449th AEG Airmen Test Readiness During Exercise Pale Serpent

Airmen assigned to the 449th Air Expeditionary Group, in conjunction with Army, Marine Corps and Navy partners, conducted readiness training at Camp Lemonnier, Djibouti, during Exercise Pale Serpent, Dec. 26-29, 2025.

The joint exercise prepared units to respond to real-world contingencies across East Africa.

The exercise placed different 449th elements into parallel training scenarios designed to test how each mission set could operate in a high-tempo environment, from trauma care to aeromedical evacuation.

At Chabelley Airfield, Djibouti, Air Force medical personnel assigned to the 776th Expeditionary Air Base Squadron treated simulated casualties inside the installation's medical treatment facility alongside partner medical teams, practicing trauma care, triage and patient stabilization.

"Triage took place outside, and then we were assigning casualties into the appropriate rooms," said Air Force Tech. Sgt. Gracie Livengood, 776th Expeditionary Air Base Squadron, aerospace medical service technician. "The most immediate patients came into the trauma bay, and we treated them while delayed and minimal patients were handled in the other bays."

The scenario forced medics to manage multiple patients at once while working through limited space, equipment and personnel, requiring constant communication and rapid decision-making across the treatment teams.

"This training helps us get prepared if an actual emergency happens," Livengood said. "It ensures our skills are up to date, that we're doing everything properly and that we have the equipment we need to provide the best quality of care."

Livengood said the exercise also highlighted the importance of teamwork in high-stress medical situations.

"There are always challenges, especially when we're relatively short-staffed for a mass-casualty exercise," Livengood said. "But everyone did really well, helping each other out, moving from bed to bed and making sure people were taken care of."

While medical teams trained at Chabelley, aeromedical evacuation personnel assigned to the 10th Expeditionary Aeromedical Evacuation Flight conducted parallel readiness training at Camp Lemonnier, preparing to move patients from the expeditionary medical facility to higher levels of care.

During Pale Serpent, the 10th EAEF employed its full aeromedical evacuation capability, including a critical care air transport team consisting of a physician, critical care nurse and respiratory therapist, along with two flight nurses and four aeromedical technicians.

"Having aeromedical evacuation capabilities in this region is important so we can quickly move patients to a higher echelon of care," said Air Force Maj. Christina Newby-Martinez, 10th EAEF commander. "We're trained to provide the capability to rapidly move large numbers of patients by air during mass casualty events, which ensures timely redistribution of casualties to appropriate medical facilities."

When this capability is integrated with critical care air transport teams specialized in transporting critically ill patients who require advanced, intensive and continuous medical care en route, there is a seamless transition of care across the full spectrum of patient acuity, Newby-Martinez explained.

Exercises like Pale Serpent are essential for preparing crews to operate under pressure.

"Training like Pale Serpent tests how quickly our teams can respond, pushes them to work outside of their normal crew complement and forces them to be ready for the unknown injuries that could arrive on an aircraft," Newby-Martinez said. "It also helps us see where we need to improve communication when we're working in a multi-service environment."

Although 449th AEG elements trained in different locations, their efforts strengthened their ability to respond immediately and effectively to mass-casualty emergencies, reinforcing crisis readiness at one of U.S. Africa Command's most operationally critical hubs in East Africa.