Medical Evacuation

what kind of cargo aircrafts is used for Aeromedical Evacuation

C-130 C-17 C-5

Line 8

Casualty Nationality and Status

Outpatients

Class 5 Class 5A- Outpatient ambulatory, non- psychiatric and non-substance abuse, going for treatment Class 5B- Outpatient ambulatory, drug or alcohol (substance) abuse, going for treatment Class 5C- Outpatients psychiatric going for treatment or evaluation Class 5D-Outpatient own letter for comfort going for treatment or evaluation Class 5E- Outpatient returning from treatment, on a litter for comfort Class 5F- Returning ambulatory outpatient

Attendants (Non Patients)

Class 6- The need for medical and non-medical attendant is determined by the attending physician. The attendants must accompany the patient to the final destination. Class 6A- Medical attendant, Medical attendants supervise and assist in the flight-car of the patient Class 6B- Non-medical attendant, Non-medical attendants are normally used to assist incapacitated or infant patients

Open statement when calling in for MEDEVAC and procedure

I HAVE A MEDEVAC REQUEST ....OVER Wait 1 to 3 seconds for acknowledgement once acknowledgement you can go ahead and transmit. If they do not answer ask DO YOU COPY?

Location of the pickup site

Line 1

TRAC2ES- Web

Main tool for entering patient data, accessing patient data and generating reports. It also provides on-stop-shopping for all your patient movement needs.

When verifying the patient ID Card what are you look for?

Make sure it belongs to the patient Make sure it is not expired

Line 7

Method of Marking Pickup site

What is the purpose of the Anti-Hijacking Statement?

Part of the Aeromedical Evacuation requirement to protect the patients, remembers and medical staff from a hijacking on the ground or in the air. The Anti-Hijacking statement should state that the physical search on patients and attendants as will as the contents of each baggage has been completed. Make sure all personnel is listed the statement.

Who is responsible for entering and updating ITV events for patients leaving and arriving to the MTF?

Patient Movement Clerk

All requests for patient movement must also be coordinated directly with the approval, review, and validation of whom?

Patient Movement Requirement Center (PMRC)

Commonly used prowords

Roger: I received your last transmission satisfactorily Wilco: Will comply Wait: One must pause for a few sec Say Again: Repeat all Negative: No Over: This is the end of my transmission and the response is necessary

Theater Patient Movement Requirements Center Europe (TPMRC-E)

TPMRC-E is located at Rammstein AB, Germany Responsible for patient movement in the European Command (EUCOM) Assist patients who need to be transferred to CONUS military treatment facilities

Line 2 INFO

This call sign (and sufic if used) is that of the person to be contacted at the pickup site. Ex: Viper Team 1 2345 BREAK

What are the three movement precedence?

Urgent- Immediate movement to save life or limb or eyesight, or to prevent complication of a serious illness Priority- Prompt movement with 24 hr and moved with the least possible delays Routine- Movement with 72 hours and moved on routine or scheduled flights

What are the five precedence?

Urgent: Emergency case that should be evacuated as soon as possible and within a maximum of 2hrs in order to life, limb, or eyesight Urgent Surgical: Emergency case that should be evacuated within 2hrs to the nearest surgical unit Priority: Sick or wounded person requiring prompt medical care and who should be evacuated within 4hrs or his medical condition could deteriorate to such a degree that he could become an urgent precedence Routine: Sick or wounded person requiring evacuation, but whose condition is not expected to deteriorate significantly. Should be evacuated with 24 hours Convenient: Person who is being medically evacuated for medical convenience rather than necessity.

DD Form 2239 Consent of Medical Care and Transportation

Used when transporting minors (under the age of 18) who will not be accompanied by a parent or legal guardian. However, minors under the age of 14 will require an attendant to accompany them during the Aeromedical Evacuation. This form must include the address and the phone number of the minor's parent or legal guardian for use in case of an emergency. A copy of this form must also be place in the minor's medical record.

What does the Patient Movement Requirement Centers (PMRCs) used TRAC2ES-Web for?

Validate both the administrative and clinical parts of the Patient Movement Requests (PMRs) submitted by the Patient Movement Clerk. The data from the validated PMR is used to regulate the patient to a specific MTF with the medical capability needed, and to schedule the flight plan to transport the patient from one MTF to another. Generate a mission plan for the validated PMR and respond to and record any changes to the mission plan.

Line 4

Special Equipment Required

Two different methods used to evacuate the casualties to the nearest treatment facility

MEDEVAC and CASEVAC

Line 9

NBC Contamination DO NOT SAY LINE 9 AT ALL IF THERE ISN'T ANY CONTAMINATION

Line 2

Radio Frequency, call sign, and suffix

Who is eligible to be moved through the Aeromedical Evacuation?

