Page 94 - JSOM Spring 2026

would individually, and certainly in combination, prohibit safe compressed gas cylinders will be secured would avoid pitfalls
hoist operations with the EEHS, thus requiring an appropri- and delays during an actual emergency. Loading and opera-
ate landing zone and negatively impacting evacuation location tion of the EEHS in anticipated evacuation aircraft should be
options. routinely practised for confirmation of plan viability and to
identify opportunities for refinement. Further assessment into
Even if technically feasible under the individual circumstances newer models of the EEHS, including assessments under pres-
of the rescue, a USCG flight crew would be well justified in surized conditions, as well as aircrew and clinician knowledge
refusing to load the EEHS on the basis of flight safety. This of EEHS transport requirements is recommended.
concern would be amplified in the setting of a crew unfamiliar
with the EEHS. Acknowledgments
The authors would like to thank Ms. Marissa Nuttall of the
Regarding the H145 aircraft, the EEHS could be loaded with- NOAA Galveston Laboratory for the use of the EEHS used in
out impact on door closure or access to crew seats using either the study, LCDR Gary Montgomery and Mr. Zachary Hile man
of the Ferno or Stryker Performance-PRO XT cots typically of the NOAA Diving Program for their technical assistance,
used in this aircraft. The optimal solution for loading the Mr. Josh Cools of Memorial Hermann LifeFlight for facilita-
EEHS would be the use of the compact Ferno “Aero-Litters” tion of the H145 physical evaluation, CDR Jeffrey Owens of
due to the small size of the aircraft. Should the aircraft present USCG Air Station – Houston for their review and comments
without either of these options, the primary issue would be on MH-65 operations, AST1 Dan Strange of USCG Air Sta-
securing the EEHS properly and in a manner deemed safe by tion for their facilitation of the MH-65 physical evaluation,
the crew, particularly with a crew unfamiliar with the EEHS. and MAJ Ronnie Hill of the U.S. Army Institute of Surgical
Research for their review.
The United States Air Force Research Laboratory completed air-
worthiness testing of the EEHS, Model 24/88/SAT/70 in 2000. Author Contributions
4
The EEHS was tested for airborne performance by AFMED NS conceived of the study, completed the testing, and wrote
aeromedical crewmembers flying on C-130 Hercules and C-141 the first manuscript draft. KB verified the analysis and revised
Starlifter, both aircraft being fixed wing, without issue. The the manuscript for submission.
EEHS was also tested on an Army UH-60A Black Hawk heli-
copter. Special note was made that 10 special “D” rings compat- Disclaimer
ible with the aircraft floor were required and must accompany The views expressed herein are those of the authors and do not
the EEHS if rotary airlift (helicopter) transport is anticipated. reflect the official policy or position of the U.S. Army Medical
The C-130, C-141 (no longer in use), and the UH-60A are much Department, the U.S. Army Office of the Surgeon General, the
larger aircraft than the aircraft assessed in this project. Department of the Army and Department of Defense, the U.S.
Government, the Canadian Armed Forces, or the Government
It should also be noted that more recently a larger version of of Canada. Use of trade or brand names in this publication is
the EEHS, commercially known as the Hyperlite 3 (SOS Group, for illustrative purposes only and does not imply endorsement
London, UK) is now available and can support two individuals. by the U.S. Government or the Government of Canada.
Due to the space limitations described above, significant con-
cerns exist regarding the loading of this model for transport in Disclosures
the MH65 or H145. Additional testing is recommended. The authors have nothing to disclose.

Finally, clinician and aircrew perception and knowledge of Funding
EEHS transport in a rotary wing airframe was not assessed No funding was received for this work.
in this paper and remains unknown. Due to logistical and
safety limitations, the EEHS could not be pressurized during References
testing as would be optimal. However, as this was a previous 1. United States Navy. U.S. Navy diving manual, Revision 7. Naval
generation “tube” of increased size and integral rigidity, this Sea Systems Command. 2016. Accessed January 14, 2026. https://
helped mitigate any dimensional differences versus a pressur- www.navsea.navy.mil/Portals/103/Documents/SUPSALV/Diving/
US%20DIVING%20MANUAL_REV7.pdf
ized chamber of current production. The requirements for safe 2. National Oceanic and Atmospheric Administration. Operating
transport of an EEHS must be known and accounted for. A standards for NOAA hyperbaric chambers. 2017. Accessed No-
lack of knowledge in this regard may result in negative im- vember 27, 2024. https://www.omao.noaa.gov/sites/default/files/
pacts on patient transport. documents/NOAA%20Operating%20Standards%20for%20
Hyperbaric%20Chambers%20Final%2001-2017.pdf
3. United States Navy. Operation and maintenance manual for the emer-
Conclusion gency evacuation hyperbaric stretcher, Revision 7. Diving & ROV
Specialists. 2007. Accessed January 14, 2026. https://diving-rov-
EEHS users should not take for granted that their intended specialists.com/index-b-documents_htm_files/docs-9-evacuation-
evacuation platform will accept the device. It would be po- hyperbaric-stretcher.pdf
tentially harmful to initiate HBO treatment and then discon- 4. Sylvester JC, Krock LP, Eshelman RE. Testing and evaluation of the
2
tinue it prior to completion in order to conduct transport, and SOS, Ltd., Hyperlite, Emergency Evacuation Hyperbaric Stretcher,
yet a critically ill patient may not be well-served by remain- Model 24/88/SAT/70. Defense Technical Information Center. 2000.
ing in the field within such a monoplace chamber. Advance Accessed November 27, 2024. https://apps.dtic.mil/sti/tr/pdf/ADA
communication with the expected helicopter transport entity 389819.pdf
would allow for preparation both by the EEHS operator and PMID: 41848501;
the flight crew. Pre-planning where the EEHS operator will DOI: 10.55460/J.Spec.Oper.Med.2026.CUVA-RU2M
sit, the means to secure the EEHS to the airframe, and where

92 | JSOM Volume 26, Edition 1 / Spring 2026