How Should Air Force Expeditionary Medical Capabilities Be Expressed

The Air Force Medical Service AFMS provides care both at home stations and in deployment missions. Two platforms provide its deployment component Expeditionary Medical Support EMEDS and the aeromedical evacuation system. These have evolved over the years to provide increasingly better care to service members during deployments. Much of this success can be credited to the concept of operations CONOPS of these systems and the tailoring of manpower and equipment to that concept. The operational emphasis of expeditionary medicine is on patient flow. An injured patient receives limited treatment locally and is then moved from the point of injury to an EMEDS facility as quickly as possible. There, the patient is further evaluated, stabilized, triaged, treated, and evacuated to a higher level of care. Each level of care is designed to be sufficient for immediate needs, not to provide definitive care. This emphasis on flow streamlines capabilities that need to be deployed and places the definitive care in the most capable facilities. Although this framework has functioned well for the mission of supporting the warfighter, two areas need improvement. First, the most common current measure of capability, both within but especially outside the Air Force, is the number of available beds. Yet, other than the final inpatient facilities that provide definitive care, the components of the expeditionary en route medical system are not intended to hold patients per se. Rather, patients are processed as quickly as is prudent and handed off to the next level to receive further care. The measure of beds does not adequately reflect this concept of operations, and requests that are stated in terms of beds are not likely to deliver the proper set of resources to meet the real requirements.