C-17 air evacuation protocol

ME-CDMS-302a
Revision 0
Approved by
Approval Date 6/7/07
Active Divisions/Departments
Active Division/Departments: Medical, McMurdo, South Pole, and
Christchurch
Raytheon Polar Services Company Medical Contract No. OPP 0000373 Hard Copy Not Controlled—Controlled Copy Available On-line
McMurdo, South Pole, Christchurch, Denver Table of Contents
Procedure .1 References.2 Attachment 1, USAP Air Evacuation Mission Information .3 Attachment 2, McMurdo Hospital Standing Orders for Medevac Patients .4 Attachment 3, Routine Aeromedical In-Flight Kit .6 Attachment 4, Patient Classification.7 Attachment 5, AE Patient Preparation Checklist (Minimum Requirements) .8 Raytheon Polar Services Company Medical Department Contract No. OPP 0000373 Hard Copy Not Controlled—Controlled Copy Available On-line
McMurdo, South Pole, Christchurch, Denver
Procedure

1. Reference RPSC Procedure ME-CDMS-302, Patient Transport and Medical Evacuation 2. USAP Lead Physician will initiate the patient transfer in accordance with NSF/USAP 3. Use the standardized Patient Movement Precedence (JP 4-02.2 and AMCPAM 11- 303, para 4.3) for category of patient severity. a. Routine / Patient transfer – Ambulatory patient / litter on request or regular aircraft seating, attendant may or may not be needed. Medical equipment or medications as required for specific medical problem, medical condition not expected to change in 72 hours b. Priority - Litter patient, Oxygen available, possible cardiac monitor, routine standardized AeroMed In-flight kit, one attendant (consider 2 attendants for cardiac patients), medications as required, medical condition could deteriorate in 24 hours c. Urgent – Litter patient, oxygen required, cardiac monitor, routine standardized Aero Med in-flight Kit + appropriate additional supplies, medications, two attendants as required, medical condition critical - immediate movement to save life, limb, eye sight. 4. USAF Flight Surgeon will call TPMRC at 13th AF in Hawaii and provide telephone notification IAW Annex Q of JTF SFA CONOPS/Operation Deep Freeze. Use outline in attachment 1. Call 791-1-808-448-1602, wait for dial tone, and then #55722643 (use the # key). 5. USAF Flight Surgeon will call the 64AW/CC or OPS desk in Christchurch and provide a report on the proposed Air Evac. Use the outline from Attachment 1 as per AMCPAM 11-303. Call 798 – (wait for tone) – (press # key to start) #697709 – (wait for tone) – 027-229-9384 (64 AW/CC) or 027-229-9287 (64 AW/Maintenance CC). 6. Fax a copy of a completed Attachment 1 to the 64AW – FAX to 798 – tone - #697709 – 7. Complete a copy of the USAP Medevac Orders and send with patient. See Attachment 2. 8. Review AMCPAM 11-303, paragraph 3.3 and assure that the appropriate equipment is available for the transport. (See Attachment 3). 9. When possible, accompany the patient to Pegasus Field for transfer to the C-17. Raytheon Polar Services Company Medical Department Contract No. OPP 0000373 Hard Copy Not Controlled—Controlled Copy Available On-line
McMurdo, South Pole, Christchurch, Denver 10. Before placing the patient on the aircraft, hold a preflight briefing with the aircrew to review expectations of patient care, special needs and significant medical issues for the flight. Have the accepting crew member sign the forms to document that the briefing has taken place. Assist the flight nurse and aircrew as appropriate in setting up the patient for the mission. 11. Hold a de-brief session upon Air Evac Team return to assess any transfer issues, enroute medical problems and overall systems issues. Report any significant problems to USAP Lead Physician, JTF Deployed Commander and 64AW/CC for correction.
References

RPSC Procedure ME-CDMS-302, Patient Transport and Medical Evacuation Procedures Raytheon Polar Services Company Medical Department Contract No. OPP 0000373 Hard Copy Not Controlled—Controlled Copy Available On-line
Attachment 1
USAP AIR EVACUATION MISSION INFORMATION

