Casualty Air Evacuation: Sine quo non of combat casualty

Abstract

Management of combat casualties has always been a challenging task. Armed Forces world over have developed effective casualty air evacuation mechanisms. The history of casualty evacuation dates back to 1870s. The first evacuation of casualty by air was during the First World War. The paper highlights the background and evolution of air evacuation in the world and discusses the Indian Scenario of casualty air evacuation. The casualty evacuation capabilities of the aircrafts in the Indian Air Force (IAF) are highlighted. To ensure prompt casualty evacuation, the Armed Forces have a chain of casualty air evacuation, thus ensuring that the injured reach the health care center in the least possible time. An indigenously developed patient transfer unit (PTU) comprising of a trauma care recovery trolley with a complement of a portable ventilator, multipara monitor, infusion pumps and oxygen system is also discussed. In addition, the paper discusses the aeromedical considerations while evacuating casualties by air and contraindications for air evacuation. The advancements in the field of medical technology and medical care has ensured safe air evacuation of casualties and has reduced the morbidity and mortality of casualties, thus boosting the morale of the troops.

Air Medical Casualty Evacuation in High Altitude: An Experience of 100 Cases in High Altitude and Hilly Terrain of Northern India

“…[3] The use of air transport to provide medical evacuation on the battlefield dates to First World War and continued during the Korean and Vietnam wars. [4] Later on, aircraft began to be used for the civilian emergency medical services. Aeromedical evacuation (AE) is referred to the long-distance usually greater than 300 miles, air transportation of patients after medical treatment that is adequate to assure a successful movement.…”

“…Often these air ambulances are specially designed, and they carry patient transport unit (PTU) with facility of special wheeled trolley having multipara monitor, infusion pumps, and oxygen cylinders with oxygen delivery system, suction apparatus and defibrillator. [4] Vital signs can be recorded at constant intervals by multipara monitor and all medical support is possible due to availability of all essential equipment and drugs on board.…”

“…While transferring any person with long bone fracture and diagnosis of fat embolism, airway should be secured as there is chance of further spillage of fat globules into circulation due to vibration inside the helicopter. [4] Cap should be applied over head with a cushion of cotton to prevent effect of cold and prevention against injury. Eyes should be covered too to prevent introduction of any foreign particles and exposure keratitis.…”

The “critical” link in the transport of critically ill patients; role of the anesthesiologist and challenges in the Indian setup

“…[1] Army Medical Corps personnel of the Indian army are actively involved in rescue operations from remote locations and difficult terrain, including those for medical emergencies. [6] The technology and infrastructure of the armed forces and its presence in numerous remote, often troubled areas has been a continuous support to the civilian medical setup.…”