• Seth R Holland, Amy Apodaca, and Robert L Mabry.
• U.S. Army Institute for Surgical Research, 3698 Chambers Pass, Building 3611, Fort Sam Houston, TX 78234-6315.
• Mil Med. 2013 May 1;178(5):529-36.

ObjectiveDetermine if a higher level of Army flight medic (AFM) training was associated with improved physiological state on arrival to a combat support hospital (CSH).MethodsA retrospective study comparing casualties who were evacuated by two AFM units with only Emergency Medical Technicians-Basic (EMT-Bs) to an Army National Guard unit with Critical Care Flight Paramedics (CCFPs) in Afghanistan with an injury severity score >16 in different time periods looking at their 48-hour mortality, hematocrit (HCT), base deficit (BD), oxygen saturation (SpO2), and physiological parameters on arrival to the CSH.ResultsThe CCFP group had better HCT [36.5 (8.8)] than the EMT-B group [33.1 (11.4); p ≤ 0.001]. BD and SpO2 were better in the CCFP group [-3.2 (4.7)]/[97.8 (4.8)] than the EMT-B group [-4.4 (5.5)]/[96.3 (10.9)] [p ≤ 0.014]. The CCFP group had a 72% lower estimated risk ratio of mortality with an associated improvement in 48-hour survivability of 4.9% versus 15.8% for the EMT-B-group.ConclusionsThere is a statistically significant improvement in the HCT, BD, SpO2, and 48-hour survivability at the CSH in the cohort transported by the CCFP group when compared to the cohort transported by the EMT-B group.Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

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