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Industry: Email Alert RSS FeedAeromedical Evacuations from Operation Iraqi Freedom: A Descriptive Study
Military Medicine, Jun 2005 by Harman, Dale R, Hooper, Tomoko I, Gackstetter, Gary D
The Department of Defense (DoD) has developed a superior aeromedical evacuation network. Capable of global patient movement, TRANSCOM has undoubtedly saved numerous lives with its rapid and efficient response to medical transportation requirements, particularly in combat environments. When aeromedical transportation is requested. TRAC^sup 2^ES coordinates and transmits all information to the patient's originating and receiving locations and to the transportation provider. Thus, TRAC^sup 2^ES is a real-time, single information interface for the entire patient movement process dedicated to protecting the health and welfare of our deployed troops.14
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In addition to supporting this vital transportation function, TRAC^sup 2^ES contains health-related information at the individual level, and it has the potential to provide useful data for surveillance purposes as well as for epidemiological studies. The Army Medical Surveillance Activity (AMSA) recently published a report on OIF aeromedical evacuations of injured Army personnel using TRAC^sup 2^ES data.15 Our assessment of this transportation database focuses on its use as an epidemiological tool with the potential to identify important force health protection issues and to provide the basis for enhanced medical planning and resource allocation and eventually the development and evaluation of appropriate preventive measures. The medical issues pertaining to OIF deserve such analyses, and our goal is to apply the lessons learned to reduce American and allied losses in future operations.
Methods
This is a descriptive study of injuries and illnesses among OIF deployed forces using an automated transportation database of aeromedical evacuations. The study population consisted of all military patients who were aeromedically evacuated from the Central Command (CENTCOM) area of operations during the calendar year 2003 (Figure 1, map of CENTCOM).
Data Sources
USTRANSCOM is comprised of elements from the Air Force Air Mobility Command, the Navy Military Sea Lift Command, and the Army Military Traffic Management Command and is responsible for meeting airlift needs, including aeromedical evacuations for members of the DoD. TRAC^sup 2^ES combines logistic information, transportation requirements, as well as clinical decision-support elements to provide complete visibility of all patient movement and worldwide responsiveness to the DoD's medical transportation needs.17
AMSA maintains the Defense Medical Surveillance System (DMSS), which includes automated, individual level data on hospitalizations, ambulatory visits, reportable diseases, acute respiratory diseases, health-risk appraisals, as well as longitudinal personnel and deployment data for all branches of the U.S. military. AMSA publishes monthly summaries of reportable diseases, illness and injury trends, disease outbreaks, and case reports.18
Construction of the Analytic Data Set
The Office of the Secretary of Defense for Health Affairs provided access to data from TRAC^sup 2^ES on medical evacuation flights originating in CENTCOM between January 1 and December 31, 2003. The data fields within TRAC^sup 2^ES include patient name, social security number, cite number (specific for a particular patient and flight), age, service branch, unit name, movement classification (ambulatory, litter, etc.), precedence (routine, priority, or urgent), originating and destination facility, conflict name (e.g., OIF), medical specialty (MEDSPEC) code (identifies the primary medical service involved in care), injury type (battle vs. nonbattle), a primary and two secondary International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes, clinical diagnoses, and a short text field for an abbreviated medical history and other information, as well as a large number of logistical fields necessary for transportation mission success.
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