template for how we—Army, Air Force, Space Force—really need to be exercising, because this is how we would absolutely be interacting in a real environment.”