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

Holland, Seth R.; Apodaca, Amy; Mabry, Robert

doi:10.7205/milmed-d-12-00286

Cited by 16 publications

(8 citation statements)

References 30 publications

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“…The US military employs both DUSTOFF evacuation helicopters staffed with a medic capable of providing basic life support and the PEDRO air evacuation teams, which include on-board fighting paramedics. Continued efforts are made to upgrade the level of training of these teams, promoting improved medical and operational capabilities (34). The British Royal Air Force operates the MERT, a platform manned by two paramedics, one physician and a nurse, capable of providing advanced life-saving interventions, including transfusion of blood products.…”

Section: Medical Evacuationmentioning

confidence: 99%

A Decade of Advances in Military Trauma Care

et al. 2014

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Background: While combat casualty care shares many key concepts with civilian trauma systems, its unique features mandate certain practices that are distinct from the civilian ones. Methods: This is a review of the most current literature on combat casualty care, based on computer database searches for studies on combat casualty care and military medicine. Studies were selected for inclusion in this review based on their relevance and contribution. Results: Over the last decade, meticulous, international data collection and research efforts have led to significant improvements in military trauma care. Combat medicine has focused on the causes of preventable deaths and targeted on bleeding control and resuscitation strategies, as well as improved evacuation. En route care and forward surgical interventions have resulted in unprecedented low fatality rates and the saving of more lives. Conclusion: This overview of the developments in combat casualty care in recent years emphasizes medical practices that are characteristic of combat medicine, yet with the potential to save lives in other scenarios, as well.

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Section: Medical Evacuationmentioning

confidence: 99%

A Decade of Advances in Military Trauma Care

et al. 2014

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“…Given that our study found that short evacuation times appear to confer the greatest benefit in those patients suffering from NCTI + AMP and other studies have found NCTI to be a leading cause of preventable combat mortality [ 7 , 9 ], when feasible, evacuation times of patients with NCTI should remain under 30 min. In those circumstances where transport of NCTI patients from the POI to a Role 2/3 facility is not possible, rapid access to blood products, forward deployed advanced medical providers and advanced en route care capabilities, and/or resources for the control of NCTI may decrease mortality [ 1 , 2 , 13 ].…”

Section: Discussionmentioning

confidence: 99%

“…Aeromedical evacuation platforms such as MEDEVAC allow for urgent evacuation to medical treatment facilities (MTF) that can provide the more complex, necessary lifesaving interventions that are not otherwise possible at point of injury (POI) or en route. Transport times may vary depending on environmental factors and the ability to land in combatant locations [ 2 ]. Urgent response and transport can be delayed due to tactical issues, which may interfere with timely life-saving care.…”

Section: Introductionmentioning

confidence: 99%

Impact of prehospital medical evacuation (MEDEVAC) transport time on combat mortality in patients with non-compressible torso injury and traumatic amputations: a retrospective study

et al. 2018

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BackgroundIn combat operations, patients with traumatic injuries require expeditious evacuation to improve survival. Studies have shown that long transport times are associated with increased morbidity and mortality. Limited data exist on the influence of transport time on patient outcomes with specific injury types. The objective of this study was to determine the impact of the duration of time from the initial request for medical evacuation to arrival at a medical treatment facility on morbidity and mortality in casualties with traumatic extremity amputation and non-compressible torso injury (NCTI).MethodsWe completed a retrospective review of MEDEVAC patient care records for United States military personnel who sustained traumatic amputations and NCTI during Operation Enduring Freedom between January 2011 and March 2014. We grouped patients as traumatic amputation and NCTI (AMP+NCTI), traumatic amputation only (AMP), and neither AMP nor NCTI (Non-AMP/NCTI). Analysis was performed using chi-squared tests, Fisher’s exact tests, Cochran-Armitage Trend tests, Shapiro-Wilks tests, Wilcoxon and Kruskal-Wallis techniques and Cox proportional hazards regression modeling.ResultsWe reviewed 1267 records, of which 669 had an injury severity score (ISS) of 10 or greater and were included in the analysis. In the study population, 15.5% sustained only amputation injuries (n=104, AMP only), 10.8% sustained amputation and NCTI (n=72, AMP+NCTI), and 73.7% did not sustain either an amputation or an NCTI (n=493, Non-AMP/NCTI). AMP+NCTI had the highest mortality (16.7%) with transport time greater than 60 min. While the AMP+NCTI group had decreasing survival with longer transport times, AMP and Non-AMP/NCTI did not exhibit the same trend.ConclusionsA decreased transport time from the point of injury to a medical treatment facility was associated with decreased mortality in patients who suffered a combination of amputation injury and NCTI. No significant association between transport time and outcomes was found in patients who did not sustain NCTI. Priority for rapid evacuation of combat casualties should be given to those with NCTI.Electronic supplementary materialThe online version of this article (10.1186/s40779-018-0169-2) contains supplementary material, which is available to authorized users.

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“…Multiple studies have been conducted evaluating the en route care of patients during transport from point of injury to first MTF (role 2 and/or 3) 5,12,[14][15][16][17][18][19][20][21][22] and out of theater to the role 4 medical center in Landstuhl, Germany. 12,[19][20][21][22][23][24][25][26][27][28] A few published reports have described patients treated by individual forward surgical teams (role 2) during specific deployments, but these studies do not include information related to patient transport.…”

Section: Discussionmentioning

confidence: 99%

En Route Critical Care Transfer From a Role 2 to a Role 3 Medical Treatment Facility in Afghanistan

Staudt

Savell²,

Biever³

et al. 2018

Critical Care Nurse

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Background En route care is the transfer of patients requiring combat casualty care within the US military evacuation system. No reports have been published about en route care of patients during transfer from a forward surgical facility (role 2) to a combat support hospital (role 3) for comprehensive care. Objective To describe patients transferred from a role 2 to a role 3 US military treatment facility in Afghanistan. Methods A retrospective review of data from the Joint Trauma System Role 2 Database was conducted. Patient characteristics were described by en route care medical attendants. Results More than one-fourth of patients were intubated at transfer (26.9%), although at transfer fewer than 10% of patients had a base deficit of more than 5 (3.5%), a pH of less than 7.3 (5.2%), an international normalized ratio of more than 2 (0.8%), or temporary abdominal or chest closure (7.4%). The en route care medical attendant was most often a nurse (35.5%), followed by technicians (14.1%) and physicians (10.0%). Most patients (75.3%) were transported by medical evacuation (on rotary-wing aircraft). Conclusion This is the first comprehensive review of patients transported from a forward surgical facility to a more robust combat support hospital in Afghanistan. Understanding the epidemiology of these patients will inform provider training and the appropriate skill mix for the transfer of postsurgical patients within a combat setting. (Critical Care Nurse. 2018;38[2]:e7-e15)

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

Abstract: There is a statistically significant improvement in the HCT, BD, SpO 2 , and 48-hour survivability at the CSH in the cohort transported by the CCFP group when compared to the cohort transported by the EMT-B group.

Cited by 16 publications

References 30 publications

A Decade of Advances in Military Trauma Care

A Decade of Advances in Military Trauma Care

Impact of prehospital medical evacuation (MEDEVAC) transport time on combat mortality in patients with non-compressible torso injury and traumatic amputations: a retrospective study

En Route Critical Care Transfer From a Role 2 to a Role 3 Medical Treatment Facility in Afghanistan

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