The role of military emergency physicians in an assault operation in Panama

The December 1989 assault in Panama provided an opportunity to examine the role of emergency physicians in low-intensity military operations. Emergency medicine specialists accompanied the assault forces and established casualty collection points (CCPs) at each target. Emergency physicians played a role in triage, resuscitation, and aeromedical evacuation. More than 275 casualties were resuscitated and stabilized at the CCPs. Two died after reaching a CCP. Casualties were flown from each CCP to a joint casualty collection point (JCCP). Surgical stabilization was required for 21 casualties at the JCCP. A team at the JCCP coordinated evacuation of casualties to the United States. The first casualties arrived at hospitals in Texas within 12 hours of the assault. From the drop zones through hospitalization in the United States, emergency physicians cared for combat casualties at every level of the evacuation system. The success of the medical plan for the assault suggests that the role of emergency physicians in military operations extends from the front lines to fixed medical facilities in the United States.