Disaster aeromedical evacuation

Successful disaster aeromedical evacuation depends on applying the principles learned by moving patients since World War II, culminating in today's global patient movement system. This article describes the role of the Department of Defense patient movement system in providing defense support to civil authorities during the 2008 hurricane season and the international disaster response to the 2010 Haiti earthquake. Adapting and applying the principles of active partnerships, establishing patient movement requirements, patient preparation, and in-transit visibility have resulted in the successful aeromedical evacuation of over 1,600 patients since the federal response to Hurricane Katrina.     

Management control of aeromedical evacuation systems

Aeromedical evacuation has been extensively used by military forces for evacuation of wartime casualties, but has also proven useful in civilian disaster response. In contrast to the broad coverage of the clinical aspects of the aeromedical evacuation, the operational and management control issues have rarely been addressed. The sophisticated battlefield of the 1980s has had an impact also in air evacuation, adding to the factors to be considered before launching an evacuation mission. The professional control of aeromedical evacuation is, therefore, crucial to the efficient and smooth operation of this high-cost resource. In an attempt to shed light on some of the operational perspectives of military air evacuation, the Israeli experience in the management control of such systems is discussed.     

Systems analysis of an aeromedical evacuation mission

The author applies general systems theory to the analysis of a social system. Through an examination of information processing in an aeromedical evacuation mission, more meaningful levels of coordination evolve. Thus system analysis, as applied here, is an approach used to not only describe an organization but, more importantly, to clearly discern the interrelationships inherent in an activity of major significance such that change or improvement, if needed, may the more readily result.     

Strategic aeromedical evacuation: the inaugural flight

Strategic aeromedical evacuation, a vital subsystem of the overall aeromedical airlift system, had its beginning in a confidential, poorly planned, poorly coordinated Air Transport Command flight from Karachi, Pakistan (then part of India) to Washington, DC, in January 1943. That the flight was successfully completed was due in large measure to the untiring efforts of the nurse, Second Lieutenant Elsie S. Ott, aboard the flight. Lessons learned in the form of recommendations made by Lt. Ott were implemented to improve succeeding strategic aeromedical evacuation missions. Largely through Lt. Ott's efforts, long range aeromedical evacuation was demonstrated to be a practicable method of transportation for seriously ill and wounded patients. A new dimension had been added to the overall aeromedical airlift mission.     

Marie Marvingt and the development of aeromedical evacuation

The development of air ambulances was one of the most important advances in military medicine in the 20th century. It is often forgotten today how difficult a task it was to achieve military, governmental, popular, and medical support in the early years of the century for this then-heretical concept. While many individuals were involved in this development, one of the most influential and effective proponents was Mademoiselle Marie Marvingt, of France. One of the foremost sports-women of her day, she was a free balloon pilot, a surgical nurse, and the third woman in the world to receive her fixed-wing pilot's license. In the area of air evacuation, she was a true visionary, ordering the construction of an air ambulance in 1912, and devoting the remainder of her long life to gaining its full acceptance in the medical armamentarium. Unlike many visionaries, she lived to see the full adoption of her proposals; her efforts should forever be remembered whenever an air ambulance is seen.     

空运医疗车在运-8C上的应用

2007年6月,我院空运医疗队首次在运-8C飞机上使用了空军航空医学研究所最新研制的空运医疗(推)车.现将我们的使用情况及体会介绍如下.     

A 55-year-old mechanically ventilated male requiring aeromedical evacuation

Objective: To present a case that illustrates the problems unique to transporting a mechanically ventilated patient by air. A 55-year-old mechanically ventilated male with Guillain-Barre Syndrome, a condition with respiratory effects often similar to those of traumatic brain injury, required air transport from Walter Reed Army Medical Center in Washington, DC, to a hospital in Nevada. A medical team, including one physician, one nurse, and one respiratory therapist, accompanied the patient. This team was not trained in air travel and its unique risks. To complete the mission they had to rapidly familiarize themselves with the specific risks of air travel and the precautions that should be taken. This case is presented to illustrate these risks and what can be done during flight to minimize them.     

Samuel Franklin Cody: aviation and aeromedical evacuation pioneer.

In the summer of 1913, Woodrow Wilson had just become the 28th President of the United States and King George V was on the throne of the United Kingdom. It was nearly 10 yr since the historical flight at Kitty Hawk and 3 yr since Blériot had first flown the English Channel. At Farnborough, "Colonel" Samuel F. Cody, originally a horseman, hunter, crack shot, showman and theatrical impresario from the USA, was preparing a new floatplane for a round Britain flying race. One of the features of the floatplane, a biplane with a four bladed pusher propeller, was that it had already demonstrated its ability to carry passengers. Cody calculated that it would allow him to carry five passengers for a 4-h flight and may even have medical uses. He arranged a demonstration of its potential as an air ambulance at Farnborough. This paper describes, with the use of photographs of the event, the airplane, the demonstration and the reasons why it would be left to others to carry out the first, real aeromedical evacuation 4 yr later.     

