GUIDELINES FOR PREPARING AND TRANSPORTING CASUALTIES

File: aaalw_05.txt
Page: 05
Total Pages: 10

SUPPLIES (ADMINISTRATION SETS, NORMAL SALINE AND BLOOD SHIPPING
BOX) ARE PROVIDED FOR PATIENTS LIKELY TO NEED TRANSFUSIONS
INFLIGHT NO BLOOD WARMING SYSTEM IS AVAILABLE INFLIGHT.
PATIENTS WITH P02 LEVELS BELOW 60 MM HG ARE CONSIDERED AT RISK FOR
AIR TRANSPORT AND SPECIAL PRECAUTIONS SHOULD BE TAKEN.
G. CHEST TUBES: CHEST TUBES SHOULD BE LEFT IN PLACE, AND WILL
REQUIRE A HEIMLICH VALVE (ONE WAY FLUTTER VALVE) AND PLASTIC, ONE
PIECE UNDERWATER CHEST DRAINAGE SYSTEM APPROVED FOR AE USE (
ARGYLE SENTINAL SEAL, MIGADA, PLEURA GARD, THORA DRAIN, III, THOR-
KLEX, ;PEUREVAC) GLASS BOTTLES ARE UNACCEPTABLE. IF A PLASTIC
ENCLOSED SYSTEM IS UNAVAILABLE, A HEIMLICH, ONE WAY FLUTTER VALVE
SHOULD BE ATTACHED TO EITHER A GLOVE OR DRAINAGE BAG PRIOR TO
TRANSPORT. CONTINUOUS SUCTION MACHINES ARE NOT PRESENTLY
AVAILABLE IN THE AEROMEDICAL EVACUATION SYSTEM. OPTIMALLY,
PATIENTS WITH RECENTLY REMOVED CHEST TUBES WILL NOT BE AIRLIFTED
UNTIL THE FOLLOWING CONDITIONS ARE MET: (1) A MINIMUM OF 24 HOURS
AFTER CHEST TUBE REMOVAL (2)NORMAL EXPIRATORY AND LORDOTIC CHEST
XRAY AT LEAST 24 HOURS AFTER REMOVAL WITH AN INTERPRETATION IN THE
PATIENT'S MEDICAL RECORD (3) AND OCCLUSIVE DRESSING TO THE SITE
WHERE CHEST TUBE WAS REMOVE. SINCE 20% OF THE VIETNAM CHEST

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CASUALTIES EVACUATED BY AIR DEVELOPED A RECURRENT PNEUMOTHORAX,
AND ARTERIAL HYPOXEMIA WAS A COMMON FINDING, IT MAY BE PRUDENT
TO MOVE THESE PATIENTS WITH A CHEST TUBE IN PLACE.
H. STRYKER FRAMES: PATIENTS WITH PARAPLEGIA, QUADRIPLEGIA,
CERVICAL FRACTURE, SEVERE BURNS, AND THOSE REQUIRING TOTAL
ASSISTANCE ARE NORMALLY TRANSPORTED ON A STRYKER FRAME. CERVICAL
INJURIES WITH A HALO TRACTION MAY BE TRANSPORTED ON A REGULAR
LITTER OR AMBULATORY IF STABILIZED. THE REFERRAL MTF. WILL PROVIDE
THE STRYKER FRAMES AND ALL ASSOCIATED EQUIPMENT, E.G. COLLINS
TRACTION, STABILIZER BARS ETC. ORDERS FOR TURNING THE PATIENT
SHOULD BE INCLUDED ON THE DD 602.
I. TRACTION PATIENTS: FREE SWINGING WEIGHTS FOR TRACTION ARE
UNACCEPTABLE. USE COLLINS TRACTION, NATO TRACTION DEVICES, OR HEAVY
RUBBER TUBING TIES TO THE LITTER FRAME.
J. THERMAL INJURIES:
(1) GENERAL: ESCHAROTOMIES ARE REQUIRED FOR ALL FULL
THICKNESS CIRCUMFERENTIAL BURNS. PATIENTS WITH FULL THICKNESS
BURNS GREATER THAN 10% SHOULD BE EVACUATED PROMPTED FROM THE FORWARD AREA TO CONUS WITHIN 2-5 DAYS POST BURN. BURNS WILL BE
COVERED WITH OCCLUSIVE DRESSINGS. BURNS AROUND THE FACE, NOSE

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AND LIPS WILL REQUIRE ESTABLISHED AIRWAY PRIOR TO MOVEMENT. THE OPTIMAL
TIME FOR MOVEMENT OF MAJOR BURN PATIENTS IS WHEN