The provision of sophisticated critical care beyond the hospital: lessons from physiology and military experiences that apply to civil disaster medical response.
OBJECTIVE
The provision of sophisticated medical care in an austere environment is challenging. During and after a mass casualty event, it is likely that critical care services will be needed beyond an intensive care unit (ICU) setting. The objective of this article is to explore existing ICU care systems such as military aeromedical transport that may be applicable to disaster medicine and to providing critical care outside of an ICU setting.


RESULTS
The U.S. Air Force Critical Care Aeromedical Transport (CCAT) Teams were developed in 1994 in response to an unmet military need for long-range air transport of critically ill and injured patients. This system has transported several thousand ICU patients and is an applicable model for the future development of extrahospital critical care capabilities needed during a disaster. We also discuss civilian aeromedical critical care systems, the types of medical devices used, and their applicability to disaster medical response.


CONCLUSIONS
The U.S. Air Force CCAT Team program, as well as many civilian critical care air ambulance services, provides a workable starting point for the development of disaster medical critical care response capabilities for disaster medical systems.
Grissom
Thomas E
TE
Center for Sustainment of Trauma and Readiness Skills, Baltimore, MD, USA.
Farmer
J Christopher
JC
D017732:Air Ambulances / Q000458:organization & administration*; D003422:Critical Care / Q000379:methods* / Q000458:organization & administration*; D004189:Disaster Planning / Q000379:methods / Q000458:organization & administration; D004632:Emergency Medical Services / Q000458:organization & administration; D004864:Equipment and Supplies; D006801:Humans; D008887:Military Medicine / Q000379:methods* / Q000458:organization & administration*; D020380:Needs Assessment; D010348:Patient Care Team / Q000458:organization & administration; D016730:Program Development; D014481:United States