Comparison of three strategies for preventing hypothermia in critically injured casualties during aeromedical evacuation

Critically injured patients are at risk for hypothermia. This study determined the efficacy of three hypothermia prevention strategies: the ChillBuster warming blanket, ChillBuster with a reflective blanket, and two wool blankets. A quasi-experimental design was used to compare changes in core temperature. Following resuscitation from hypovolemic shock, 20 swine were assigned to one of the three interventions, placed in an environmental chamber set to reproduce in-flight conditions onboard a military cargo aircraft (50 degrees F/airspeed 0.2 m/s), and monitored for 6 hours. A repeated measures analysis of variance and least-squared difference post hoc were performed. The ChillBuster/reflective blanket group was significantly warmer than the ChillBuster only group and the wool blanket group (p < 0.01). After 6 hours of cold exposure, the ChillBuster/reflective blanket group remained warm while the ChillBuster only and wool blanket groups developed mild hypothermia. Combined use of a warming blanket and reflective blanket was effective in preventing hypothermia over 6 hours and is feasible in a deployed military environment.     

Simulated aeromedical evacuation exacerbates burn induced lung injury: targeting mitochondrial DNA for reversal

Background: Aeromedical evacuation of patients with burn trauma is an important transport method in times of peace and war, during which patients are exposed to...     

西方国家军队空运医疗后送体系建设综述

目的 综述当前西方国家军队空运医疗后送体系建设的特点和发展趋势,指出构建完善的空运医疗后送体系所需的要素.资料来源与选择 国内外相关领域的学术专著、公开发表的学术论文和研究报告.资料引用 引用文献27篇.资料综合 近年来,空运医疗后送作为西方国家军队伤病员后送的首选方式,在组织指挥、保障力量、卫生装备、专业训练和法规制度建设方面更加完善,在平战时伤病员救治中发挥了重要作用.目前各国关注的重点是通过研发、改进卫生飞机及机载医疗设备,加强空运医疗人员训练来提高途中救治能力.同时,提供机上远程医疗服务已成为外军空运医疗后送体系建设的发展趋势.结论建立完善的组织指挥体系,加快研发专用卫生飞机,加强空运医疗后送人员训练将是我军空运医疗后送体系建设的重点.     

西方国家军队空运医疗后送体系建设综述

目的 综述当前西方国家军队空运医疗后送体系建设的特点和发展趋势,指出构建完善的空运医疗后送体系所需的要素.资料来源与选择 国内外相关领域的学术专著、公开发表的学术论文和研究报告.资料引用 引用文献27篇.资料综合 近年来,空运医疗后送作为西方国家军队伤病员后送的首选方式,在组织指挥、保障力量、卫生装备、专业训练和法规制度建设方面更加完善,在平战时伤病员救治中发挥了重要作用.目前各国关注的重点是通过研发、改进卫生飞机及机载医疗设备,加强空运医疗人员训练来提高途中救治能力.同时,提供机上远程医疗服务已成为外军空运医疗后送体系建设的发展趋势.结论建立完善的组织指挥体系,加快研发专用卫生飞机,加强空运医疗后送人员训练将是我军空运医疗后送体系建设的重点.     

Physician roles in aeromedical evacuation: current practices in USAF operations

Physicians play an increasingly important role in the critical medical process of aeromedical evacuation (AE). Incomplete or inappropriate preparation for AE can result in increased patient discomfort, and in the worst cases, potentially serious or insurmountable in-flight medical problems. During military operations and in response to natural disasters, physicians are responsible for four processes necessary for a successful AE mission. These include: 1) AE screening, including determination of appropriate classification, precedence, and special medical requirements; 2) validation; 3) medical preparation; and 4) clearance. Physicians responsible for preparing patients for AE need to understand both the patient evacuation system and the unique medical aspects associated with AE. The U.S. military patient evacuation system is comprised of three principal transportation phases: casualty evacuation; inter-theater AE; and intra-theater AE. Important elements of the USAF AE system are patient movement requirements centers, the validating flight surgeon, aeromedical staging facilities, AE liaison teams, aeromedical crews, and critical care air transport (CCAT) teams. Important medical aspects unique to AE include the effects of flight physiology on medical conditions, oxygen limitations, and distinctive medication and supplies requirements.