Military and civilian emergency aeromedical services: common goals and different approaches

Military and civilian organizations in the U.S. operate separate but parallel emergency aeromedical services. Despite common origins, military and civilian approaches and methods have diverged. This article compares and contrasts the capabilities, priorities, safety, equipment, training and personnel of the largest military service, the U.S. Army, to civilian rotary wing (helicopter) emergency aeromedical programs. The different successes of military and civilian emergency aeromedical programs can be considered for use to improve the services of each. In general, Army programs operate larger aircraft and utilize two pilots per aircraft. Safety is a high priority and the Army aeromedical safety record is excellent. The Army also places a high degree of emphasis on crashworthiness and protective gear for the crew. Most civilian air Emergency Medical Service (EMS) programs operate small to moderate-sized aircraft flying with a single pilot. The recent safety record has improved dramatically. Civilian programs may add to their safety by considering two pilots and incorporating the crashworthy and protective advancements made by the military. Civilian programs fly with two highly trained medical technicians, nurses or physicians, equipped with state-of-the-art medical equipment. Army helicopters fly with one lesser-trained medical crewmember and less equipment. Improved combat casualty care and battlefield survival may be possible by increasing both the number and training of the medical attendants on Army aircraft.