Active duty military members and their dependents Retired military members and their dependents Beneficiaries of the US Public Health Services Veterans Administration (VA) beneficiaries

Patient care is given according to the orders and instructions of whom?

Attending physician

Who determine the need for evacuation or transfer of patients in their care?

Attending physician

What are some unauthorized items that are not allow when boarding?

Flammables Weapons Knives Explosives Aerosol Cans

Some of the main job performance tasks that Patient Movement Clerks will need to complete in TRAC2ES-Web are?

Submitting and tracking Patient Movement Request (PMRs) Entering in-Transit Visibility (ITV) events for patients leaving the MTF and arriving at your MTF Updating bed reporting and medical capabilities for the MTF Updating facility contact information, such as phone numbers, physical address, and email addresses

TRAC2ES

is used to combine transportation, logistics and clinical decision elements into a seamless patient movement process, capable of assessing and prioritizing patient movement requirements.

3 or 5 day supply of listed medication

3 day supply of med is provided for patients traveling within the Continental United States (CONUS) and within the overseas theaters. 5 day supply of med is provided for patients traveling from overseas to the CONUS

How many Patient Movement Requirement Center (PMRCs) are there coordinating/regulating the global movement of patients?

4

How many phases to the patient movement process is there?

4

How to request for MEDEVAC?

9-line

Litter Patient

A patient requiring letter accommodations while in transit

Ambulatory patient

A walking patient requiring only seat accommodations while in transit

Phonetic alphabet

A- Alpha B- Bravo C-Charlie D-Delta E-Echo F-Foxtrot G-Golf H-Hotel I-India J-Juliet K-Kilo L-Lima M-Mike N-November O-Oscar P-Papa Q-Quebec R-Romeo S-Sierra T-Tango U-Uniform V-Victor W-Whiskey X-X-ray Y-Yankee Z-Zulu

What forms is included in the Aeromedical Evacuation Packet Contents and also procedure is needed to be done?

AF Form 3899 Patient Movement Record Da Form 3981 Request for Transfer DD Form 600 Baggage Tap DD Form 2239 Consent of Medical Care & Transportation Copy of Pertinent Patient Records 3 or 5 days supply of listed Medication Place all required items in an envelope and mark the outside of the envelope with the patients: name, rank, or status, SSN (if applicable, nationality (if not US citizen), organization, date of departure and the destination MTF

What should you avoid when call in a request for MEDEVAC?

Avoid over classification, which is the tendency to classify a wound or injury as being more severe than it actually is.

Which feature in TRAC2ES allows users to update the bed capability for the MTF?

Bed/ Medical Capability Reporting Bed reporting in TRAC2ES is broken into Contingency Bed Reporting and Non-Contingency Bed Reporting.

Line 8 INFO

Brevity Codes: A (Military U.S.) B (Civilian U.S.) C (Military Non- U.S.) D (Civilian Non- U.S.) E (Enemy prisoner of war) Do not put the number of casualties Ex: Alpa BREAK

Line 4 INFO

Brevity Codes: A (None) B (Hoist) C (Extraction equipment) D (Ventilator)

Line 7 INFO

Brevity Codes: A (Panels) B (Pyrotechnic Signal) C (Smoke Signal) D (None) E (Other)

Line 3 INFO

Brevity Codes: A (Urgent) B (Urgent Surgical) C (Priority) D (Routine) E (Convenience) If two or more categories must be reported in the same request, insert the proword BREAK between each category. Ex: 2A BREAK 3C

Line 5 INFO

Brevity Codes: L (Litter) A (Ambulatory) If both type are included in the same request insert the proword BREAK between the type Ex: 2L BREAK 2A

Line 6 INFO

Brevity Codes: N (No enemy troops in area) P (Possible enemy troops in area, approach with caution) E (Enemy troops in area; approach with caution) X (Enemy troops in area; armed escort required)

Line 9 INFO

Brevity Codes: N (Nuclear) B (Biological) C (Chemical) This line is included only when applicable DO NOT transmit line 9 if no CBR contamination is present!

Crazy Little Walking Babies Out for Drinks

Class 1- Crazy- Psychiatric Class 2- Little- Litter Class 3- Walking- Ambulatory Class 4- Babies- Infants Class 5- Out for- Outpatient Class 6- Drinks- Class sic (attendants)

What are the six classifications?

