title: MEDEVAC: survival and physiological parameters improved with higher level of flight medic training.
abstract: OBJECTIVE
  Determine if a higher level of Army flight medic (AFM) training was associated with improved physiological state on arrival to a combat support hospital (CSH).
  
  
  METHODS
  A retrospective study comparing casualties who were evacuated by two AFM units with only Emergency Medical Technicians-Basic (EMT-Bs) to an Army National Guard unit with Critical Care Flight Paramedics (CCFPs) in Afghanistan with an injury severity score >16 in different time periods looking at their 48-hour mortality, hematocrit (HCT), base deficit (BD), oxygen saturation (SpO2), and physiological parameters on arrival to the CSH.
  
  
  RESULTS
  The CCFP group had better HCT [36.5 (8.8)] than the EMT-B group [33.1 (11.4); p ≤ 0.001]. BD and SpO2 were better in the CCFP group [-3.2 (4.7)]/[97.8 (4.8)] than the EMT-B group [-4.4 (5.5)]/[96.3 (10.9)] [p ≤ 0.014]. The CCFP group had a 72% lower estimated risk ratio of mortality with an associated improvement in 48-hour survivability of 4.9% versus 15.8% for the EMT-B-group.
  
  
  CONCLUSIONS
  There is a statistically significant improvement in the HCT, BD, SpO2, and 48-hour survivability at the CSH in the cohort transported by the CCFP group when compared to the cohort transported by the EMT-B group.
authors.affiliation: U.S. Army Institute for Surgical Research, 3698 Chambers Pass, Building 3611, Fort Sam Houston, TX 78234-6315.
authors.forename: Seth R
authors.initials: SR
authors.lastname: Holland
authors.forename: Amy
authors.initials: A
authors.lastname: Apodaca
authors.forename: Robert L
authors.initials: RL
authors.lastname: Mabry
mesh_terms: D000328:Adult; D000488:Allied Health Personnel / Q000193:education*; D004632:Emergency Medical Services / Q000592:standards*; D004634:Emergency Medical Technicians / Q000193:education*; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008889:Military Personnel; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D014481:United States / Q000453:epidemiology; D014857:Warfare; D014947:Wounds and Injuries / Q000401:mortality / Q000628:therapy*