Innovations in the En Route Care of Combat Casualties

Abstract

The en route care environment is dynamic and requires constant innovation to ensure appropriate nursing care for combat casualties. Building on experiences in Iraq and Afghanistan, there have been tremendous innovations in the process of transporting patients, including the movement of patients with spinal injuries. Advances have also been made in pain management and noninvasive monitoring, particularly for trauma and surgical patients requiring close monitoring of their hemodynamic and perfusion status. In addition to institutionalizing these innovations, future efforts are needed to eliminate secondary insults to patients with traumatic brain injuries and technologies to provide closed-loop sedation and ventilation.

Research at the Bedside: It Makes A Difference

“…[1][2][3] To optimize care and outcomes under these dynamic conditions, research must address care not only at a specific point in the continuum of care (eg, at a field hospital), but also care provided as patients move across the various settings in the care continuum. 4 As an example of research across the continuum, a series of studies were completed to describe en route pain and pain management strategies for military patients undergoing aeromedical evacuation from the war zone to Germany. [5][6][7] One finding was that the most severe pain occurred during transport from the ground facility to the aircraft.…”