Class 1- Neuropsychiatric Patients Class 2- Litter Patients (Non Psychiatric) Class 3- Ambulatory (Walking) Patients Class 4- Infants Class 5- Outpatients Class 6- Non-medical and medical attendants

Neuropsychiatric Patients

Class 1- Travel under routine precedence only Class 1A- Severe psychiatric patient, litter, sedated and restrained Class 1B- Psychiatric, Intermediate severity, litter, sedated, restraints Class 1C- Ambulatory psychiatric patient not restrained or sedated

Litter Patients (Non Psychiatric)

Class 2- Classification of these patients is dependent on their inability to move, e.g., a patient in a body cast may require intense medical treatment, and would be unable to move to save himself in a emergency Class 2A- Immobile letter patient, unable to move in an emergency Class 2B- Mobile litter patient able to move during an emergency

Ambulatory (Walking) patients

Class 3- Active duty military should be in their uniform Class 3A- Ambulatory patient requiring minor attention Class 3B- Recovered patient requiring no medical attention Class 3C- Ambulatory substance abuse patient

Infants

Class 4- All necessities, e.g., bottles, formula, diapers, etc. must be provided by the originating MTF Class 4A- Infants under three years of age occupying a seat Class 4B- Recovered infant, under 3yrs of age occupying a seat Class 4C- Infant requiring an incubator Class 4D-Infant under three years of age occupying a litter Class 4E- Outpatient under three years of age

What two forms is needed to start the patient movement process?

DA Form 3981 Request for Transfer AF Form 3899 Patient Movement Record

What does all patient baggage must have?

DD Form 600 attached and a copy of travel orders placed inside each bag.

How can you help the patient updated on the Aeromedical Evacuation process?

Destination MTF and estimated time of arrival at final destination Possible necessity for remaining overnight Specific routing when known otherwise, approximate routing time en route Baggage limitations and prohibited items Procedures for the anti-hijacking inspection Any other information that may be helpful to the patient

What baggage size is authorized for patient?

Each patient and attendant is authorized up to 66lbs of baggage to include one carry on bag, not to exceed 72 in length and must be sufficiently durable. Active duty patients may be authorized up to 100 lbs.

Copy of Pertinent Patient Records

Ensure any clinical documentation, outpatient/inpatient records, U.S. Field Medical Cards, X-rays, reports, lab reports and any other documents relating to the patient's treatment are copied. Make sure to review all documents for completeness before copying.

Patient Movement Clerk responsibility

Ensure that the physician has completed all requirements of the forms. Then report the patient movement into the Aeromedical Evacuation System by using the AF Form 3899 to create and submit the Patient Movement Request (PMR) via TRANSCOM Regulating and Command and Control Evacuation System (TRAC2ES). Also responsible for receiving patients from other MTFs by arranging for transportation to be available to take the patients from the airfield to the MTF.

AF Form 3899 Patient Movement Record

Ensure this form is completed and signed by the attending physician. This form contains the patient's personal data and clinical information, and will serve as the patient's chart during the patient movement.

TRANSCOM Regulating and Command and Control Evacuation System (TRAC2ES)

Is an automated support system that functions within a global network to assist i the Aeromedical Evacuation process.

ITV

Is the TRAC2ES feature that allows users to track the planned itinerary and last reported location of patients from origination MTF to the final destination.

MEDEVAC

Is the movement of casualties on medical ground/air vehicles with medical personnel aboard Uses a standardized and dedicated vehicle providing en route patient care. Red cross, medical personnel, and medical equipment

CASEVAS

Is the movement of casualties on non-medical vehicles with no dedicated medical personnel aboard. Uses non-standardized and non-dedicated vehicles that does not provide en route patient care.

What is the primary mission of the Patient Movement Requirement Centers (PMRCs)?

Is to work with at services (Patient Movement Clerks) to coordinate and regulate Aeromedical Evacuation requirements of all eligible patients form one MTF to another, utilizing the TRANSCOM Regulating and Command & Control Evacuation System (TRAC2ES)

Joint Patient Movement Requirement Center (JPMRC)

JPMRC is located at AI Udeid (AUAB) AB, Qatar Responsible for patient movement in the Center Command (CENTCOM) and Africa Command (AFRICOM) Responsible for approving and regulating the movement of patients within and out of CENTCOM and AFRICOM Over see middle east and Africa

How to begin the mission

Lines 1 through 5 must be transmitted before the evacuation mission begins

Which lines use brevity codes?

Lines 3 through 9

Line 1 INFO

Location Ex: LZ12345678 BREAK

What are three reasons for patients tone evacuated through the Aeromedical Evacuation system?

Medical Reasons: *Lack of adequate medical facilities locally *Lack of professional medical staff *Non-availability of medical equipment Administrative Reasons: *Patient requires prolonged hospitalization *Physical Evaluation Board (PEB) determination *Court Martial Requirement Personal or compassionate reasons: *Family *Patient Morale *Sickness in family

What else does the physician must determine for the patient?

