U.S. Transportation Command coordinates theater patient movement, the most critical part of the aeromedical evacuation process Published Oct. 30, 2019 By Michael P. Kleiman United States Transportation Command SCOTT AFB, Ill -- Moving America’s wounded warriors safely and securely begins at the in-theater point of injury, which, in the combat environment, remains most critical in the initial hour or so following the incident, when prompt medical care increases an individual’s survivability. As the Department of Defense’s single manager for global patient movement, one of its five Unified Command Plan responsibilities, U.S. Transportation Command conducts this vital, lifesaving mission employing the U.S. Air Force’s aeromedical evacuation construct that ensures comprehensive, in-transit treatment for the injured and ill. Theater patient movement begins in the combat zone with wounded warfighters requiring medical support. For example, in the U.S. Central Command theater of operations that includes the North Atlantic Treaty Organization-led Resolute Support Mission in Afghanistan, the Patient Evacuation Control Cell, a joint organization providing operational, clinical, and medical unity of effort at the tactical level, coordinates patient transport from point of injury to a Role 2 medical treatment facility, where patients can be stabilized with surgery if needed. The Role 2 medical treatment facility initiates a patient movement request through the USTRANSCOM Regulating and Command and Control Evacuation System. Next, USTRANSCOM’s Patient Movement Requirements Center – East, Ramstein Air Base, Germany, validates the requirement. “Following the validation process, the TPMRC-E, Ramstein AB, coordinates with the USCENTCOM’s Combined Air Operations Center, Al Udeid AB, Qatar, for the appropriate AE response,” said U.S. Air Force Lt. Col. Sean Wilkinson, chief, Global Patient Movement Integration Cell, USTRANSCOM Command Surgeon Directorate. “The heart and soul of theater patient distribution and movement is the AE hub and spoke system, which capitalizes on flight efficiencies. For instance, in Afghanistan, a C-130 Hercules or C-17 Globemaster III aircraft transports patients from the location of initial resuscitative treatment at the spoke - a forward operating base - to a surgical facility situated at a hub such as Al Udeid AB, as well as Bagram AB and Kabul in Afghanistan.” Next, in-theater AE and critical care air transport team members assigned to the 379th Expeditionary AE Squadron at Al Udeid AB provide in-flight medical treatment to U.S. warriors, NATO and coalition forces, as well as Afghan military members. U.S. Transportation Command coordinates theater patient movement “In any healthcare system, transitions or handoffs of patients from one team to another are the most likely points in the care continuum to generate a medical error. USTRANSCOM leads the effort globally to close the seams between DOD theater and strategic patient movement,” stated U.S. Air Force Col. John Andrus, USTRANSCOM command surgeon. “We coordinate planning and execution activity to synchronize theater and strategic resources and processes to assure safe and reliable movement from point of injury or illness to the point of definitive care for our defenders.” Based at Ramstein AB, the 10th Expeditionary Aeromedical Evacuation Flight, a USTRANSCOM-assigned organization, executes patient movements from USCENTCOM’s area of responsibility to Germany and to America. “Regardless of whether it’s an intra-theater or inter-theater patient movement, the most important priority is the injured or ill individual, and also providing an extraordinary level of in-flight medical care,” said Wilkinson. “That patient-focused commitment extends from the immediate point of injury to the final medical treatment destination. USTRANSCOM exists as a warfighting combatant command to project and sustain military power. Powered by dedicated men and women, we underwrite the lethality of the joint force, advance American interests, and provide our nation's leaders with strategic flexibility to select from multiple options and create multiple dilemmas for adversaries.