Emergency War Surgery NATO Handbook: Part III: General Considerations of Wound
Management: Chapter XIII: Aeromedical Evacuation
Intra- and Intertheater Medical Evacuation
United States Department of Defense
Intratheater medical evacuation moves patients from one hospital to another within the
theater of operations. This includes evacuation between combat zone hospitals, between
communication zone (COMMZ) hospitals, or from combat zone hospitals to COMMZ hospitals.
Out-country, or intertheater medical evacuation moves patients from hospitals located
within the theater of operations to designated casualty-receiving Medical Treatment
Facilities (MTFS) located in the Continental United States (CONUS) or in host nations
outside the theater. This complex evacuation system consists of two interrelated
processes: patient regulation and patient movement. Whereas the medical officer is always
responsible for any decision that impacts on the clinical welfare and stability of his
patient, the patient administrator and the medical regulating officer (MRO) provide
invaluable assistance by communicating up and down the echelons of the combat health care
delivery system to facilitate the provision of safe, timely, and efficient movement of
casualties. MROs at each echelon function as the gatekeepers and facilitators who achieve
an even distribution of cases, assist in minimizing surgical backlogs, maintain an
adequate number of available beds for current and anticipated needs, route patients
requiring specialized treatment to the proper facilities, and coordinate the smooth, safe
retrograde movement of casualties. This system is designed to ensure both the efficient
and safe transfer of patients, often over great distances, in such manner that the welfare
of the patient is second only to the success of the tactical mission. To achieve these
objectives, MROs must maintain current information on the tactical situation, the
availability of all types of transportation, the location and capacity of facilities with
special capabilities, the current bed status of treatment facilities, surgical backlogs,
the number and location of patients by diagnostic category, the location of airfields and
seaports, and, most important of all, the individual patient's suitability to withstand
evacuation.
Fixed-wing aircraft of the nonmedical variety are utilized to transport personnel and
supplies into the theater of operations. After off loading, these same aircraft can be
quickly converted and internally reconfigured to accommodate both litter and ambulatory
patients. With the exception of aircraft specifically designed to transport patients, most
aeromedical evacuation is performed in reconfigured standard military transport aircraft.
These aircraft and their medical teams are selected carefully in consideration of the
patient's needs. Jet-powered aircraft are capable of rapid patient movement in smooth air
at high altitude in pressurized comfort. These movements can be accomplished for short or
long-distances as required. Overnight rest stops can be provided along the way, depending
upon the patient's clinical status and the distances involved.
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Operational Medicine 2001
Health Care in Military Settings
Bureau of Medicine and Surgery
Department of the Navy
2300 E Street NW
Washington, D.C
20372-5300 |
Operational Medicine
Health Care in Military Settings
CAPT Michael John Hughey, MC, USNR
NAVMED P-5139
January 1, 2001 |
United States Special Operations Command
7701 Tampa Point Blvd.
MacDill AFB, Florida
33621-5323 |
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