ABSTRACT
Medical evacuation of combat casualties in Operation Enduring Freedom-Afghanistan is achieved primarily by helicopter, because of distances involved as well as ground-based threats. In Helmand Province, evacuation from the point of injury may occur on a variety of helicopter evacuation platforms with disparate levels of attendant medical expertise. Furthermore, triage to a medical treatment facility may involve varying echelons of care before definitive management. Consequently, considerable differences in medical care may be encountered between point of injury and definitive treatment. We discuss the role of helicopter-based medical evacuation in Helmand, Afghanistan, as well as triage and timelines to the most appropriate medical facilities. Based on our experience and available evidence, we have made recommendations to regional commanders which favor the utilization of prehospital critical care teams aboard helicopter-based evacuation platforms and direct triage to the highest echelon of care available when feasible.
Subject(s)
Afghan Campaign 2001- , Emergency Medical Services/organization & administration , Military Medicine/organization & administration , Military Personnel , Transportation of Patients/organization & administration , Triage/organization & administration , Wounds and Injuries/therapy , Humans , United StatesABSTRACT
Psoriatic arthritis is a chronic spondyloarthropathy whose pathogenesis is unknown. We present a case of a naval flight officer who presented with chronic psoriatic arthritis, which ultimately became well controlled with etanercept treatment. The naval flight officer was granted military aeromedical waivers for psoriatic arthritis, cutaneous psoriasis, and chronic medication use. We also review the medical literature on psoriatic arthritis disease and etanercept and discuss their aeromedical implications in military aviation.
