Doctor on board? What is the optimal skill-mix in military pre-hospital care?

Abstract

MERT-E is a high value asset which makes an important contribution to patient care. A relatively small proportion of missions require interventions beyond the capability of well-trained military paramedics; the indirect benefits of a physician are more difficult to quantify.

Trauma treatment in a Role 1 medical facility in Afghanistan

“…With regard to trauma mechanism, 30% of the patients had suffered GSW, which is slightly higher than recent studies15 16 but similar to older studies 6. As anticipated, military personnel represented the largest number of GSWs (12/ 29 patients) compared with civilians (7/35) due to the higher risk of being engaged in small arms fire; some however presented after accidental shootings.…”

Defining the essential anatomical coverage provided by military body armour against high energy projectiles

“…This value was derived from current guidelines produced by the UK and USA for the ‘gold standard’ maximum time interval between notification of injury and arrival of the casualty at the Role 2 medical facility. Although this timeline is achievable in Afghanistan where well established evacuation protocols existed,9 it is recognised that timelines in future conflicts may be significantly longer, especially in early operations 18. Therefore the structures necessitating essential coverage may alter should a timeline of 60 min be unfeasible.…”

MEDEVAC: Survival and Physiological Parameters Improved With Higher Level of Flight Medic Training

“…37,38 Even when it has been proposed to place a provider on board a helicopter to transport patients, the provider needs to be appropriately trained in emergency medicine and/or critical care and have the necessary experience to transport the casaulty. [39][40][41][42][43] Training and experience appear to be key to improved outcomes.…”