Aeromedical Operation: Review

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Table of Contents

Theater aeromedical Evacuation System (TAES)
Trends in aeromedical policies
Comparing and contrasting suitability of different emergency helicopters
Recommendations
Conclusion
Works cited

Aeromedical operations involve provision of intra-theater and inter-theater intervention of injured and sick personnel as they undergo medical check-up while being transported to a medical care center. In respect to military, it can be described as “the movement of patients under medical supervision to and between Military Treatment Facilities by military or military chartered air transportation” (Wayne 12). This paper is a detailed report of what aeromedical entails.

Aeromedical is a sensitive operation that requires specially trained crew members, special medical equipment designed for aeromedical aircrafts, and “special air traffic control considerations to comply with patient driven altitude and pressurization restrictions” (Wayne 23). Aeromedical is essentially entitled to support humanitarian efforts by offering transport for medical check-up (hence improving their chances of recovering); however, it is predominantly used by armed troupes to transport those in need of advanced medical check-up.

The medical fraternity began contemplating on the benefits of transporting their patients by air as early as 1784. It was however not until 1917, that the first air ambulance belonging to a French Dorand AR II took to the skies. The aeromedical industry expanded dramatically over the following few decades. Most of the developments took place in Europe and the USA. The increase in aeromedical transport particularly recorded an exponential increase during World War II conflict. The table below shows the effectiveness of aeromedical in the Korean and Vietnam wars in 1950s and 1960s, when a helicopter was first used as medical evacuation vehicle (Wayne 23).

Table 1: Effectiveness of aeromedical transport

Conflict	Time to care(hours)		Mortality %
World War 1	12-18		8.8
World War II	6-12		5.8
Korea (with Helicopter)	2-4		2.4
Vietnam (with Helicopter)	1-1.4	1.7

Although largely developed by the military, aeromedical industry has of late been embraced by the civilian pre-hospital set-up. “Worldwide, the practice of aeromedical transport, whether for the purpose of pre-hospital casualty response or inter-facility transfer, has been recognized as a vital component in the continuum of patient care” (QFCI 3).

Aeromedical evacuation consists of a number of cycles, all of which are very important. It starts with evacuation of the patient from the scene of conflict or accident. This operation is carried out by specially trained professionals who include a radio operator, a flight medical corpsman and a flight nurse. Communication with the aircraft is handled by the radio operator. The patient is normally transported to the staging area by this team (QFCI 3).

The patient is then stabilized and prepared for transport by the aeromedical staging squadrons evaluate crews (they include aeromedical technicians, flight nurses and health service administrators). These crews coordinate the flight and track the patient. Thereafter, the patients are handed over to the Aeromedical Evacuation Crew who waits at the aircraft. This team is made up of three aeromedical technicians and two flight nurses. The technicians are specially trained to assess and make sure that the aircraft equipment is in order, after which they turn it into a flaying intensive care room.

Theater aeromedical Evacuation System (TAES)

TAES is a flexible program that can be used to satisfy the demands of both military operations and combat operations other than war. TAES is composed of a number of diverse functional components aimed at facilitating “transition of patient movement from a forward user service to the rear for more definitive care” (Miller 1). Basically, the primary goal is to increase the chances of the injured survival. This is attained through opportune, alert and scheduled aircraft. The cargo is by this time brought to the theater by the aircraft and hence termed ‘opportune’. The casualties are essentially back hauled from the theater by the aircraft.

Aeromedical Evacuation procedure is composed of an Advance Echelon Team. This is the team that oversees TAES through provision of liaison with the rest of the user services involved in logistical and site support. In addition, it is their responsibility to establish evacuation procedures as well as performing a stand-alone component as Aeromedical Evacuation Coordination Center is scheduled for creation. The following is an example of a specialist team structure.

