U S Army Aeromedical Evacuation Critical Care Flight Paramedic Standard Medical Operating Guidelines 2023 2024

CONTENTS: 1. U.S. ARMY AEROMEDICAL EVACUATION CRITICAL CARE FLIGHT PARAMEDIC STANDARD MEDICAL OPERATING GUIDELINES - CY23 Version Published January 2023, 318 pages 2. TCCC Guidelines for Medical Personnel - 15 December 2021, 19 pages 3. JTS Clinical Practice Guidelines, 2,260 total pages - current as of 19 September 2023: INTRODUCTION The SMOG continues to go through significant improvements with each release as a result of the collaboration of Emergency Medicine professionals, experienced Flight Medics, Aeromedical Physician Assistants, Critical Care Nurses, and Flight Surgeons. There has been close coordination in the development of these guidelines by the Joint Trauma System, and the Defense Committees on Trauma. Our shared goal is to ensure the highest quality en route care possible and to standardize care across all evacuation and emergency medical pre-hospital units. It is our vision that all of these enhancements and improvements will advance en route care across the services and the Department of Defense. Unit medical trainers and medical directors should evaluate Critical Care Flight Paramedics (CCFP) ability to follow and execute the medical instructions herein. These medical guidelines are intended to guide CCFPs and prehospital professionals in the response and management of emergencies and the care and treatment of patients in both garrison and combat theater environments. Unit medical providers are not expected to employ these guidelines blindly. Unit medical providers are expected to manipulate and adjust these guidelines to their unit’s mission and medical air crew training / experience. Medical directors or designated supervising physicians should endorse these guidelines as a baseline, appropriately adjust components as needed, and responsibly manage individual unit medical missions within the scope of practice of their Critical Care Flight Paramedics, Enroute Critical Care Nurses, and advanced practice aeromedical providers. The medication section of this manual is provided for information purposes only. CCFPs may administer medications only as listed in the guidelines unless their medical director and/or supervising physician orders a deviation. Other medications may be added, so long as the unit supervising physician and/or medical director approves them. This manual also serves as a reference for physicians providing medical direction and clinical oversight to the CCFP. Treatment direction, which is more appropriate to the patient’s condition than the guideline, should be provided by the physician as long as the CCFP scope of practice is not exceeded. Any medical guideline that is out of date or has been found to cause further harm will be updated or deleted immediately. The Medical Evacuation Concepts and Capabilities Division (MECCD) serves as the managing editor of the SMOG and are responsible for content updates, managing the formal review process, and identifying review committee members for the annual review. The Standard Medical Operating Guidelines are intended to provide medical procedural guidance and is in compliment to other Department of Defense and Department of the Army policies, regulatory and doctrinal guidance. Nothing herein overrides or supersedes laws, rules, regulation or policies of the United States, DoD or DA.

CONTENTS: 1. U.S. ARMY MEDEVAC CRITICAL CARE FLIGHT PARAMEDIC STANDARD MEDICAL OPERATING GUIDELINES - CY20 Version Published January 2020, 278 pages 2. TCCC Guidelines for Medical Personnel - 1 August 2019, 24 pages 3. Joint Trauma System Clinical Practice Guideline Special Edition v2.0 - Management of COVID-19 in Austere Operational Environments (Prehospital & Prolonged Field Care) - 28 May 2020, 40 pages 4. DoD C-19 PRACTICE MANAGEMENT GUIDE - Clinical Management of COVID-19, 124 pages 5. COVID-19 Considerations in the Deployed Setting (Presentation) - 27 May 2020, 35 pages INTRODUCTION The STANDARD MEDICAL OPERATING GUIDELINES (SMOG) continues to go through significant improvements with each release as a result of the collaboration of Emergency Medicine professionals, experienced Flight Medics, Aeromedical Physician Assistants, Critical Care Nurses, and Flight Surgeons. There has been close coordination in the development of these guidelines by the Joint Trauma System, and the Defense Committees on Trauma. Our shared goal is to ensure the highest quality en route care possible and to standardize care across all evacuation and emergency medical pre-hospital units. It is our vision that all of these enhancements and improvements will advance en route care across the services and the Department of Defense. Unit medical trainers and medical directors should evaluate Critical Care Flight Paramedics (CCFP) ability to follow and execute the medical instructions herein. These medical guidelines are intended to guide CCFPs and prehospital professionals in the response and management of emergencies and the care and treatment of patients in both garrison and combat theater environments. Unit medical providers are not expected to employ these guidelines blindly. Unit medical providers are expected to manipulate and adjust these guidelines to their unit’s mission and medical air crew training / experience. Medical directors or designated supervising physicians should endorse these guidelines as a baseline, appropriately adjust components as needed, and responsibly manage individual unit medical missions within the scope of practice of their Critical Care Flight Paramedics, Enroute Critical Care Nurses, and advanced practice aeromedical providers. The medication section of this manual is provided for information purposes only. CCFPs may administer medications only as listed in the guidelines unless their medical director (supervising physician) orders a deviation. Other medications may be added, so long as the unit supervising physician and/or medical director approves them. This manual also serves as a reference for physicians providing medical direction and clinical oversight to the CCFP. Treatment direction, which is more appropriate to the patient’s condition than the guideline, should be provided by the physician as long as the CCFP scope of practice is not exceeded. Any medical guideline that is out of date or has been found to cause further harm will be updated or deleted immediately. The Medical Evacuation Concepts and Capabilities Division (MECCD) serves as the managing editor of the SMOG and are responsible for content updates, managing the formal review process, and identifying review committee members for the annual review. The Standard Medical Operating Guidelines are intended to provide medical procedural guidance and is in compliment to other Department of Defense and Department of the Army policies, regulatory and doctrinal guidance. Nothing herein overrides or supersedes laws, rules, regulation or policies of the United States, DoD or DA.

