Forward Medical Evacuation

Bricknell, Martin; A, Johnson

doi:10.1136/jramc-157-4s-07

Cited by 15 publications

(6 citation statements)

References 8 publications

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“…As helicopters became more powerful, casualties were able to be carried inside the fuselage alongside increasingly skilled medical attendants. It is likely that the apogee for helicopter MEDEVAC was in Afghanistan in 2010-2012 where several nations were mutually supporting each other with a breadth of helicopter MEDEVAC capabilities that could be tailored to specific missions including collection from contested pick-up points ( Bricknell and Johnson, 2011: S444-S448 ; Olson Jr, et al, 2013: S130-S136 ).…”

Section: Medical Evacuationmentioning

confidence: 99%

Observations from the Korean War for Modern Military Medicine

Bricknell

2023

Korean J Med Hist

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This paper reviews developments in military medicine during the Korean War and places them in the evolution of military medical lessons from the Second World War and the subsequent development of military medicine through the Vietnam War to the present day. The analysis is structured according to the ‘10 Instruments of Military Healthcare.’ Whilst there were incremental developments in military medicine in all these areas, several innovations are specifically attributed to the Korean War. The introduction of helicopters to the battlefield led to the establishment of dedicated medical evacuation helicopters crewed with medical personnel and the evolution into the DUSTOFF system during the Vietnam War. Helicopter evacuation was the primary medical evacuation system in the wars in Iraq and Afghanistan. The establishment of the Mobile Army Surgical Hospital during the Korean War were founded upon the US Auxiliary Surgical Groups or the UK Casualty Clearing Stations of World War II. The requirement for resuscitation and surgical teams close to the battlefield has endured through the development of mobile hospitals of varying sizes from Field Surgical Teams to the current ‘modular’ Hospital Centre and other international equivalents. There were many innovations in the clinical care of battle casualties covering wound shock, surgical techniques, preventive medicine, and acute psychiatric care that refreshed or advanced knowledge from the Second World War. These were enabled through the establishment of medical research programs that were managed within the theatre of operations. Further advances in all these clinical topics can be observed through the Vietnam War to the wars in Iraq and Afghanistan – all of which were underpinned by institutional directed research programs. Finally, collaboration between international military medical services and the development of Korean military medical services is a major theme of this review. This ‘military-tomilitary’ and ‘civil-military’ medical engagement was also a major activity during the Vietnam War and more recently in Iraq and Afghanistan. Overall, the topics and themes in military medicine that were important during the Korean War can be considered to be part of trajectory of innovation in military medicine have been replicated in many subsequent wars. The paper also highlights some ‘lessons’ from World War II that had to be relearned in the Korean War, and some observations from the Korean War that had to be relearned in subsequent wars.

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Section: Medical Evacuationmentioning

confidence: 99%

Observations from the Korean War for Modern Military Medicine

Bricknell

2023

Korean J Med Hist

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“…The relatively small geographical area comprising the UK military area of operations in the Afghanistan conflict (Op HERRICK), combined with comprehensive air superiority allowed consistently rapid aeromedical evacuation of service personnel from point of injury to a medical treatment facility (MTF). 8 The 2014 UK Deployed Medical Capability Study (DMCS) concluded that if Op HERRICK had occurred with a less permissive air environment, it would have had a direct impact on aeromedical casualty evacuation. 9 This would increase the likelihood of prolonged field care and the time to provision of DCS and acute medicine at Deployed Hospital Care (Forward) (DHC(F)).…”

Section: Deployed Medical Capability Studymentioning

confidence: 99%

Extending existing recommended military casualty evacuation timelines will likely increase morbidity and mortality: a UK consensus statement

et al. 2020

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IntroductionFuture conflicts may have limited use of aviation-based prehospital emergency care for evacuation. This will increase the likelihood of extended evacuation timelines and an extended hold at a forward hospital care facility following the completion of damage control surgery or acute medical interventions.MethodsA three-round Delphi Study was undertaken using a panel comprising 44 experts from the UK armed forces including clinicians, logisticians, medical planners and commanders. The panel was asked to consider the effect of an extended hold at Deployed Hospital Care (Forward) from the current 2-hour timeline to +4, +8, +12 and +24 hours on a broad range of clinical and logistical issues. Where 75% of respondents had the same opinion, consensus was accepted. Areas where consensus could not be achieved were used to identify future research priorities.ResultsConsensus was reached that increasing timelines would increase the personnel, logistics and equipment support required to provide clinical care. There is a tipping point with a prolonged hold over 8 hours, after which the greatest number of clinical concerns emerge. Additional specialties of surgeons other than general and orthopaedic surgeons will likely be required with holds over 24 hours, and robust telemedicine would not negate this requirement.ConclusionsRetaining acute medical emergencies at 4 hours, and head injuries was considered a particular risk. This could potentially be mitigated by an increased forward capacity of some elements of medical care and availability of a CT scanner and intracranial pressure monitoring at over 12 hours. Any efforts to mitigate the effects of prolonged timelines will come at the expense of an increased logistical burden and a reduction in mobility. Ultimately the true effect of prolonged timelines can only be answered by close audit and analysis of clinical outcomes during future operations with an extended hold.

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“…Overall, this was primarily a ‘Ground’ medevac system. Medical evacuation in counterinsurgency operations has been discussed in a previous paper in this Journal 9. Nearly all casualties were collected by Forward Aeromedical Evacuation (AE) from/near the point of injury, with ground medevac relegated to a contingency plan where aeromedical evacuation was not available; this was primarily an integrated ‘Air’ medevac system.…”

Section: Planning Factorsmentioning

confidence: 99%

For debate: health service support planning for large-scale defensive land operations (part 1)

Bricknell¹,

Finn²,

Palmer³

2018

J R Army Med Corps

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This is the first of two articles that considers the medical planning implications of large-scale defensive military operations. This paper considers the military context and planning factors that may require a medical plan that is different from that seen in recent counterinsurgency operations. The scale and complexity of the challenge is likely to require a greater level of decentralisation and a more sophisticated approach to medical planning at the strategic and operational levels.

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Forward Medical Evacuation

Cited by 15 publications

References 8 publications

Observations from the Korean War for Modern Military Medicine

Observations from the Korean War for Modern Military Medicine

Extending existing recommended military casualty evacuation timelines will likely increase morbidity and mortality: a UK consensus statement

For debate: health service support planning for large-scale defensive land operations (part 1)

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