Divide and Save: A Critical Care Air Transport Team Case With Prolonged Field Care

Area of Science:

• Emergency Medicine
• Military Health
• Critical Care Transport

Background:

• Critical care air transport teams (CCATTs) are vital for medical evacuations.
• A 2014 mission highlighted challenges in providing care during urgent air evacuations.
• Trust issues with local medical facilities complicated patient management.

Purpose of the Study:

• To illustrate the evolving mission scope of CCATTs.
• To demonstrate the necessity of adaptability in critical care air transport.
• To highlight the use of prolonged field care and split team strategies.

Main Methods:

• A case study of a 2014 CCATT mission involving 6 service members with gunshot wounds.
• Rapid deployment with limited pre-mission information.
• Adaptation of resources, including securing additional equipment and blood products.
• Implementation of a split team approach for prolonged field care and continuous renal replacement therapy (CRRT).

Main Results:

• One patient required CRRT due to acute renal failure from prolonged tourniquet time and surgical delay.
• A CCATT nurse transported 5 stabilized patients while the physician and respiratory therapist provided 2 days of prolonged field care.
• The mission demonstrated successful adaptation to unforeseen critical care needs.

Conclusions:

• CCATT missions may extend beyond standard air evacuation to include ground triage and prolonged field care.
• The use of atypical equipment like CRRT and split team operations is becoming increasingly relevant.
• Updated policies and training are essential to prepare CCATTs for diverse and flexible en route critical care missions.