SLS
(click to view full)

US aeromedical evacuation has changed. Forward-based units or helicopters are still the primary link from the battlefield during the “golden hour” that follows major trauma. Once a patient has been stabilized, however, more advanced care at more advanced facilities may be needed. For several decades, the USA had a fleet of dedicated aircraft, the last being its DC-9 derived C-9A “Florence Nightningale” fleet. In its place is a new approach devised by USAF Lt. Gen. Paul K. Carlton Jr., the Air Force surgeon general until 2002. The idea is that every USAF Air Mobility Command aircraft can become an aeromedical aircraft, as newly arrived aircraft on the tarmac are loaded with about 800 pounds of gear and supplies per patient and diverted to hospitals like Landstuhl in Germany. Instead of waiting for days to stabilize a patient, outbound flights are sometimes coordinated while a patient is still in surgery. The result? Lower average cargo volume and weight statistics for US transport aircraft missions, and a 90% survival rate for troops injured in current operations. In Operation Desert Storm in 1991, the rate was about 75%.

On to the next step in quality improvement, which could have significant implications for civilian disasters as well. USAF aircraft without organic litter systems rely on the patient support pallet (PSP), whose weight and bulk make it heavily reliant on cargo handling equipment for loading and unloading. This assumes the PSP is even present with the evacuation crew, of course; if not, additional stops will be required to pick up the equipment. In an age of rising fuel prices, those side-trips get very expensive, and time is always of the essence.

Enter the Air Mobility Battlelab. They were established in 2001, and will deactivate in September 2008 as part of a USAF cost-savings initiative. Before they go, however, they’re developing an idea that might solve these problems…

C-17 prep
(click to view full)

What if the lighter systems used for helicopters could be adapted for larger fixed-wing aircraft, and used to create a portable litter system that needed no cargo equipment support, and could be kept with aeromedical evacuation crews?

AMB teamed with Lifeport, Inc. to demonstrate the concept using the company’s stacking litter system (SLS) which weighs less than 150 pounds. The initiative’s initial approval date was April 2007, and the concept demonstration was completed in June 2007 on a KC-135 Stratotanker. The team demonstrated compatibility with the NATO mesh litter, a litter backrest, and the special medical emergency evacuation device. The SLS encountered some minor compatibility issues due to its helicopter origins, but none were show-stoppers and the system could be loaded by 2 people without equipment, and installed in the plane in under 20 minutes.

AMB briefed AMC headquarters in December 2007, and recommended modification and eventual fielding.
As of the March 24/08 USAF article, Air Mobility Command’s Surgeon General Readiness Division is “interested in fielding this type of capability,” but has not made a specific decision and did not give a target date.