JOINT BASE ELMENDORF-RICHARDSON, Alaska - When a mariner on a cargo vessel sailing in the Gulf of Alaska became critically ill June 15, Alaska Air National Guardsmen of the 176th Wing came to the rescue.
Alaska Air National Guard Maj. Miles Brodsky was the 176th Wing search and rescue duty officer who took the call from the Alaska Rescue Coordination Center at JBER after the Coast Guard determined the vessel, Panama-flagged Ocean Dream, was too far for their MH-60 Jayhawk to carry out the mission.
“I got a call from the RCC saying we got a sick sailor on an ocean vessel 300 nautical miles south of Cold Bay in the middle of the ocean,” Brodsky recalled. “Coast Guard can’t get to them right now, and they’re asking for help.”
The officer said the sick mariner’s condition warranted a rapid response despite the great distances to travel over a cold northern Pacific Ocean.
“I quickly developed a picture about the patient status: 22-year-old male, lost consciousness Saturday morning, he was feeling ill the past two or three days, was unconscious, and when I looked at the vital trends, they were moving in a very bad direction,” Brodsky said. “Blood pressure was decreasing, heart rate was increasing.”
Though missions hundreds of miles into ocean territory are rare for the 176th Wing, Brodsky spent much of his career with the 129th Rescue Wing at California’s Moffett Federal Airfield.
“Ninety-nine percent of our missions are these long-range search and rescue over the water, so I have a lot of experience either being on the mission, mission commanding, or being in the decision-making process,” Brodsky said.
The patient’s life-threatening symptoms only exacerbated the challenge.
“The initial diagnosis from the Coast Guard doc, who was working on basically the same information we had, was a ruptured appendix, which is life-threatening, so our first assessment was sepsis,” Brodsky said. “So, I called the crews immediately because I knew we were going to accept this mission.”
Brodsky said the fastest way to get medically trained pararescue and combat rescue officer Guardian Angels of the 212th Rescue Squadron to the ship was by parachute.
“With the distance and how far it was out, having a jump team going would be the fastest,” Brodksy said. “The patient 100 percent warranted getting pararescue there. He was dying.”
In addition to Guardian Angels of the 212th RQS, the wing also operates HH-60G Pave Hawk helicopters of the 210th Rescue Squadron and HC-130J Combat King II fixed-wing aircraft of the 211th Rescue Squadron. The HH-60 is the rescue aviation workhorse, allowing the wing to insert Guardian Angels precisely and to extract them by air, land or hoist cable. The HC-130 is quicker and can employ pararescuemen by parachute drop, and the Combat King can fly over the weather while providing long-range communications relay.
“[Course of action] No. 1 was to push King forward and do a jump option while the HH-60 made its way to Cold Bay to reduce risk for the jump option and also to be COA 2 in case the jump option didn’t go,” Brodsky said.
“Once King was overhead, they realized they couldn’t see the vessel because the cloud deck was closer to the water than what was previously reported,” Brodsky said. “That’s when Harry made the call that jumping wasn’t an option, so we moved to COA No. 2: an HH-60G hoist recovery off the bow.”
To expedite the rescue and increase safety margin, Brodsky asked the vessel to make a straight course toward Cold Bay.
“The closer that vessel is getting to the ring, the risk to force – our people – is reducing, but the risk to mission is increasing,” Brodsky said. “So, we’re looking for the sweet spot where our commanders are willing to take the risk to force by pushing out a single-ship HH-60 or a jump team, but without delaying and increasing risk to mission, which is getting medical care to that patient or getting him to a higher level of care.”
On her way to Joint Base Elemendorf-Richardson following the alert call, Pave Hawk pilot Maj. Stephanie Wilson said her first call was to an area weather service.
“He initially said, ‘Oh, you’re going 300 miles south of Cold Bay; our maps don’t go that far,’” Wilson said. “That was the first glimpse of reality that this is going to be a long mission.
“He pulled up [National Oceanic and Atmospheric Administration] data for me and told me there was a low-pressure system sitting around Unalaska probably producing rain showers,” Wilson continued. “We know it’s the ocean. It can produce a lot of moisture, so we were thinking clouds and rain showers once we got to Cold Bay.”
The HH-60 stopped in King Salmon for ground refueling before pushing forward to Cold Bay for another splash of gas. To get out to sea, the Pave Hawk crew would rely on air-to-air refueling from the HC-130.
“We talked about how we could mitigate the risk by ensuring we were taking sips of gas along the way so that no matter what happened – based on our last top-off – we could always get back to Cold Bay if we had any problems,” Wilson said. “With that plan, we were pretty confident we had mitigated the risk factors.”
In Cold Bay, the HH-60 crew and the Guardian Angels donned anti-exposure suits that would keep them alive if they had to endure frigid Gulf of Alaska waters. They set out and surveyed the horizon.
“As we took off, we got our first glimpse of the weather, and there was a pretty solid cloud deck just outside of Cold Bay south of there, and we ended up climbing to 3,500 feet for [helicopter air-to-air refueling],” Wilson said.
