Monday, September 24, 2012

Medical Air Evacuation in World War II—Part 1

I am so so pleased to host amazing author and fellow research hound, Sarah Sundin, back to Redwood's this week. Sarah is a fabulous historical author whose novels highlight the WWII era. This week she is discussing her research into medical air evacuation and flight nursing.

Sarah has also graciously agreed to give away one copy of her newest release, With Every Letter, to once commentor on any of this weeks posts. Simply leave a comment with your e-mail address. Must live in the USA. Drawing will be midnight, Saturday September 29th. Winner anounced here at Redwood's Sunday, September 30th.

Welcome back, Sarah!

“Do you have room for one more litter case?” the doctor asked. “Private Jenkins fell headlong on a landmine. The nearest hospital’s in Cefalù, a long ambulance ride over rough roads. By air he’ll be in Mateur in two hours. He needs a thoracic surgeon.”

Mellie stared at the unconscious patient. He lay on a litter, his torso swaddled in white gauze.
Bloody streaks painted his face, arms, and khaki pants. “We’re his only hope.”

In my novel With Every Letter, the heroine serves as a flight nurse. If you’re writing a novel set during World War II, a soldier character may get sick or wounded, and you might need to understand medical air evacuation.

Today I’ll discuss general principles of air evacuation and share resources, on September 26th we’ll follow one patient’s flight experience, and on September 28th we’ll meet the flight nurse.

History of Air Evacuation

As soon as the Wright brothers took to the air, clever minds thought of ways to use the new contraption. In 1910 two Army officers constructed the first ambulance plane, and during World War I the Army experimented with transporting patients by air.

The advent of large multi-engine cargo planes in the interwar years made these dreams realistic. In November 1941, the US Army Air Force authorized the Medical Air Ambulance Squadron. Air evacuation was first performed informally early in 1942 during the construction of the Alcan Highway and in Burma and New Guinea. The first official air evacuation with flight nurses was flown on March 12, 1943 in Algeria.

Advantages of Air Evacuation

Speed is the primary benefit of air evacuation. Planes can also traverse inhospitable terrain or dangerous seas. The military came to see that air evacuation required less equipment than ambulance transport, aided recovery, and increased morale on the front.

However, planes were unable to fly in bad weather, and planes were not reserved for ambulance use. Since top priorities for transport planes were airborne missions and carrying supplies, medical air evacuation depended on availability. Also, dangers existed from crashes and enemy planes. Since transports carried cargo and troops, they were not allowed to be marked with the Red Cross and were legitimate military targets. Fighter coverage was provided in some combat theaters.

Use of Air Evacuation in World War II

Thirty Medical Air Evacuation Transport Squadrons served in World War II in every combat theater. In all, 1,172,000 patients were transported by air. About half were ambulatory patients (the “walking wounded”) and half were litter patients. Only 46 patients died in flight, although several hundred died in crashes. By 1944, 18 percent of all Army casualties were evacuated by air.


The C-47 was the workhorse of air evacuation. This dependable two-engine plane was used for shorter flights within a combat theater and could fly into forward landing strips close to the battlefield. A C-47 carried 18-24 patients, depending on how many were on litters.

For transoceanic flights, the four-engine C-54 Skymaster was used. The preferred load for a C-54 was 18 litter patients and 24 ambulatory. These flights carried patients from the combat theater stateside when the patient required 90-180 days of recovery or was eligible for medical discharge.

The C-46 Commando was used less frequently. Although it could carry 33 patients, the cargo door made loading difficult, and the plane had an unsavory habit of exploding when the cabin heater was used.

Medical air evacuation revolutionized the care of the wounded. Gen. Dwight Eisenhower credited air evacuation, sulfa drugs, penicillin, and the use of plasma and whole blood as key factors in the significant drop in the mortality rate among the wounded from World War I to World War II.


Sarnecky, Mary T. A History of the U.S. Army Nurse Corps. University of Pennsylvania Press, Philadelphia. 1999.

Links, Mae Mills & Coleman, Hubert A. Medical Support of the Army Air Forces in World War II. Office of the Surgeon General, USAF. Washington, DC. 1955.

“Winged Angels: USAAF Flight Nurses in World War II.” On National Museum of the US Air Force website.

The World War II Flight Nurses Association. The Story of Air Evacuation: 1942-1989. Taylor Publishing Co., Dallas TX, 1989. [Source of most of the photos used in this article]

Website of the World War II Flight Nurse Association. Contains photos, news clippings, and PDF of The Story of Air Evacuation.

