{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T22:55:47Z","timestamp":1792536947067,"version":"4.5.0"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"5-6","funder":[{"DOI":"10.13039\/100000090","name":"Congressionally Directed Medical Research Programs","doi-asserted-by":"publisher","award":["J917EC02"],"award-info":[{"award-number":["J917EC02"]}],"id":[{"id":"10.13039\/100000090","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000090","name":"Congressionally Directed Medical Research Programs","doi-asserted-by":"publisher","award":["J917EC02"],"award-info":[{"award-number":["J917EC02"]}],"id":[{"id":"10.13039\/100000090","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,5,18]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Emergent clinical care and patient movements through the military evacuation system improves survival. Patient management differs when transporting from the point-of-injury (POI) to the first medical treatment facility (MTF) versus transporting from the Role 2 to the Role 3 MTF secondary to care rendered within the MTF, including surgery and advanced resuscitation. The objective of this study was to describe care provided to patients during theater inter-facility transports and compare with pre-hospital transports (POI to first MTF).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>We performed a retrospective chart review of patients with the Role 2 to the Role 3 transports in Afghanistan and Iraq from 2007 to 2016. Data collected included procedures and events at the MTF and during transport. We compared the intra-theater transport data (Role 2 to Role 3) to data from a previous study evaluating pre-hospiital transports (POI to first MTF).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We reviewed the records of 869 Role 2 to Role 3 transport patients. Role 2 to Role 3 transports were longer in duration compared to POI transports (39\u2009minutes vs. 23\u2009minutes) and were more likely to be staffed by advanced personnel (nurses, physician assistants, and physicians) (57% vs. 3%). The sample primarily consisted of military-aged males (mean age 27\u2009years) who suffered from explosive or blunt force injuries. Procedures performed during each phase of care reflected the capabilities of the teams and locations. Pain and cardiac events were more common in POI evacuations compared to the Role 2 to Role 3 transports, but documentation of respiratory events, hemodynamic events, neurologic events, and equipment failure was more common during the Role 2 to Role 3 transports. Survival rates were slightly higher among the Role 2 to Role 3 cohort (98% vs. 95%, difference 3% [95% confidence interval of the difference 1-5%]).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Inter-facility transports (Role 2 to Role 3) are longer in duration, transport more complex patients, and are staffed by more advanced level provider types compared to transports from POI.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usad404","type":"journal-article","created":{"date-parts":[[2023,11,15]],"date-time":"2023-11-15T17:59:27Z","timestamp":1700071167000},"page":"e1003-e1008","source":"Crossref","is-referenced-by-count":7,"title":["Management of\u00a0Combat Casualties during Aeromedical Evacuation from a Role 2 to a Role 3 Medical Facility"],"prefix":"10.1093","volume":"189","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1017-5619","authenticated-orcid":false,"given":"Joseph K","family":"Maddry","sequence":"first","affiliation":[{"name":"United States Air Force En route Care Research\/59th Medical Wing\/Science & Technology , JBSA Lackland Air Force Base, TX 78236,","place":["USA"]},{"name":"Department of Emergency Medicine, Brooke Army Medical Center , JBSA Ft. Sam Houston, TX 78234,","place":["USA"]},{"name":"Department of Military and Emergency Medicine, Uniformed Services University , Bethesda, MD 20814,","place":["USA"]},{"name":"US Army Institute of Surgical Research , JBSA Ft. Sam Houston, TX 78234,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allyson A","family":"Ara\u00f1a","sequence":"additional","affiliation":[{"name":"United States Air Force En route Care Research\/59th Medical Wing\/Science & Technology , JBSA Lackland Air Force Base, TX 78236,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandra G","family":"Mora","sequence":"additional","affiliation":[{"name":"United States Air Force En route Care Research\/59th Medical Wing\/Science & Technology , JBSA Lackland Air Force Base, TX 78236,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven G","family":"Schauer","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Brooke Army Medical Center , JBSA Ft. Sam Houston, TX 78234,","place":["USA"]},{"name":"Department of Military and Emergency Medicine, Uniformed Services University , Bethesda, MD 20814,","place":["USA"]},{"name":"US Army Institute of Surgical Research , JBSA Ft. Sam Houston, TX 78234,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren K","family":"Reeves","sequence":"additional","affiliation":[{"name":"United States Air Force En route Care Research\/59th Medical Wing\/Science & Technology , JBSA Lackland Air Force Base, TX 78236,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie E","family":"Cutright","sequence":"additional","affiliation":[{"name":"United States Air Force En route Care Research\/59th Medical Wing\/Science & Technology , JBSA Lackland Air Force Base, TX 78236,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joni A","family":"Paciocco","sequence":"additional","affiliation":[{"name":"United States Air Force En route Care Research\/59th Medical Wing\/Science & Technology , JBSA Lackland Air Force Base, TX 78236,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Crystal A","family":"Perez","sequence":"additional","affiliation":[{"name":"United States Air Force En route Care Research\/59th Medical Wing\/Science & Technology , JBSA Lackland Air Force Base, TX 78236,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William T","family":"Davis","sequence":"additional","affiliation":[{"name":"United States Air Force En route Care Research\/59th Medical Wing\/Science & Technology , JBSA Lackland Air Force Base, TX 78236,","place":["USA"]},{"name":"Department of Emergency Medicine, Brooke Army Medical Center , JBSA Ft. Sam Houston, TX 78234,","place":["USA"]},{"name":"Department of Military and Emergency Medicine, Uniformed Services University , Bethesda, MD 20814,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick C","family":"Ng","sequence":"additional","affiliation":[{"name":"United States Air Force En route Care Research\/59th Medical Wing\/Science & Technology , JBSA Lackland Air Force Base, TX 78236,","place":["USA"]},{"name":"Department of Emergency Medicine, Brooke Army Medical Center , JBSA Ft. 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