Performance Improvement Evaluation of Forward Aeromedical Evacuation Platforms in Operation Enduring Freedom

Abstract

The following three helicopter-based medical evacuation platforms operate in Southern Afghanistan: the US Army emergency medical technician (basic)Yled DUSTOFF, US Air Force paramedic-led PEDRO, and UK physician-led medical emergency response team (MERT). Nearly 90%of battlefield deaths occur in the prehospital phase, comparative outcomes for these en route care platforms are unknown. The objective of this investigation was to characterize the nature of injuries in patients transported by three evacuation platforms. In addition, it aimed to compare observed versus predicted mortality among these provider groups. METHODS: Aperformance improvement study involving 975 coalition patients injured in SouthernAfghanistan, transported from the point of injury to a military hospital, was performed. All patients were alive on admission with prehospital documentation recorded in the US Department of Defense Trauma Registry from June 2009 to June 2011. The main outcome measure was in-hospital mortality and observed versus predicted (Trauma and Injury Severity Score [TRISS]) survival were the primary end points. RESULTS: MERT transported more amputation and polytrauma casualties and included patients with higher mean Injury Severity Score (ISS) compared with PEDRO and DUSTOFF (16 [13] vs. 11 [10] and 10 [10] respectively; p G 0.001). DUSTOFF was excluded fromthe subgroup analysis owing to insufficient numbers of severely injured casualtieswith only one death. The overall mortality forMERTand PEDRO was similar (4.2% vs. 4.6%, p = 0.967). Stratifying by ISS, therewas lower mortality in MERT compared with PEDRO in the range of 20 to 29 (4.8% vs. 16.2%, p = 0.021). The observed mortality among PEDRO casualties was as predicted with the exception of the range of 20 to 29, while mortality in MERTwas lower than predicted for all ISS groups with greater than 10. CONCLUSION: MERT achieves greater than predicted survival, which may be related to the additional capabilities onboard.

Open PDF

Document Details

Document Type
Technical Report
Publication Date
Aug 01, 2013
Accession Number
ADA620124

Entities

People

  • Amy Apodaca
  • Brian J. Eastridge
  • Chris M. Olson Jr.
  • Eric Kuncir
  • Frank Butler
  • Jeffrey Bailey

Organizations

  • United States Army Institute of Surgical Research

Tags

Communities of Interest

  • Biomedical

DTIC Thesaurus Topics

  • Aeromedical Evacuation
  • Afghanistan Conflict
  • Body Regions
  • Casualties
  • Combat Casualty Care
  • Combat Injuries
  • Department Of Defense
  • Evacuation
  • Health Services
  • Hospitals
  • Medical Evacuation
  • Medical Personnel
  • Military Hospitals
  • Paramedics
  • Patient Care
  • Statistical Analysis
  • Warfare

Fields of Study

  • Medicine

Readers

  • Housing Policy Studies in Military Families with Privatization and Telomerase Allowance Units, Multi-Family Housing, and Telomere Lengths.
  • Medical or Health Care Field.
  • Trauma Surgery or Emergency Medicine.