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- Coordination of operations and aeromedical problem solving were impaired 
because not all locations (including CENTAF forward initially) had credible 
senior flight surgeon experience.

-Conflicts arose at some locations when the senior ranking flight surgeon was 
from the ARC but had less aeromedical expertise than the active duty flight surgeon.

-The 1990 ATC Concept of Operations made no clear provision for integration of 
multiple SME's at a single location resulting in poor coordination at many bases

-Security and accountability of controlled drugs was a problem in a few locations

T r a i n i n g

-Exercise deploymenents are the best training for wartime mission

- Operational Readiness Exercises and the Combat Casualty Care Course taken at 
Camp Bullis were judged very valuable

-Despite directives, most SME flight surgeons and technicians felt inadequate in 
assessment of food and water quality -- this was particularly true of 
Commands/components without SME's.

-Aeromedical technicians were poorly trained to assist with patient care

-Maintaining currency in wartime skills for both flight surgeons and technicians 
is a problem.

-The average experience level of deployed flight surgeons was low.

ATC Equipment

-Not all ATC's were stocked with the May 1990 Table of Allowances resulting in a 
variety of functional deficiencies, most notably an outdated formulary.

-The plan for ATH backup within 30 days was seldom realized, forcing ATC's to 
care for growing base populations up to 1200 in some cases -- at the end of the first 
month, 13 of 17 Air Force beddowns were supported only by SME's

"Squadrons deployed to Desert Shield with much higher numbers of individuals 
than predicted by exercise experience and planned for in the ATC Concept of
Operations

-Condition of the ATC's on arrival was variable but most of the problems were 
related to heat in theater or poor maintenance while in WRM storage

-Continually growing base populations overstressed the designed supply 
capabilities of the ATC and routine sick call medications were rapidly depleted.

-Although the ATC ConOps requires ability to communicate with crash, rescue 
and other agencies, there was no system in place to guarantee this capability.

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