Futrell, Robert F. Development of Aeromedical Evacuation in the USAF: 1909-1960. USAF Historical Division, Research Studies Institute, Air University, 1960. Available free online at

Sarah Sundin is the author of the Wings of Glory series from Revell: A Distant Melody (March 2010), A Memory Between Us (September 2010), and Blue Skies Tomorrow (August 2011). She has a doctorate in pharmacy from UC San Francisco and works on-call as a hospital pharmacist.


  1. Wow, what a fun post! It's so interesting reading about nurses and their part in WW2. I also really enjoyed the short exerpt from the book... can't wait to read it! =)


  2. I enjoyed this post... so informative! I can only imagine what sort of things these nurses had to endure!


  3. Fun post and awesome giveaway! I'm a huge fan of WW2 and enjoy learning anything I can about it... this was something I didn't know much about!


  4. Oh, awesome! I love Sarah's books and enjoy how much she puts in her books research wise. I learned a lot reading them!


  5. I love learning WWII facts and appreciate the dedication to research for novels. There are so many stories that are being lost daily as time passes and we lose our precious veterans.

    HM at HVC dot RR dot COM

  6. My first introduction to Medical Air Evac was through reading Cherry Ames, Flight Nurse by Helen Wells when I was a teen. I was fascinated!

    I'm awed by the amount of research you must've poured into this book!

  7. Great resources, ladies! Both Sarah AND the sources she references. These are timely for WIP of mine about the P-61 Black Widow. Thanks!

  8. Love this post!!! I could litereally soak up anything about WW2! Thanks for the information and for the giveaway! I absolutely love Sarah's books!


  9. This was really cool! I've always been into history, but never really looked too far into this time period. My daughter loves it, however, so I hear a lot about WW2. Thanks for the interesting history lesson, can't wait for next time!


  10. I'm entering for my daughter....this was an extremely interesting post! It's great to hear all about stuff like this....keeps that time alive more! I'm sure there are plenty of lessons we could learn from life back then!


  11. Wow! This books sound fascinating! My major was History and I specialized in WWII. I definitely want to read this!!

  12. Erica - I adored Cherry Ames! I'm not sure if I read Flight Nurse, but I must have because I read over a dozen of the books.

    Becky - the P-61 Black Widow? What fun! Make sure you visit the hyperwar website I referenced. HUNDREDS of online documents about WWII. The main website link is

    Elyssa, Emily, and family - always good to see you :)

    Kelli Jo - I just broke into a cold sweat :) But seriously, I hope you enjoy it and don't find too much incorrect. I try to be accurate, but you can never, ever achieve 100% accuracy.

  13. WOW, what interesting information. As a former Army Nurse as well as a lover of World War II history, I have been waiting for this book for what seems like forever. So far, I am not disappointed. These historical tidbits will just add to my enjoyment.

    Erica, I too grew up with Cherry Ames. I recently found a couple in an antique store, one of which was Army Nurse which is the reason I grew up to be an Army Nurse! I also found Flight Nurse which I was in the middle of reading . . . had to put it aside for "With Every Letter" . . sorry Cherry!

  14. Anonymous - Well, I hope you like it after all that build-up :)

    Cherry Ames made me flirt with the idea of nursing, but I'm super-squeamish. Pharmacy allows me to be in the health care world without all that icky stuff :) I'm such a wimp.

  15. Sarah, thank you for these wonderful posts. I've never heard of these Cherry Ames novels. Guess what I'm going over to Amazon to look up!

    And Sarah-- really, you are that squeamish?

  16. What a great cover! Sounds like a wonderful story, too!

  17. Jordyn - oh, you'll love Cherry Ames! The Nancy Drew of nursing :)

    And yes, I'm squeamish. Being a mom changed that a lot - having to clean up all sorts of ick - including washing my own diapers. But I love the sterility of pharmacy - so clean and shiny :)

    Patricia - thanks! I love the work Revell did on the cover.

  18. My Dad was in WWII and in the Army Air Corp, so your story line is something I have a lot of interest in. It always amazes me how many "firsts" came out of those war years. Thanks for writing your book!


  19. My Dad was in WWII and in the Army Air Corp, so your story line is something I have a lot of interest in. It always amazes me how many "firsts" came out of those war years. Thanks for writing your book!


  20. Wow, great compilation of information here. Always impressed when an author puts this much effort into researching a period for writing historical fiction, especially a niche like this (and one I happen to be a huge nerd in myself). The definition of an air ambulance has come a long way since then, but it's just very impressive how effective the first flight nurses and aircraft were at evacuating injured soldiers all the way back in the 40s before so many of the technological advances that the crews rely on these days. I've read about the flight nurses of the WWII era before, but there are a few facts here I haven't heard before. Great post!