The purpose of the handbook is to provide these medical professionals a printed resource that outlines the latest techniques and procedures used by the US Army Medevac and critical care flight paramedic communities.

The definitive treatment on the medical evacuation and management of injured patients in both peace- and wartime. Edited by eminent experts in the field, this text brings together medical specialists from all four branches of the armed services. It discusses the history of aeromedical evacuation, triage and staging of the injured patient, evacuation from site of injury to medical facility, air-frame capabilities, medical capabilities in-flight, response to in-flight emergencies, and mass emergency evacuation. Specific medical conditions are addressed in detail, including such general surgical casualties as abdominal wounds and soft tissue, vascular, maxillofacial, head and spinal cord injuries, ophthalmologic, orthopaedic, pediatric, obstetric-gynecologic casualties, burns, and more. Over 80 illustrations provide a review of transport equipment and both medical and surgical treatment. A must-have reference for all armed forced physicians and flight surgeons, for general and trauma surgeons, internists, intensive care specialists, orthopaedic surgeons, and public health service physicians.

The purpose of the handbook is to provide these medical professionals a printed resource that outlines the latest techniques and procedures used by the US Army Medevac and critical care flight paramedic communities.

Aeromedical psychology is that branch of psychology pertaining to the assessment, selection and evaluation of aviation personnel. This book, Aeromedical Psychology, is designed to provide the means for a variety of clinicians to carry out sound assessment and selection procedures, perform informed evaluations and make subsequent recommendations regarding flight status and treatment strategies geared to the aviation environment. To facilitate a dynamic understanding of the field, the book emphasizes an integration of applications and theory, case examples and research. The book is divided into three parts. The first presents assessment and selection procedures for aviation personnel (i.e. air traffic controllers, flight officers and pilots) and astronauts and the many ways in which both psychologists and psychiatrists are involved in these roles. In the second part, the waiver standards put forth by both the FAA and the various branches of the military are presented, as well as the waiver decision process. Clinical issues unique to aviation - notably fear of flying, motivation to fly and airsickness - are addressed, as well as possible courses of intervention, treatment and disposition. In the final part, more specialized issues pertaining to aeromedical psychology are dealt with, namely the psychopharmacological research and regulations applicable to recreational pilots and aviation personnel, managing the aftermath of aviation mishaps and the psychologist's role in accident investigations.

Meant to aid State & local emergency managers in their efforts to develop & maintain a viable all-hazard emergency operations plan. This guide clarifies the preparedness, response, & short-term recovery planning elements that warrant inclusion in emergency operations plans. It offers the best judgment & recommendations on how to deal with the entire planning process -- from forming a planning team to writing the plan. Specific topics of discussion include: preliminary considerations, the planning process, emergency operations plan format, basic plan content, functional annex content, hazard-unique planning, & linking Federal & State operations.