Recent Issues and Advances in Aeromedical Evacuation (MEDEVAC)

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T-4 These operational requirements are based on the fact that it is not sensible for nations to com- pete for Aeromedical Evacuation in a multinational theater of operat ions. Frank (paper # 11) discussed U.S. Transportation Command’s (US TRANSCOM) efforts to regu- late global movement for world- wide intertheater aeromedical evacuation. Working closely with all levels, US TRANSCOM’s Sur- geon is developing TRANSCOM’s Regulating and Command and Con- t rol Evacuation System (TRAC2ES). It provides three major data pieces: patient information requirements, recei- ving medical treatment facility capability and patient transportation capability. In her presentation Ms Fonne (paper # 12) dealt with the impact of occupational differen- ces in air rescue crewmembers which could interfere with the mission. With regard to medical treatment and evacuation (paper # 13), Lynch noted the impor- tance of a sustainment training priority. Habitual training and support relationships are necessary in peacetime if they are to be effective in missions. 6.3Medevac Transfer of Casualties: Converted Air Carriers and Hos- pital Shim Nielsen (paper # 14) explained a different Danish approach to airvac transport utilizing stan- dardized ambulances which are driven onboard a C-130 Hercules, permitting door to door transport. However, this solution is only practicable for individual cases. In this context, a new concept of consolidated contai- ner based system for use in the C-130 was introduced. How to deal with a mass casualty situation was explored by Nist- ler (paper # 15). She presented a conversion kit for the Boeing 767, which was certified by FAA for two confi- gurations (111 or 87 litter patients). Medical oxygen and electrical outlets are available at each potential litter posit ion. Civilian airline pilots w i l l fly the Civil Reserve Air Fleet Aeromedical Evacuation Shipsets (CRAF- AESS). 19 complete shipsets out of 44 have been delivered to date. The prototype UH-6OQ Blackhawk with enhanced navigation and communication, and improved access to patients and medical uti 1 ities improves US-Army ability to perfom typical Mede- - vac missions . Some components of the medical interior require refinements, however, as Licina - stated in paper # 16. Similar results were shown by Schroedl (paper # 17) when he described the capabi 1 ities and perfor- mance of the CH-53 G as a con-- verted airvac helicopter cur- rently used by the German Army. Due to the shortage of hospital beds Cdr Knutsen presented in paper # 18 the Norwegian approach to convert civilian vessels into hospital ships. So far 17 vessels have been pre-requisi- tioned. However, cost is a major concern. Equ i pment
Spencer suggested in Paper #20 that a 'Full Airworthiness Stan- dard' yet to be determined for aeromedical equipment could be the basis for coordination of Medevac equipment scales used by NATO allies. In paper # 21, Richardson introduced a commercially available transportable pressure ventilator, that is approved for USAF aeromedical evacuation use. It permits the aeromedical evacuation of ventilator dependent patients using any liquid or pressurized oxygen system deli- vering a pressure of 20 to 50 psi. The question whether an Onboard Telemetry Equipment should be carried on a Medevac helicopter was discussed by Lynch (paper # 22 by Granger). Based on own experience, he concluded that it is unnecessary and a poor utili- zation of scarce resources to provide telemetered monitoring of airborne patients in the helicopter evacuation environ- ment. 6.5Combat Casualty Care in the Air The analysis of the effect of aeromedical evacuation on clinical outcomes in patients was discussed by Saenger (paper # 24). In the study, 28,199 patients of the CONUS Aeromedi- cal Evacuation System were screened . There was a total of 26 clinical outcomes reported in 24 patients during this period for a rate of 0.09 %. It was summarized that the adverse clinical outcome rate for AE patients is very low, however "high risk" patients should be followed up by specialists within 48 hours after A. E. Mild hypoxia in a pressure cabin may adversely affect the oxygen supply of patients whose lung function is reduced. T-5 Christensen (paper # 25) showed in his study that effects of hypoxia on arterial blood gases in subjects with lung dysfunc- tion may occur because of the non-linear shape of the oxygen dissociation curve and the effect of impaired lung function. The drop in Sa02 was signifi- cantly correlated with poor lung ventilation, with low lung diffusion capacity and with the extent of pulmonary shunting. This has to be considered for A. E. 6.6 Combat Casualty Care Providers Specialized and trained Medevac personnel has proven t o have the specific experience and training to perform in the role of in-flight medical attendant. Lyons (paper # 26), evaluated the role of flight surgeons. In his opinion, the presence of physicians on the crew has distinct advantages. Their understanding of the AE system enables them to provide sophisticated medical coverage of transiting patients. In conclu- sion he recommended, that agen- cies with,MEDEVAC units should consider assigning flight surgeons to these units. The necessity of specalized nursing personnel for air eva- cuated patients was noted by Katsi ka and Papastogianidou (paper #27). They illustrated the Flight Nurse school in the Hellenic Air Force, which was established in 1988. Apart from education, a primary goal is to integrate the school into the air evacuation system of the Hellenic Air Force. 7. CONCLUSIONS 7.1.Aeromedical evacuation is medi- cally necessary. It opens the wide scale of sophisticated care at home and guarantees a high standard of medical care in the theatre.
