Use of medical specialties in medical operations other than war: lessons from Saudi Arabia

From the experience of a U.S. Army Air Defense Artillery "battalion-plus" task force serving a 6-month rotation in the Kingdom of Saudi Arabia, we compiled the requirements for specialty consultations on deployed personnel in the predeployment screening phase, during deployment (including both inpatient hospitalizations and medical evacuations), and immediately upon return to home station. We required a wide variety of specialty expertise. In every phase of the operation, we consulted orthopedic surgery most often. Nonsurgical and surgical specialists were consulted in roughly equal numbers. Almost every field of adult medicine was represented in our sample. The distribution of consultations across specialties differs from what would be expected in combat but is similar to that seen in the few other studies of comparable populations. Excellent host nation support allowed us to use specialty expertise to an almost ideal extent. These data represent the most complete "snapshot" that has been taken of the requirements for specialty medical consultations in a military operation other than war (MOOTW). They demonstrate that under MOOTW conditions, even a healthy Army population requires the assistance of a full panel of medical specialties. They should serve as a benchmark for planners estimating the medical specialty needs that the Army must provide. Military medicine must provide access to essentially all medical specialties for personnel deployed under MOOTW conditions, whether through host nation support, telemedicine, or medical evacuation.