Evolution of Pararescue medicine during operation Enduring Freedom.
This article highlights recent advances made in U.S. Air Force Pararescue Medical Operations in relation to tactical evacuation procedures. Most of these changes have been adopted and adapted from civilian medicine practice, and some have come from shared experiences with partner nations. Patient assessment includes a more comprehensive evaluation for hemorrhage and indications for hemorrhagic control. Ketamine has replaced morphine and fentanyl as the primary sedative used during rapid sequence intubation and procedural sedation. There has been an increasing use of the bougie to clear an airway or nasal cavity that becomes packed with debris. Video laryngoscopy provides advantages over direct laryngoscopy, especially in situations where there are environmental constraints such as the back of a Pave Hawk helicopter. Intraosseous access has become popular to treat and control hemorrhagic shock when peripheral intravenous access is impractical or impossible. Revisions to patient treatment cards have improved the efficacy and compliance of documentation and have made patient handoff more efficient. These improvements have only been possible because of the concerted efforts of U.S. Air Force and partner platforms operating in Afghanistan.
Departments of Neurosurgery and Radiation Oncology, NYU Langone Medical Center, 550 First Avenue, New York, NY 10016, 103rd Rescue Squadron, NY Air Guard, 150 Old Riverhead Road; Westhampton Beach, NY 11978.
Stephen
S
Rush
Department of Emergency Medicine, North Shore University Hospital, Long Island Jewish Medical Center, 300 Community Drive, Manhasset, NY 11030.
Eric
E
Boccio
Prehospital and Disaster Medicine Fellowship, Department of Emergency Medicine, San Antonio Uniformed Services Health Education Consortium, 3851 Roger Brooke Drive, Ft Sam Houston, TX 78234.
Chetan U
CU
Kharod
Department of Emergency Medicine, North Shore University Hospital, Long Island Jewish Medical Center, 300 Community Drive, Manhasset, NY 11030.
Jason
J
D'Amore
D055826:Afghan Campaign 2001-; D006801:Humans; D008887:Military Medicine / Q000458:organization & administration*; D008889:Military Personnel; D018635:Rescue Work / Q000458:organization & administration*; D014481:United States