Medical Service Corps 2
Aeromedical Evacuation Technician 1
Flight Nurse 1
Logistics 1
Radio operator 1
Radio operator 1
Medical administrator 1
Computer Systems Technician 1

Trends in aeromedical policies

In some countries such as the US, smaller forward medical footprint has been necessitated by smaller contingency operations. Contrary, in the past there used to be a large number of inpatient beds in theaters and hence no need for smaller contingency operations. The heightened demand for Aeromedical Evacuation has nowadays increased since the availability downrange of specialties has since declined. As such, the necessity to transport ‘stabilized’ versus ‘stable’ patients has come about. Stabilized is the scenario where the patients receive initial acre including airway maintenance, treating for shock, and splinting of fractures. Additionally, ‘evacuation and replace’ has become a common policy. It means that, rather than being treated in a theater; a patient is evacuated and replaced if they are not capable of resuming duties soon (Miller 2).

Of late, though still an experimental issue, aeromedical industry is making remarkable breakthrough in telemedicine. It involves sending patient information through electronic transmission. Telemedicine allows tracking of a casualty throughout the entire medical system. “As designed, Aeromedical Evacuation crew members with the aid of a laptop computer could contact destination physicians with updates or for new orders without having to go through the pilot.” (Miller 2).

Figure 1. Aviation tasking procedure flow charts (aeromedical primary response)

Comparing and contrasting suitability of different emergency helicopters

Agusta 109

Has a high performance for operating in high altitude and high temperature rescue missions, therefore suitable for mountainous regions.
It has a spacious passage cabin and sufficient payload which allows medical operations to be undertaken effectively on air.
A wide slipping cabin door (1.40 m – 4 ft 7in) on both sides which allows for easy access for patients.
It is powered by two engines with good ratings (960 shp) which facilitate quick take-off and hence making it suitable for rescue mission in mountainous settings.

Boeing MD Explorer

It has a single engine with high ratings
Has an improved NOTAR inlet design as well as a powerful stabilizer control system.
The model has an improved range and endurance together with a high maximum takeoff weight which is essential for medical ambulances.
The low noise levels and controllability enhancements make it suitable for hospital environments.
Enhanced digital communications as well as an NVG compatible integrated cockpit.

Eurocopter EC135

It is an extremely powerful twin-engine and is capable of multi-tasking and can operate well in mountainous regions.
It has a take-off weight of 2,910kg which allows for high passage or fuel capacity. This also increases its endurance level
Has an external noise level of as low as 6dB which allows operation in environments close to hospitals

Recommendations

Swiss air ambulance is operating in mountainous and highly populated area. As such, our company needs a helicopter that will best suit the environment while at the same time meeting the organization’s missions and objectives in the most effective manner. All the three categories of the helicopters seem to have different attribute that suits the task in question, however, Agusta 109 which has low noise level, wide and slipping cabin door and a spacious passenger cabin among other good attributes is recommended as the most suitable for our organization at this particular time.

Conclusion

Aeromedical consist of a flexible system which is used to transport patients from the conflict destination to a rear echelon where they receive more conclusive Medicare. In the world where conflict and peacekeeping missions have continued to increase, there is a need to consistently adapt Aeromedical Evacuation to the needs of the day as well having it tailored to meet the needs of the user services. An evacuation policy with smaller medical footprint is necessary in order to adapt Aeromedical Evacuation to meet its demands. As discussed, there is a strong need to shift from transporting stable patients to those who are stabilized. This will increase the need for advanced nursing care training as well as utilization of Critical Care Air Transport Team. Ideally, the success of tactical aeromedical evacuation will continually be determined by its flexibility.

Works cited

Miller, Captain. Evolving Doctrine in the Theater Aeromedical Evacuation System (TAES): Operation JOINT ENDEAVORlGUARD and Beyond. North Carolina: Aeromedical Evacuation Squadron, 2006. Print

QFCI. Aeromedical and air rescue network: helicopter tasking guidelines. Queensland: QFCI, 2003. Print

Wayne, Smith. Aeromedicine: A Regional Approach. Western Cape: Emergency Medical Services Provincial Government, 2004. Electronic

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