NATO report: NATO – Medical Evacuation in Afghanistan MP-HFM-157-05

This Official NATO report is an assessment of MEDEVAC efforts in Afghanistan.


Joint Forces Command in Brunssum (JFCBS) is the operational level headquarters (HQ) for the International Security Assistance Force (ISAF) mission in Afghanistan. From the view of the current Medical Advisor of this HQ this article lights aspects of Aeromedical Evacuation (AE) in the Afghan theatre. The operational planning for ISAF is based on the respective doctrinal NATO documents. This doctrine reflects, that in contrary to plans from the cold war aera the focus lies no longer on the relief of the fighting troops from casualties but on the state of the art care for the patients. Whilst the timelines for Medical Evacuation have recently come under discussion the doctrine has proven worthwhile in the current conflict as it balances the benefit for the patient against feasibility. The article goes into detail on the limitations for AE in Afghanistan, be it national caveats, the availability of suitable airframes and medical AE specialists, weather and altitude, night flying capability or the tactical situation. It specifies a Patient Evacuation Coordination Cell (PECC) and challenges in Command and Control (C2).

Despite a higher tempo and intensity of operations the number for the “Killed in Action” (KIA) has relatively decreased whilst the figures for the “Wounded in Action” have increased. This shows, that the medical treatment and not at least the medical evacuation has significantly improved. Meanwhile more than 3200 patients have been flown in over 2063 missions, of which 30% were cases of the highest urgency. More than half of the patients were rated as casualties that need to see a surgeon latest after two hours of wounding. When 2007 still 12 percent of all flights were outside the two our timeline, it was possible to reduce that figure to 7 percent in 2008 by improving mainly command and control but also by employing more airframes. The vast majority of patients were ISAF casualties, followed by ANSF.

The current Combined Joint Status Of Requirement (CJSOR) is by far not yet filled and national caveats hamper COM ISAF’s flexibility in employing Aeromedevac Airframes. A medical theatre reserve is mandatory for future operations. Current British experiences suggest, that highly interventional pre-hospital treatment of casualties as close to the point of wounding might be beneficial (scoop and play).

Read the entire report NATO – Medical Evacuation in Afghanistan MP-HFM-157-05

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