Combat & Casualty Care

Q2 2016

Military Magazines in the United States and Canada, Covering Combat and Casualty Care, first responders, rescue and medical products programs and news\Tactical Defense Media

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Page 30 of 39 Combat & Casualty Care | Summer 2016 | 29 evacuation will affect the medical care provided to soldiers, sailors, airman, marines, other government employees, and civilians. Conf licts of increasing complexity will prevent robust prepositioning of medical supplies and personnel with appropriate skills. The resulting just in time transport requirements will necessitate more frequent utilization of alternate transport mechanisms, such as ship and railways, due to the limited availability and increased costs of rapid air transport. Contracting with private entities may decrease reliance on a few military units but realistically, the Department of Defense will still have the mission of moving personnel and material along with the evacuation of our wounded. "Bullets, beans and band aids" are the terms often heard when considering multipurpose movement requirements into the theater of operations. Prioritization of aircraft and mission assignments may result in decreased capacity for medical teams and supplies. Limited access to forward operating bases will require small team medical tactics to support the mission. These medical roles are not typically filled by civilians or contractors. There are no longer dedicated aircraft available for aeromedical evacuation and aircraft of opportunity are routinely utilized for patient movement. This provides f lexibility, but also increases training requirements. We are discovering there is much to learn about patient injury types in a combat environment and we must provide additional research to assist our decision making process of how and when to move these patients. Point of Injury/Evac Prep Care Current airframes are typically large cargo aircraft in the U.S. military inventory such as the C17, C130, KC135 and others for long distance movement. Theoretically, these airframes are moving supplies and equipment into theater and transporting patients back to more sophisticated medical care in the regional theater hospital or directly back to the U.S. These are just a few of the recent achievements of our military medical teams. Future conf licts will see the tyranny of distance become a significant factor and may degrade some of these recent enhancements. Concepts and procedures for prolonged field care and resources for tactical and strategic enroute care are the next step for prioritized development to support current and future missions. This will assist the DoD in meeting the challenges of the tyranny of distance. Care in the Air Unique concepts and equipment need to be developed, procured and deployed in order to keep our excellent survival statistics and meet the challenges of the tyranny of distance. Advances in telemedicine capabilities, remote monitoring and decision support will be required. In order to facilitate current care and these suggested advancements, a f lying intensive care unit will need to be employed. Current modules exist and can be utilized to enhance enroute care. Physiologic changes affect the patient and also the medical crew members. Prolonged missions in both time and distance will require improvements over current aircraft of opportunity and " bulk head medicine." MedEvac Spotlight Evolution in Mobile Care During the recent combat experience, we have decreased the lethality of injuries and decreased suffering by developing novel techniques and policies: 1. Additional training for our soldiers in the field for hemorrhage control and airway management 2. Enhanced small medical teams with expert resuscitation, critical care and surgical expertise 3. Rapid evacuation (DoD policy guidance to evacuate a patient within one hour) 4. Development of Joint Trauma Registry (to collect and analyze data) Maximized Medical Solutions For The New Global Environment Medevac Pallets • Specialized Medical Modules • Universal Patient Modules (UPM) • Aeromedical Biocontainment Modules (ABCM) This modular capability optimizes our ability to overcome the tyranny of distance in critical times. -Lieutenant General (Dr.) Paul K. Carlton (Retired) US AF Surgeon General

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