Movement precedence Patient classification If special equipment is needed medical/non-medical attendant to accompany

Line 5

Number of Casualties by Type This line is required to let the evacuation crew know the number of casualties that will be evacuated on a litter (lying down) and the number of casualties that are ambulatory (can sit and walk)

Line 3

Number of casualties by precedence

What are some of the other functions of the PMRCS include? 2

Provide in flight treatment to include: Flight nurses, medical technicians, and other necessary personnel In flight equipment routinely carried, e.g., cardiac monitor, Collins Traction Unit, Ohio incubator, eat.

What are some of the other functions of the PMRCS include? 1

Providing administrative and clinical validation, medical regulating (matching patients to beds), and coordinate patient movement requirements by the most appropriate and efficient means of transportation.

What must the Patient Movement Clerk do to prepare the patient for movement?

Providing the ward nurse with flight departure time and place of departure. Gathering all patient documents/records (medical, finance, personal) Arranging for pick-up of in-flight medication Arranging for necessary special equipment to be available Arranging for availability of special or modified diet if required Arranging for ground transportation of patients to the airfield for flight departure

Line 6

Security of Pickup Site

TRAC2ES Mobile

Serves as a stand-alone subsystem for remote users in areas with low bandwidth or limited network connectivity. It is loaded on the user's computer before deployment, and is used to create, submit, and track PMRs via email.

What are some advantages of moving patients through Aeromedical Evacuation? Some Fat Cat Eats Meow mix

Speed- Provides immediate availability of necessary medical treatment to the patient. Flexibility- Patients may be diverted en route to the required medical treatment facilities. En route patient treatment- In fight medical treatment may be provided by trained medical specialists whom are members of the aircraft crew. Comfort- Travel by air is less taxing to the patients compared to ground transportation which may be over rough and uneven terrain. Morale- The air evacuated patients tends to have a more positive and mental attitude.

Theater Patient Movement Requirement Center Pacific (TPMRC-P)

TPMRC-P is located at Hickam AB, Hawaii Responsible for patient movement in the Pacific Command (PACOM) Responsible for approving and regulating the movement of patients within and out of PACOM

What are the two separate subsystems of TRAC2ES?

TRAC2ES- WEB TRAC2ES- Mobile

Theater Patient Movement Requirements Center Americas (TPMRC-A)

TRI-SERVICE agency located at Scott AFB, Illinois Under the supervision of the Department of Defense TRMRC-A is the lead agent for worldwide patient movement overseeing and supporting all other PMRCs Responsible for patient movement within the Northern Command (NORTHCOM) and Southern Command (SOUTHCOM) Over see Patient Movement North and South America

Who is responsible for teaching all patients, attendants, and baggage prior to aircraft boarding?

The Originating MTF

What must be done once the Anti-Hijacking search is complete?

The Patient Movement Clerk must complete and sigh the locally devised Anti- Hijacking Statement

What and when are the phases utilized?

The first two phases, Forward and Tactical, are utilized during wartime. The other two phases, Strategic and Domestic, are active during both wartime and peacetime.

Forward Phase

The phase provides airlift of patients from points within the battlefield to the initial point of treatment. The patient is still within the combat zone. This is where self aid buddy care and an aid station would be utilized. Ex: From combat area to a more secured area

DD Form 600 Baggage Tag

This form must be attached to all accompanied baggage. Detach the patient's stub and give it to the patient.

DA Form 3981 Request for Transfer

This form serves as written order for patient transfer by the attending physician

Strategic Phase

This phase provides airlift for patients from overseas areas back to CONUS Ex: From Hospital in deployment area back to US

Domestic Phase

This phase provides airlift for patients within the CONUS; also to and from offshore installations in Iceland, Puerto Rico, Cuba, Alaska, Bermuda, Haiti, and Panama Ex: From one state to another where ever is need for patient but within the US

Tactical Phase

This phase provides airlift of patients from theater to point outside of the combat zone Ex: From combat area to hospital in deployment still

Aeromedical Evacuation Coordinating Officer Responsibility

This position can either be filled by a Patient Administration NCO or a designee. Supervise the Patient Movement Clerks and be responsible for the evacuation of the patient from the time of notification by the attending physician until the patient is airborne. Establishing the evacuation procedures for the MTF, and assisting the Patient Evacuation Clerk to coordinate the Aeromedical Evacuation activities for patient movement.

Why are patients classified into categories?

To help the Aeromedical Evacuation crew identify the types of patients they are receiving aboard their aircraft. This enables the evacuation crew to determine the priority for loading and unloading patients as well as the approximate amount of room the patient will need while aboard the aircraft.

How many classifications of patients is there?

six and each classification is further broken down into subclassifications.

Aeromedical Evacuation

the process of transporting and providing essential medical care to any sick, injured, or wounded personnel between MTFs.