Tuesday, January 11, 2011


Patient movement is integral to our mission.  In a civilian hospital, a critically ill patient would go from the emergency room or the operating room to the ICU.  We can not do this.  The FST has limited holding capacity due to staffing, facilities, and equipment.  In addition, the military doctrine on casualty care holds that a patient is moved from Level 1 (the field) in one hour, from Level 2 (the FST) in 4-8 hours, from Level 3 (the medical centers at KAF and BAF) in 24-72 hrs, and from Level 4 (theater hospital in Landstuhl) in one week.

Post operative patient in "burrito".  Patient remains on the ventilator.  Chest tubes are connected to water seal containers at the foot of the litter.

The challenge for our team and the MEDEVAC flight crews is preparation and careful movement of patients on ventilators with the potential for sudden deterioration of their condition.  The burritos are designed for heat conservation since helo flights in winter weather can be quite cold, and hypothermia can result in bleeding and deterioration.  Portable ventilators and monitors are attached to the litters.  Blood may be sent with the patient.

Louie, our flight nurse, prepares a patient for MEDEVAC.

The litters are carried to ambulance which then transports them to the flight line.

Litter bearers

Ambulance loading.
Care continues throughout the process.

Air Force PJ tends to a patient.
Blackhawk helicopters are the workhorses of the MEDEVAC system, flying at night and in poor visibility to move patients to the next level of care.

Litter on flight line.
Enroute to the next level.
The rapid movement of patients from point of injury to a hospital in the US sometimes causes substantial disorientation for patients.  There is no gathering of one's belongings or goodbyes to their units and friends.  Imagine the shock when the soldier's last memory is lying in the dirt next to a just damaged vehicle, only to come to in a clean hospital room in the US a week later with no memory of the interim.

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