Response teams extract, treat F-22 pilot in joint exercise Published Nov. 29, 2020 By Senior Airman John Linzmeier 154th Wing JOINT BASE PEARL HARBOR-HICKAM, Hawaii – Firefighters, paramedics and medical response Airmen raced to the flight line Nov. 20 in an exercise to extract pilots from fifth-generation aircraft. The scenario was designed to test Team Hickam's competency in rapidly aiding, egressing and transporting an F-22 Raptor pilot – experiencing signs of decompression sickness – to a U.S. Navy hyperbaric chamber. "Thankfully, we don't see this type of emergency very often, thankfully," said Hawaii Air National Guard Lt. Col. Steven Augugliaro, 154th Wing F-22 flight safety officer. "When you don't get to execute the processes and procedures that you have, then it's important to practice going through the motions every so often. You'll find things in the books may need to be updated, such as phone numbers, who the point of contact is for a certain function, or if new rescue equipment is and is not compatible with pilot's gear." The event began in the same manner as any other in-flight emergency, with the pilot alerting the ground staff of the emergency and initiating a call-in sequence for first responders to make their way toward the pilot's grounding location. Within minutes, the first wave of personnel arrived. The "Crash Net 1" crew included firefighters and emergency medical service personnel from the Federal Fire Department based out of Joint Base Pearl Harbor-Hickam and Tripler Army Medical Center, the supervisor of flying, followed by Air Force medical teams – a flight surgeon, aerospace physiologist and aerospace medical technicians. While the potential for experiencing physiological ailments can happen to any airborne traveler, F-22 operations rely on additional layers of safety precautions due to the advanced maneuvering capabilities, higher altitudes and the single occupancy limit of each aircraft. For training purposes, the pilot was experiencing paralysis on one side of his body and slurred speech, a condition that Maj. Kimberly Dowd, 15th Medical Group aerospace physiologist and exercise planner, considers a neurological (Type 2) form of decompression sickness, warranting an immediate extraction and transport to a hyperbaric chamber for treatment. Decompression sickness can lead to long-term medical complications, potentially ending an aviator's career. When nitrogen bubbles make their way out of the bloodstream and into the circulation to joints, lungs, heart, brain and skin, it can impair a pilot's cognitive faculties and motor functions. In these cases, administering high-flow oxygen and rapidly transporting the pilot to the hyperbaric chamber is paramount. "This exercise allows us to identify any holes in our internal checklists, correct them, and continuously work to improve, learn and execute it better during the next exercise or potentially for a real-world event," Dowd said. Unlike more conventional airframes such as the KC-135 Stratotanker and C-17 Globemaster IIIs based at JBPH-H, the F-22 cockpit is accessed through a canopy, requiring maintenance crews to deploy specially adjusted stands for extraction. The aircraft's sensitive instruments present another challenge during egress. "Today was also important because it allows the folks who would respond to an aircraft emergency actually to get up close and personal to the aircraft," said Augugliaro. "That refreshes their memory of what to watch out for, where the sharp objects are on the aircraft, what not to touch, etc., when responding to an aircraft emergency." As first responders care for the pilot and coordinate a transit plan, a secondary wave of 15th Wing and Hawaii Air National Guard support agencies assimilate information to improve the condition of command and control and produce a detailed after-action report. Members of Wing Safety, Air Terminal Operations Center and the Wing Control Center communicate via conference calls, on-scene notes and direct reports from medical points of contact. Following the egress and initial medical treatment, the pilot is loaded onto a medical vehicle and taken to the hyperbaric chamber. Capt. Nick Crain, 15th Medical Group flight surgeon, oversees his patient's condition and relays the information by radio to Navy divers who operate the lifesaving equipment at their destination. The mobile recompression chamber is packaged into a structure that resembles a freight car and is staged where divers and aircrew can receive treatment. After the pilot is escorted through the re-recompression process, accompanied by a tending Sailor inside the chamber, the Airmen and Sailors hold a briefing.