Emergency War Surgery NATO Handbook: Part III: General Considerations of Wound Management: Chapter XIII: Aeromedical Evacuation
United States Department of Defense
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As the intensity of combat operations varies, so varies the flow of wounded and the strain placed upon all echelons of medical care. At the same time, the ever-present requirement of maintaining available bedspace for additional incoming casualties creates the constant requirement for evacuation of those occupying the system's forward beds. The provision of optimal, individualized surgical care, in concert with the efficient utilization of resources, necessitates close coordination between the direct care providers at all levels and those responsible for the administration 'and operation of the full spectrum of medical evacuation.
Aeromedical evacuation is a modern, complex transportation system designed to move casualties rapidly. Appropriate utilization of this system markedly reduces the time lapse from initial wounding to definitive care. That such rapid movement of patients results in overall decreases in morbidity and mortality has been demonstrated repeatedly in recent conflicts. This holds true regardless of the category of patients considered.
At the point of initial wounding, where medical capability is limited to first-aid measures, dedicated rotary-wing air ambulances are utilized to provide rapid transfer of the casualty to an area providing first-line resuscitation capability. Triage is accomplished at each echelon of medical care Patients are evaluated at aeromedical evacuation battlefield collecting points and categorized as to their relative needs and general stability. From these collection points, and with an awareness of each casualty's individual clinical needs and personal stability, further retrograde movements are programmed. Patients may be removed from the evacuation chain at any medical facility along the evacuation route when it is the professional opinion of the evaluating surgeon that patient safety will be compromised by continued transfer.
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