You can get an image of the Air Force Combat Action Medal here: en.wikipedia.org/wiki/Air_Force_Combat_Action_Medal . And check out the description there of the difficulty of obtaining the ribbon style used for this medal.

The ribbon's diagonal stripe at first could not be manufactured in the United States; but military medals cannot be manufactured outside the U.S. This design problem was resolved when a mill in Pennsylvania, Bally Ribbon Mills, bought a new loom specifically to weave the diagonal stripe. A Rhode Island firm, Ira Green Inc. in Providence, made the metal parts.[2]

The medal is the only award of the United States military to have a diagonally patterned ribbon, much like various British awards (such as the Distinguished Flying Cross).