Long Range Transport of War-Related Burn Casualties

U.S. military burn casualties are evacuated to the U.S. Army Institute of Surgical Research (USAISR) Burn Center in San Antonio, TX. Patients are transported by USAISR Burn Flight Teams, Air Force Critical Care Air Transport Teams, or routine aeromedical evacuation. This study characterizes the military burn casualties transported by each team and reports associated outcomes. The authors performed a retrospective review of burn center registry data, identifying all U.S. burn casualties admitted to the Army's burn center between March 2003 and February 2007. Data included total body surface area (TBSA) burn, ventilatory status, inhalational injury, associated injuries, injury severity, disposition, morbidity, and mortality. During 4 years of military operations in Iraq and Afghanistan, 540 casualties were admitted to the burn center for treatment of injuries resulting from war-related operations. Mean burn size was 16.7% total body surface area (range, 1%-95%) with a mean Injury Severity Score of 12.2 +/- 13.7. One hundred eight-one (33.5%) casualties required ventilatory support in flight; inhalation injury was confirmed in 69 (12.7%) patients. Two hundred six (38.1%) were transported by the Burn Flight Team and 174 (32.2%) were transported by the Critical Care Air Transport Team, with a mean transit time of 4 days after injury. One hundred sixty (29.6%) patients were routine aeromedical evacuees. There were no in-flight deaths reported; 30 (5.6%) patients died of their wounds at the burn center. Burn casualties represent a group of patients with severe traumatic injuries. The current system of selectively using specialty medical transport teams for the long-range transport of burn casualties is safe and effective. Pub. in the Journal of Trauma: Injury, Infection, and Critical Care, v64 n2(Suppl), pS136-S145, Feb 2008.