Naval operational medicine institute



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Points of Contact:

  • Global Patient Movement Requirement Center (GPMRC)
    Scott AFB, IL
    DSN: 576-6161/6162/6262   Com: (618) 256-6161/6162/6262

  • Navy Liaison Officer
    DSN: 576-4938/4939   Com: (618) 256-4938/4939

  • Theater Patient Movement Requirement Center (TPMRC)

  • Europe (UECOM)
    Ramstein Air Base, Kaiserslautern, Germany
    DSN: 480-8040/8041/8042/8043*   Fax 480-8045*

  • Pacific (PACOM)
    Yokota, Japan
    DSN: 225-4700*

*Call your local DSN operator to see if applicable geographical area voice codes are required.

 

DOD Policy

It is DOD policy that the movement of patients of the armed forces, in both peace and war, be accomplished by airlift when airlift is available, when conditions permit and if not medically contraindicated. The policy further states that this mission will be carried out by units specifically assigned that task except when urgent medical requirements dictate otherwise. In that case, any suitable aircraft may be pressed into service.

 

General

Aeromedical evacuations from the field, from aboard ship and from in-garrison facilities are frequently of sufficient urgency that local aircraft assets are used in order to transfer a patient to the nearest available medical facility suitable to that patient's needs. In cases requiring higher levels of care, where immediate danger to life and limb are not urgent considerations or where considerable distances are involved, the Worldwide Aeromedical Evacuation system is used. Or, it may be that urgent cases may require removal from a remote site using local aircraft assets and a link up with the aeromedical evacuation system at some location for further transport. The Navy overseas component commander is responsible for providing aeromedical evacuation over routes solely of interest to the Navy and where the facilities of the Worldwide Aeromedical Evacuation System cannot provide this service. Thus, a burn case requiring evacuation from the middle of the Mediterranean would require use of Navy assets for transportation to some land-based U.S. facility in Sicily or Italy where the patient can then be entered into the worldwide aeromedical evacuation system.

 

Caution

Aeromedical evacuation is a very helpful tool, but DOD policy should not be interpreted as an absolute requirement. You may be called upon for advice or to accompany a medical evacuation requested by a non-flight surgeon medical officer. In some cases, evacuation by air may not be in the best interests of the patient or may cause harm.

One must also bear in mind that an aviator will press a mission further than he otherwise would if he believes lives are at stake, and he must so assume when an aeromedical evacuation is requested. He may, therefore, launch in bad weather or other than ideal circumstances. It is incumbent upon the flight surgeon to evaluate all factors, and if an aeromedical evacuation seems ill advised, to present that opinion to the attending physician and through the medical chain of command if necessary. Clearly, these opinions must be presented in the most diplomatic and informed of methods. When presented with carefully reasoned objectives based on patient interests and safety, most physicians will look at alternative methods of transportation. Entry into the Worldwide Aeromedical Evacuation system is a bit more tightly controlled and run by people who do this every day. That system has a series of checks which prevent such problems.

 

 

Organization of the Worldwide Aeromedical Evacuation System



    Patient Evacuation System (2 components)

  1. Medical Regulation (DOD)

    The Armed Services Medical Regulating Office (ASMRO) is a tri-service organization which processes requests from medical facilities for evacuation of individuals to facilities able to provide higher levels of care, and then arranges movement to those facilities after having balanced requirements with current capabilities. This office handles cases from overseas and within CONUS during war and peace. Regulation of patients to be transported within the overseas area is not an ASMRO function, but is rather the mission of the Unified Commander of that theater of operations who has a Joint Medical Regulating Office (JMRO) which arranges for movement. There are two JMROs, one located at Frankfurt, Germany for the European theater, and one at Ft. Smith, Hawaii covering the Pacific theater of operations.

  2. Patient Movement

    This is the charter of the U.S. Air Force Military Airlift Command (MAC), 375th Aeromedical Airlift Wing. The 375th has four Aeromedical Evacuation Squadrons (AESs):

  • 57th AES, Scott AFB, IL - Largely administrative and scheduling.

  • 1st AES, Pope AFB, NC - The tactical evac squadron in combat situations.

  • 9th AES, Yokota AFB, Japan.

  • 2nd AES, Rhein-Main AFB, Germany.

