Navy En Route Care: A three-year review of 428 Navy air evacuations
Background: En Route Care (ERC) is not a program of record in the Navy. According to the VANGUARD studies of 2005 and 2009, “CASEVAC/MEDEVAC/ERC for each phase of an operation, to include the sea base”, represents a Navy doctrinal capability shortfall. Records indicate this mission is not new to Navy medicine, as Navy assets have been reporting ERC missions through Search and Rescue (SAR) reports since the 1970’s. Our objective was to report clinical ERC cases treated by Navy operational assets from January 2012–January 2015. Methods: The Search and Rescue Model Manager (SARMM) office collects SAR reports for all patient transports involving Navy personnel and equipment. Permission to perform retrospective analysis of prospectively collected data was obtained from the SARMM office. Total number of patients transported, ratio of Advanced Life Support (ALS) versus Basic Life Support (BLS) transports, time of transport, and type of ERC provider for the transport were collected. For statistical analysis we compared the incidence with chi-square. Categorical data were reported as frequencies and percentages. Wilcoxon test was used for non-parametric continuous variables. Data were reported as mean ±SD (median [IQR]). A p<0.05 was considered significant. Results: From Jan 2012–Jan 2015, 428 patients were transported. Transport time was 67±65; 54[IQR 30–78] minutes. Missions were staffed by 76% Search and Rescue Medical Technicians (SMT), 25% Flight Surgeons (FS), and 21% other. 22% of missions had more than one type of provider. Patients were 75% male, 36±20; 30[IQR 22–50] years old, 47% military, and 48% trauma.f40% of patients were ambulatory. 54% were ALS transports. 47% were transported with an IV, 40% used supplemental oxygen, 13% had an airway device, 49% required monitoring, and 32% received medications. Medical patients were more likely to be ALS transports than trauma patients (61% vs 46%, p=0.002). FS were not associated with transport level or patient type. SMTs were more likely to staff ALS transports than all other providers (59% vs 40%, p=0.0004). Conclusion: In our review of 428 SAR reports, we found that 76% of the missions were performed by SMTs and that FS participated in 25% of ERC missions. The role of critical care ERC nurses is not clearly defined with this data set. 54% of the patient transports required ALS. Our study supports that Navy ERC should be funded as a program of record to optimize the readiness of Navy Medicine to support the warfighter.
Walrath, Benjamin D, "Navy En Route Care: A three-year review of 428 Navy air evacuations" (2016). Texas Medical Center Dissertations (via ProQuest). AAI10131754.