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surgeons had no equipment/supply packages arid had to improvise on short notice
and with little jnforrnation.
      Some crews were not given chemical warfare antidotes prior to deployment.
      Air National Guard initially deployed in volunteer status only and each
state made its own rules.
      Poor pr~deployment medical screening became apparent quickly on arrival
in theater.  Many individuals who were not previously in mobillty positions were
deployed.
      The average experience level of deployed flight surgeons was low. Several
had no experience except completion of the Aerospace Medicine Priinary Course.
      Flight surgeons perceived by squadrons to be "weak" performers were not
identified in the peac~time setting. This resulted in one SME being replaced just
prior to deployment and another being returned from the theater in less than sis
weeks.
      Special preparations for tactical aircrews involved convincing pilots to ~ake
adequate fluids for the long over~water flight.  Many took insufficient piddle
packs.  Some had problems with catheters disconnecting in flight.      Several
squadrons deployed with partially inflated donuts in their seats.  These crews
were briefed about the potential problems of dynamic overshoot if they needed to
eject with the donuts in place.  Most tactical aircrews had dexedrine (Go pills)
issued prior to departure. Some also took arttticial tears which they f~und use~l.
      Pilots tended to be very liberal in accepting aircraft. One pilot made the 1~
hour flight unpressurized and had to descend to 5000 feet at night over water
because of possible hypoxic symptoms. Another pilot deployed with a flill-on a~
conditioning system, forcing him to fly with one hand while he warmed the other
against his body.        -
      Multiplace aircraft deployed with augmented crews.  Single/dual seaters
found fatigueasi      ificant factor and dexednne was used by 65%.    The first
capsule was typicaly used at about six hours into the flight or within~one hour of
transition to night conditions.

                                ARRIVAL

      Squadron medical elements were the first deployed medical assets of any
service to be operational in theater.  The Chief of Staff of the Air Force has
frequently briefed that within 4 days, 5 squadrons and AWACS were in place in
theater. Most SME's arrived within a day of their aircrews. Some flight surgeons
flew on their Wing's assigned aircraft, some went on MAC airlift with other
elements of the support package, and still others went on commercial charter.
Stopovers were usually in Spain or Germany.
      In many case., ATC'a were delayed up to 10 days and the only m.dical
supplies available were the "fly.away'1 kits, optional equipment or nesting boxes
that the flight surgeons brought with them.     At 9 of 13 locations, the ATC
equipment package arrived more than 4 days after the SME or a complete package
never arrived at all.  Most SME's arrived at partial bare bases with buildings of
opportunity available. Few needed the ATO tentage. At least one location which
attempted to erect the TEMPER tent was riot prooided the necessary base support
specified in the ATC ConOps. Initial need to assess food and water quality as well
as see particularly heavy sick calls1 placed tremendous demands on the SME
reso';irc*s. Most felt additional manpower was needed in the form of an IDMT or
environmental health technician.   IDMT's would add patient care as well as
environmental monitoring expertise.        Flight surgeons and aeromedical

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