Page 1: d m 9 n 0 A z 3 AGARD-CP-554 AGARD
Page 4 and 5: The Mission of AGARD According to i
Page 6 and 7: Aerospace Medical Panel Chairman: P
Page 8 and 9: Experience Learned from the Spanish
Page 11 and 12: * 1. 2. 3. SYMPOSIUM RECENT ISSUES
Page 13: Several papers reviewed the intra-
Page 19 and 20: ADVANCED TRAUMA LIFE SUPPORT (A.T.L
Page 21 and 22: are reassessed. The total patient e
Page 23 and 24: epidemiologic characteristics of in
Page 25: PHYSICIAN PARTICIPATION IN THE A.T.
Page 28 and 29: 1-2 applicability of the TOC applie
Page 30 and 31: 1-4 INJECTION: Total force integrat
Page 32 and 33: 2-2 The Canadian Air Force flies si
Page 34 and 35: 2-4 Canada, and to have returning p
Page 36 and 37: 2-6 our operational airevac plans,
Page 38 and 39: 3-2 concentrated on establishing an
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Page 51 and 52: CRITICAL EVALUATION OF AEROMEDICAL
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EXPERIENCES LEARNED FROM THE SPANIS
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specialist support if needed, from
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SUMMARY The complexity and dynamics
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Deliberate Planning Deliberate Plan
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12-2 consequence development of a c
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12-4 Pilot Doctor Paramedic Norway
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12-6 practices and values, crews wh
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- .
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13-2 The requirement for dedicated
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14-2 road vehicle. At present 3 suc
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- - Civil Reserve Air Fleet-Aeromed
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- SUMMARY FIRST MEDICAL TEST OF THE
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Medical equipment tests The U.S. Ar
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8. Bruckart, J.E. and Licina, J.R.,
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17-2 3 Operational Concepts By the
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- Summ'q htemational Access to Aero
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There are four levels of interface
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20-2 5.2 Power Sources 5.2.1 Extern
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20-4 12. APPLICABILITY OF STANDARDS
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1. INTRODUCTION Mechanical ventilat
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2.4. Ground transportation: The loc
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providers receive training and demo
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22-2 population supported during an
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22-4 ~ Number Reauirement for Onboa
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Care in the Air - A System Analysis
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Regllhlthg: patient Report SfhedOli
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- without examining the. patient. T
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need a pocedure it shouldbe aecompl
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25-2 where Eqa02 is the alveolar ve
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25-4 we found to influence the insp
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26-2 the flight surgeon was largely
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26-4 addition, an increasing number
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26-6 10. Rhee, K.J.; Strozeski, M.;
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26-8 TABLE I.B. RETROSPECTIVE REVIE
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26-10 TABLE 11. TOTAL NUMBER OF U.S
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27-2 A) Historical background of th
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27-4 Aircrafts with Flight Nurses a
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REPORT DOCUMENTATION PAGE 1. Recipi
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. I a@- -+- NATO OTAN \I’ 7 RUE A
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Recent Issues and Advances in Aeromedical Evacuation (MEDEVAC)

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