The pilot said windspeeds at Cold Bay were 30 to 35 knots, which had her wondering how the refueling drogue would perform.
“Surprisingly, the winds didn’t affect the drogue that much, and we were able to make a successful plug and take on the required gas,” Wilson said. “... We sent the HC-130 forward to get eyes on the ship, make contact with the captain, get patient updates, and then also do a weather reconnaissance for us.”
Wilson said this last refuel gave her the confidence to push forward.
“At that point, we had all the gas that we required to conduct the recovery with approximately 30 minutes on scene, which was our best guess if the GA team had to go below deck to retrieve the patient,” Wilson said.
The cloud deck was 500 to 1,200 feet, requiring the crew to navigate with instruments.
“To mitigate that risk, we navigated to the largest scattered layer of clouds we could find, and we conducted a straight-ahead descent down until we could see the ocean clearly,” Wilson said. “At that point, we were about 1.7 miles away from the ship. We made one sweeping turn and immediately had eyes on the ship due to the C-130 passing us its position by radar.”
The vessel’s captain assessed it would take his crew 5 minutes to deliver the patient topside.
“We started working with the team on the helicopter to select the best location on the ship to conduct a hoist recovery,” Wilson said. “There were multiple cranes on the ship, so we began a discussion about which cranes and equipment the captain could move out of the way to give us the largest area to be able to hoist the patient off of the ship.”
To safely insert help, Wilson would have to rely on her experience training with ocean vessels.
“Leaning on some previous training I’ve had, I have conducted all of my underway training off the bow of the boat,” Wilson said. “I was more familiar with that, so we gave that a shot.
“I had the helicopter pointed into about a 35-knot headwind perpendicular to the ship,” Wilson said. “They were cruising at about 10 knots, and we were able to establish a pretty stable hover there. Based on fluctuations in my radar altimeter, I would say we were dealing with about 3- to 5-foot waves and a swell of approximately 20 feet on top of that, so about every 7 seconds you get that 20-foot rolling swell with the ship.
She worked with Tech. Sgt. Dave Hayes, special mission aviator, to get in a stable hover and work the hoist cable down to the boat’s bow.
Alaska Air National Guard 2nd Lt. Joshua Doherty, 212th RQS combat rescue officer, said the hoist target was only about 10 or 15 meters wide and 10 meters tall.
“As soon as I got on the deck, as quickly as I could, I disconnected and sent the cable back up so it wouldn’t interfere with us doing work on the ship,” Doherty said.
Wilson maneuvered the helicopter to best support operations on the ship.
Once the patient was hoisted on board, they climbed from 300 feet to the top of the clouds at 1,200 feet.
Doherty said he didn’t have strong signs of life until he saw the patient’s breath on the protective glasses he gave him for a safe hoist.
“Once he was in the aircraft, it was business as usual and we just started working on treatment,” Doherty said. “It was very clear that he was in a lot of distress. The initial call was that he may have had a ruptured appendix, so we were really concerned about him being in septic shock, so we needed to get fluid on him right away.”
“I put in an IO (intraosseous) needle, which is like an IV, but it doesn’t go into the vein; it goes into the bone,” Doherty said. “His pressure was so low, there wasn’t any profusion.”
They knew the patient was in some form of systemic distress, but they didn’t know why.
“We thought he was in some form of shock, whether that’s septic shock, distributive shock, or hypovolemic shock, but there was no signs of any of those,” Doherty said. “There were no signs of anything trauma or septic related.”
They put him on an epinephrine drip and got his blood pressure up.
After landing in Cold Bay and moving the patient and Guardian Angels to the waiting HC-130, they tested his blood glucose level at the suggestion of 212th RQS pararescueman Staff Sgt. Jaide Francis.
“The BGL came back high, and everyone took a half step back, and we realized the patient is in ketoacidosis,” Doherty said. “We had a young male with no history of diabetes going into a diabetic episode called diabetic ketoacidosis. He basically went into this state where his body couldn’t metabolize any sugar.”
Doherty said the now-combined team of five Guardian Angels worked together to get the patient “to a place where we could hand him off with the best chance of survival.”
The HC-130 landed at JBER, and the Guardian Angels accompanied the patient in an ambulance to Providence Alaska Medical Center in Anchorage. Doherty said the doctors were impressed with their medical handiwork.
“The guys we had with us that day were all level-headed, calm, cool and collected, and that resulted in us doing outstanding medicine,” Doherty said.
Medical officials said the patient awoke from his coma and made a full recovery.
Wilson credited the team of rescue operators, rescue maintenance crews, the AKRCC, and other support personnel for completing the arduous mission deep into the Gulf of Alaska.
“There were a lot of micro-decisions that had to be made for this to be done safely,” she said. “And there were a lot of elements that don’t always align when you’re flying in Alaska that definitely aligned in our favor and the favor of the patient getting him extracted from that vessel and on to higher medical care.”