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Invited Commentary
August 2014

The Military's Evolved En Route Care Paradigm: Continuous, Transcontinental Intensive Care

Author Affiliations
  • 1The US Combat Casualty Care Research Program, Fort Detrick, Maryland
  • 2The Uniformed Services University of the Health Sciences, Bethesda, Maryland
JAMA Surg. 2014;149(8):814. doi:10.1001/jamasurg.2014.620

Ingalls and colleagues1 have provided a clinical study of the largest series of injured US service personnel to undergo aeromedical evacuation with the military’s Critical Care Air Transport Team capability. The authors have documented a standard for high stakes, advanced en route care capability in reporting this number of patients who have been moved thousands of miles within 40 hours of severe wartime injury. These findings demonstrate the effectiveness of the US military’s continuum of intensive care that aims to bring and maintain high-level critical care to the injured warfighters through the continuum of evacuation. This capability is in contrast to previous wars when severely injured troops were maintained in the country of warfare for much longer periods, a strategy that kept patients away from care and comfort in the United States and added a large logistical footprint. Along with a low case fatality rate, capabilities outlined in the Ingalls et al article have now become an expectation of commanders in the field, patients, their families, and the American public.2,3