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surgeons had no equipment/supply packages and had to improvise on short notice 
and with little information. 
	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 pre-deployment medical screening became apparent quickly on arrival 
in theater. Many individuals who were not previously in mobility positions were 
deployed. 
	The average experience level of deployed flight surgeons was low. Several 
had no experience except completion of the Aerospace Medicine Primary Course. 
	Flight surgeons perceived by squadrons to be "weak" performers were not 
identified in the peace-time setting. This resulted in one SME being replaced just 
prior to deployment and another being returned from the theater in less than six 
weeks. 
	Special preparations for tactical aircrews involved convincing pilots to take 
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 artificial tears which they found useful. 
	Pilots tended to be very liberal in accepting aircraft. One pilot made the 16 
hour flight unpressurized and had to descend to 5000 feet at night over water 
because of possible hypoxic symptoms. Another pilot deployed with a full-on air 
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 fatigue a significant factor and Dexedrine was used by 65%. The first 
capsule was typically 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 cases, ATC's were delayed up to 10 days and the only medical 
supplies available were the "fly-away" 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 ATC tentage. At least one location which 
attempted to erect the TEMPER tent was not provided the necessary base support 
specified in the ATC ConOps. Initial need to assess food and water quality as well 
as see particularly heavy sick calls, placed tremendous demands on the SME 
resources. 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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