Impact of Low Volume Air Force Ground Surgical Team Deployments

The Air Force Ground Surgical Team (GST) Phase 1 course is a 2-week pre-deployment training for the Air Force's conventional austere surgical care platform. A prior study evaluated the deployed experiences of GSTs from 2017 to 2020. This study is an update on the 2021-2023 deployed experience and also specifically seeks to understand the effects of low-volume deployments on clinical preparedness.

A total of 366 surgeons, emergency physicians, CRNAs, and anesthesiologists took the course from 2017 to 2024. Respondents were included if they deployed between 2021 and 2023, and excluded if they deployed to Afghanistan. A total of 16 surgeons, 12 anesthesia providers, and 18 emergency physicians met the inclusion and exclusion criteria and responded. An Institutional Review Board exemption was issued before study initiation.

Of the 16 surgeons, they performed a median of 3 surgical procedures during a 6-month deployment, but after excluding the surgeons who did not operate during deployment, the remaining 10 surgeons performed a median of 5 surgical procedures in 6 months. A total of 40% of the surgeons who performed surgical procedures took care of pediatric patients who were younger than 5 years old. A total of 61% of providers felt that their deployment had a negative impact on their ability to practice in their specialty.

Air Force Ground Surgical Teams in the deployed environment continue to encounter prolonged periods of clinical inactivity over the traditional 6-month period, in line with the previous study from 2017 to 2020, which has a negative impact on providers' ability to practice in their field post deployment. When teams did provide care, they very frequently managed special populations of patients who did not align with the primary objective for the team. Whether training and equipment should be introduced to manage these populations must be balanced with mission requirements. Although a future fight can be anticipated where clinical volume will be much higher, efforts to mitigate the effects of current GST deployments with low clinical activity should be addressed.