Maintaining the continuum of en route care

Abstract

As life-sustaining and life-preserving surgical capability is moved far forward, it creates the opportunity to salvage casualties who may have otherwise died of their wounds. The remarkable capabilities and effectiveness of the small, austere surgical resuscitation teams (mobile forward surgical team, flying ambulance surgical trauma, forward resuscitative surgery system teams) has been amply demonstrated during the recent conflicts of Operation Iraqi Freedom and Operation Enduring Freedom. The life-saving capability of far-forward surgery creates the need for a new and unique capability, which is the cornerstone of the en route care continuum, namely, the ability to move stabilized, but not necessarily stable, patients. The current system of en route care serves as a primary and indispensable portion of the continuum of critical care. The scope of this article describes the origins, composition, equipment sets, medical considerations, and future directions of the en route care support process and the U.S. Air Force Critical Care Aeromedical Transport Teams.