Command, control: Prescription for aeromedical-evacuation success
by Master Sgt. Paul Fazzini
Air Mobility Command Public Affairs
9/21/2004 - SCOTT AIR FORCE BASE, Ill. (AFPN) -- A battlefield injury or illness poses a threat to those deployed worldwide. When that threat turns into reality, the Air Force’s extensive aeromedical-evacuation network ensures wounded warriors are moved rapidly to a medical facility to get the care they need.
The expansive network includes Airmen here from Air Mobility Command’s tanker airlift control center and the U.S. Transportation Command’s global patient movement requirements center, along with many medics at facilities worldwide. They work together to plan and accomplish every patient movement.
Together, the team becomes the prescription for aeromedical-evacuation success.
The first step in aeromedical evacuation begins long before a servicemember is injured in combat.
“When officials at U.S. Central Command begin planning a military operation, the No. 2 most sought after support is aeromedical-evacuation missions,” said Capt. Tim Smith, a member of the control center’s planning team who specializes in Airmen sourcing and tasking for AE missions. “They want to make sure the wounded get the medical attention they need as quickly as possible.”
To plan for this, CENTCOM officials determine how many missions are required based upon the anticipated number of casualties. They then provide their requirement to TRANSCOM officials here, who in-turn communicate with control center officials to schedule missions and crews.
Every patient aerovac mission is based on an official request initiated from within the theater of operations. There, an attending medical provider determines the clinical status of the patient and the need to move that patient to a facility for the next level of treatment.
“A clinical staff of nurses, medical administrative personnel and a validating flight surgeon work together to validate and classify each patient,” said Lt. Col. Judy Daly, the control center’s AE division chief here. “Patients are classified as urgent, priority and routine at one of several patient movement requirements centers around the world. They also determine means of transportation -- airlift, ground or hospital ships.”
At the global operations center, Lt. Col. Bob Davis and other operations directors work to align aircraft with specific missions.
“We give AE missions a very high priority. First, we look at all suitable aircraft already in the theater [and] available to move the patients. If nothing is available, there is an aircraft sitting in alert status [that] we can fall back on,” Colonel Davis said.
“The directors will go after the aircraft best suited for the patient. If the alert [aircraft] is used, units will begin working to get another one ready to replace it as soon as possible,” Colonel Daly said.
Close communication among all agencies has been and continues to be the reason the Air Force has had such great success in expeditious patient movement worldwide, officials said.
Within the AE environment, the goal is to move routine patients within 72 hours of the official movement request; however, that does not mean it will only take 72 hours to get the patient from the theater to his or her hometown in the United States.
“At each leg of a patient’s journey a clinical re-evaluation is accomplished,” Colonel Daly said. “This is because each leg of the mission, each patient movement, ensures the ‘next level of care,’ and the patient is re-evaluated to determine if (his or her) clinical needs have changed. The 72 hours begins once the next leg of the journey is requested. We normally move the patient faster, within 24 to 48 hours.”
The goal is to move priority patients within 24 hours of receiving a request. The most critical, urgent patients are moved on the first available aircraft to save life, limb or eyesight.
One of the biggest challenges in patient movement is coordinating unscheduled missions.
“When we have to select a specific aircraft to move a patient that wasn’t scheduled, it takes a tremendous amount of communicating with multiple agencies to make it happen,” said Tech. Sgt. Kathy Bredbury, a control center AE mission controller.
While the challenges are great, those in the AE community said they will not accept failure.
“Each request for patient movement means we’re dealing with a person, and we make it happen every time,” Captain Smith said.
There are more than 1,650 scheduled and 350 unscheduled AMC aeromedical-evacuation missions each year. Making it all come together is an AE team composed of aircrew and medics, including the Air National Guard and Air Force Reserve. Guardsmen and reservists account for 87 percent of the AE community.
“When we look to task aircrews and medical teams, we first look to the Guard and Reserve,” Captain Smith said. “If they can’t support, we’ll task the active-duty personnel, and as a last resort, initiate a partial mobilization.”
Initially, individuals like Tech. Sgt. Mark Major, of the control center’s AE allocation division, will reach out to guardsmen and reservists who want to support the mission.
“When it comes to getting the patient where (he or she needs) to go, we’ll always start with volunteers,” he said. “We could never do it without the Guard and Reserve, and fortunately we rarely experience a shortage of people wanting to do the job.”
No matter whether they are volunteers from the Guard and Reserve or are dedicated active-duty Airmen, the AE prescription is filled when those who plan, allocate and accomplish an aeromedical-evacuation mission ensure patients are given the best care possible and are either returned to their family or returned to duty, officials said. (Courtesy of AMC News Service) |
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