This week, we further explored the medical evacuation logistics problem in our beneficiary interviews and found that, in general, this could help 18D’s save time and improve work focus during the right point in time as compared to the standardized clinic set-up. Having a more accessible database of information- ideally with pictures and filters for higher levels of care, such as availability of safe and vetted blood, or sterile surgical equipment, could mean the difference between a med evac 48 hours away versus 12 hours. This eases the burden of shrinking resources on the medic as well as the time the medic would spend sitting on a patient in prolonged field care. The major challenges to this kind of product, though, stem from the need for a database that can be offloaded due to cost and reliability of cell service, security in geo-based products, and implementation among groups so that this information on such a database (on higher levels of care) is constantly refreshed by medics and does not go stale.

 

Interview 1: CPT Amanda Canada

• Testing of new technology could be an essential part
• Better diagnosis, documentation will be beneficial for med eva and database or guide will help make decisions
• Extra work like availability of higher levels of care and prolonged field care slows medic down

Interview 2: SGT Bill Kelly

• It takes 2-5 minutes sometimes 30 or more to figure out med evac logistics
• Clinic set-up is not really a huge need

Interview 3: SGT John Carlson

• Role of medic: Triage, treat, stabilize, delegate, repeat, document
• Need high level of testing to ensure safety in the field

Interview 4/5: General Stanley McChrystal

• Curious about possibility of disconnect between higher ups (Central Command) and individual operations/missions.
• Risk understanding to force, mission, reputation…can be variable and has high effect in decision making.
• Captains tell Central Command that it was high risk and it’s hard to understand what happens when you don’t know the situation.

Interview 6: General Dempsey

• Get specific on what medical scenarios we want to be able to aid medics in treating on the field
• Even solving a niche problem (such as 1 aspect of the med evac logistics) would provide value
• Advised us to get more anecdotal context from our beneficiaries on what they need/want from this product

Interview 7: SFC Chase

 

• Need strong validation- what we see from info online often doesn’t align with reality, and SF’s own clinics often are better than what these hospitals can provide
• Main issues in solving problems that aren’t covered in training, which is why he sees the clinic set-up as a possibly valuable tool for new medics
• Not always about time saving: Increasing survivability in that you’re providing shared understanding of how it’s supposed to work and where they are

 

Interview 8: SOFACC Trainee Michael

• SOFACC Trainee binder is pretty well organized, in a training setting it’s very helpful to have even if it’s more brief and not fully in depth for what may be necessary
• An app solution could be helpful but needs to be really easy to navigate- and a lot of the binder info should be in our heads already anyway so an app would be looked to as the last resort

Interview 9: 18D Mike

How useful would a database be?

• Usually don’t have internet access in austere environments
• A lot of info about local facilities and resources already exists, it’s just about having to find and organize the evacuation based on all that information
  • 18D’s have someone else doing that logistics work as they perform patient care
  • Database/app could be more helpful stateside but wouldn’t be super operable abroad

Interview 10: Army Nurse Josette Noxon

• Medical Evacuation process, what it looks like:
  • Role 1, Role 2, Role 3, Germany, then US Hospital (either DC or San Antonio – where the burn center is)
  • Existing system: A “JSTAR” system currently exists for home theater medical evacuations where patients are tracked and evacuated based on acuity of injury
    • “Med evac” means critically ill patients
    • “Air evac” means less urgent or serious injuries
• The core of the issue is that Role 1/Role 2 facilities can be 8-10 hours away distance wise

Interview 11: Company Physician Assistant – 44th Medical Brigade – US Army Garrison CPT Bob

• Medics need to decide what method of transportation to use (helicopter, ambulance, etc.)
• Be aware of data security concerns