DATE: _____________
MISSION INFORMATION (One patient per page): NOTE: If the political/operational climate is
such that information below cannot be given, inform the TPMRC.
1. INDIVIDUAL ANNOTATING INFORMATION AND PHONE NUMBER:
_________________________________________________________________________
McMurdo Clinic 720-568-1048 (From the US); e-mail: [email protected]
2. REFERRING PHYSICIAN: ___________________________________________
3. HOSPITAL/CLINIC NAME: McMURDO STATION HOSPITAL
4. PATIENT’S NAME / RANK: _____________________________________________
5. PATIENT’S SSN: ______________________________
6. PATIENT’S COMMAND AND ORGANIZATION:
(RPSC) (NSF) (GRANTEE) (T-Event) (ANG) (US MILITARY) (NZ)
7. NATURE OF INJURY: __________________________________________________
8. DIAGNOSIS: __________________________________________________________
9. VITAL SIGNS: SpO2 _____% Temp ______ Pulse _______ Resp______ B/P______
10. PATIENT EQUIPMENT REQUIRED FOR MISSION:
_______________________________________________________________________
11. MEDICAL AUGMENTATION PERSONNEL REQUIRED: Y / N
12. CATEGORY: ______________________________________________
13. REQUESTED MOVEMENT DATE: ___________________________
14. DESTINATION: (MCMURDO STATION) (CHRISTCHURCH) (OTHER)
15. REQUESTED AIRFIELD FOR PICK-UP: (PEGASUS) (WILLIAMS FIELD)
16. OTHER CONTACTS, IF ANY: USAP MEDICAL COORDINATOR, CHRISTCHURCH, NZ, 798 - #699020 – 0274-714-282 17. TPMRPC NOTIFIED (Name, date and time):_______________________________ This message contains FOR OFFICIAL USE ONLY (FOUO) information which must be protected under the Privacy Act and AFI 33-332. The information contained in this E-mail message is privileged and confidential information intended only for the use of the SFA FLIGHT SURGEON or entity named above. If the reader of this message is not the intended recipient, you are hereby notified that any reading and dissemination, distribution, or copying of this communication i ited. If you have received this communication in error, please notify the SFA Flight Surgeon immediately by telephone at Attachment 2
MCMURDO HOSPITAL STANDING ORDERS FOR MEDEVAC PATIENTS
Date: _____________ Pt Name/DOB: ______________________________________ Allergies: __________________________________________ □ Pulse Oximetry, apply oxygen PRN to keep SpO2 > 93% (prefer humidified) IVF: _____________________ @ ________ ml/hr Tylenol 650 mg /1000mg every 4-6hrs PRN (max 4G/day) Morphine 2-5mg IV every 10 minutes for pain if SBP >100, resp rate >12. (if allergy to Morphine:___________________________________________) Narcan 0.4mg IV if resp rate <8/min and/or SpO2 < 90% with supplemental O2 Ativan 1 mg po/IV for anxiety every 6 hrs PRN Prochlorperazine (Compazine) 5-10mg IV/IM every 6-8 hrs PRN nausea Promethazine (Phenergan) 25mg IM/IV every 4-6 hrs PRN nausea Benadryl 25-50mg IV/IM for extrapyramidal effects of Compazine/allergic IV antibiotics: (please right out orders) ____________________________________________________________________________________________________________________________________ Oral Intake: Regular diet____ Soft Diet____ Clear Liquids______ NasoGastric Tube to: Continuous Suction_____ Intermittent Suction_______ □ Foley catheter to gravity drainage □ Activity: Confined to litter_____ May ambulate with Assist____ Bathroom Privileges: Bedside_____ With Assist____ Independent_____ If chest pain:
□
NTG 1 spray SL every 5 minutes x 3; keep SBP >90. (IF NO VIAGRA IN THE
LAST 24 HOURS) –if no relief of chest pain, then:
Nitroglycerin drip – start at 10mcg/min, titrate by 5-10mcg every 5 minutes until Nitropaste 1inch to chest wall every 8 hours for CP not resolved with SL NTG. If no relief with NTG, use morphine 2-5mg every 10 minutes for CP. □ Follow ACLS protocols for cardiac arrest conditions. Please list all other orders pertinent to patient condition: ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ ________________________________________________________________________ Provider Signature: _______________________________ Attachment 3

ROUTINE AEROMEDICAL IN-FLIGHT KIT

1. Life-Pak 12 Cardiac Monitor and Defibrillator
2. Life-Pak 12 Battery Support System
3. Portable Suction unit
4. Pulse Oxymeter
5. Oxygen Source - Certified "H" tank for C-130, PT-Lox Liquid Oxygen unit, or Internal
Oxygen System for the C-17
6. Frequency Converter (for aircraft lacking 115 VAC/60Hz power source)
7. IV Infusion Pump
8. Electrical cable assembly set / extension cords
9. Ambu-bag with Oxygen connector
10. Intubation Kit
11. Emergency Medications
12. ACLS medication and equipment
(List per AMCPAM 11-303, 3Nov2000)

Attachment 4

PATIENT CLASSIFICATION
Attachment 5

AE PATIENT PREPARATION CHECKLIST (MINIMUM REQUIREMENTS)
A. DOCUMENTS TO ENTER PATIENT INTO DMRIS AF Form 3839 or USAP Mission Information Data Collection Sheet ___________ B. DOCUMENTS REQUIRED TO ACCOMANY PATIENT FOR AE AF Form 3899 or USAP Air Evacuation Orders ------------------------------------___________ Anti-Hijacking Certificate ------------------------------------____________ Medical/Nursing Inpatient Transfer Summary ------------------------------------___________ Travel Orders (Military patient) -----------------------------------____________ Medical Records as required -----------------------------------____________ --------------------------------------- ____________ ----------------------------------------____________ ----------------------------------------____________ AF Form 3838 for DNR patient ----------------------------------------____________ ----------------------------------------____________ ----------------------------------------____________ DD Form 2239 Consent for Medical Care in the AE System -------____________ ----------------------------------------____________ ----------------------------------------____________ ----------------------------------------____________ ----------------------------------------____________ ----------------------------------------____________ ----------------------------------------____________ ----------------------------------------____________ Other Supplies as Requested by Physician ----------------------------------------____________ Destination as confirmed in the Mission Data Sheet ----------------------------- ____________ ----------------------------------------____________ ----------------------------------------____________ ----------------------------------------____________ ----------------------------------------____________ ----------------------------------------____________ --------------------------------------- ____________ ----------------------------------------____________ Availability of Flight Insurance/ Health Insurance -----------------------------____________ ----------------------------------------____________

Source: http://www.mednice.com.ua/about/contracting/rfqs/support_ant/docs/environ_health_safety/usap_sandh_policy_man/airevaculationproto-302a.pdf