The most extensive utilization of evacuation has occurred in time of combat. Many steps in the evacuation process under combat deserve review. Steps may be bypassed or consolidated depending on the geographic and tactical situation. The entire operation has reflected the highest degree of inter-service cooperation.
On the battlefield, emergency medical care is promptly rendered on the spot by medical technicians or physicians assigned to the combat unit. A "Med Evac" helicopter, usually supplied by the Army, is called to the site by radio and the patient is enplaned for transportation to a forward medical facility. Normally a helicopter pad is also close to an airstrip. At this facility, the patient's wounds are cared for, casts are applied, and blood administered if necessary. The patient is observed long enough to be certain of stabilization throughout the next phase of their journey.
When the patient is stabilized and ready for travel, they are taken by ambulance to the airstrip. They are enplaned aboard a reconfigured cargo aircraft to the nearest major medical facility serving the area. They are examined by a specialist and assessment is made regarding further treatment and evacuation. Prompt treatment is provided until they are ready for further evacuation or returned to duty. If treatment can be delayed and if the patient is likely to return to duty in a reasonable time, they may be transported to another neighboring hospital. If they are able to travel further and not likely to return to duty in a specified time, they are evacuated to the United States by multipurpose aircraft. Upon arrival in the United States, the patient usually remains overnight at an Aeromedical Staging Facility. They are carefully reexamined and retained if further treatment is necessary.
These facilities are strategically located throughout the United States and overseas to provide care and treatment for patients' traveling via the air evacuation system. Each facility will assess the patients' condition and treat as necessary. If the patient is deemed unfit for duty, they are shipped to closest care facility to their home. Time required for completion of these stages depends on distances involved, aircraft utilized, and the patients' condition. The use of helicopters for initial pickup of casualties makes it possible to have a patient in a forward hospital with a few minutes after injury. When prolonged treatment has not been required en-route, it has been possible to have a patient moved to the United States within 24 hours after departure from the Area of Responsibility (AOR).
In peacetime, air evacuation for the sick and injured Armed Forces personnel and their dependents are provided in overseas areas and the Continental US (CONUS). When cleared by the Department of Defense and the Department of Transportation, seriously ill or injured civilian patients are airlifted to medical facilities for specialty care.
The lesson learned from combat airlift of Vietnam Battle Casualties would be applicable to the civilian situation in case of disaster as the overall improvement of future air evacuation. High speed aircraft and airborne medical care in the future need not be based solely on a system of evacuation dictated by war. A system of transport worldwide to areas which offer the diagnostic facilities and definitive care are required to support the United States military members.