There are Dets of AESs as well at various turn around points and receiving facilities in the U.S. and the Pacific which provide support.

 

 



How it Works

The flight surgeon elects to medevac a patient. The nearest U.S. medical facility does not have the capability to handle the case but does have a large airport available. The flight surgeon prepares the patient for transport while the staging medical facility contacts the ASMRO (JMRO in European and Pacific theaters) with the request for movement of the patient. ASMRO (or JMRO) matches the patients requirements with the capabilities of higher level facilities for that day and then contacts the cognizant AES for movement to the final destination. Each case is regulated individually except during wartime, when large numbers of casualties may dictate regulation and transport on the basis of injury categories such as neurology injury, orthopedics, burn or other.



Airframes in Use:

  • C-130 used by 1st AES primarily in the tactical role. 74 litters, 94 ambulatory.

  • C-9A Nightingale (specific configuration). 30 litters (40 wartime) 40 ambulatory.

  • C-141 (multi-purpose configuration). 103 litters, 168 ambulatory.

Medical Crews on Board:

  • 2flight nurses.

  • 3 aeromedical evacuation technicians.

  • May be augmented as required.

No medical officer is aboard. The medical crew relies on the orders and diagnosis of the originating medical officer.

 

 



Patient classification (based on condition and ability to egress in an emergency)

Class 1 (Psychiatric)

  • 1A - Severe psychiatric

a) litter
b) hospital attire
c) sedated
d) restrained

  • 1B - Intermediate psychiatric

a) litter
b) sedated
c) restraints available

  • 1C - Moderate psychiatric

a) in uniform
b) ambulatory

 

Class 2 (Litter)



  • 2A - Immobile

a) litter
b) hospital attire
c) cannot egress

  • 2B - Mobile

a) litter
b) hospital attire
c) can egress

 

 



Class 3 (Ambulatory)

  • 3A - Non psych, non substance abuse going for treatment.

  • 3B - Recovered patients returning home.

  • 3C - Drug/substance abuse patients going for treatment

 

Class 4 (Infants)

  • 4A - Infant/child under 3 in bassinett/car seat

  • 4B - Recovered infant/child requiring seat

  • 4C - Infant in incubator

  • 4D - Under 3 on a litter

  • 4E - Outpatient under 3

 

Class 5 (Outpatients)

  • 5A - Ambulatory, non psych/substance abuse going for treatment.

  • 5B - Ambulatory, psych/substance abuse going for treatment.

  • 5C - Psychiatric outpatient going for treatment/evaluations.

  • 5D - On litter for comfort/safety going for treatment.

  • 5E - Returning on litter for comfort/safety.

  • 5F - All other returning outpatients.

 

Class 6 (Attendants)

  • 6A - Medical attendant

  • 6B - Non-medical attendant

 

 

Movement Precedence:

1. Urgent - move immediately

Indication - to save life/limb/eyesight or prevent complications of serious illness.

Requires - Doctor to doctor referral.

*Validation by surgeon at Wing or designated overseas flight surgeon.

2. Priority - move within 24 hrs

Requires - Doctor to doctor referral.



*Validation as with Urgent.

3. Routine - move within 72 hrs

Routine flight.

GPMRC locates a bed for the patient.

4. Special - Inflight care exceeds usual capabilities

Requires special equipment/teams/expertise/limit stops/RON.



 

 

Your Responsibilities for Patient Preparation:

  1. DD form 602 - (Patient evacuation tag) Legible, with primary and secondary diagnoses, orders and treatments.

  2. Narrative summary.

  3. Patient x-rays, records.

  4. Medications: CONUS Travel - 3 day supply, Overseas Travel - 5 day supply.

  5. Special Diets.

  6. IV fluids, supplies, etc.

 

 

Special considerations:



1. Physicians

  • Originating M.D. is responsible for care until patient reaches destination hospital.

  • Medical crew may request flight surgeon evaluation.

  • Death in flight. 

  • Do not resuscitate orders (DNR).

 

2. Patient

  • Cardiac --10 days post MI, 5 days complication free.

  • Anemia -- Hb/Hct 8.5/30 -- May need continuous 02.

  • Chest tubes -- HeimlichValve -- XR to assure lung expansion.

  • Infectious Disease -- Usually not accepted -- Special precautions -- Isolation is possible.

  • Immobilized Jaw --Aspiration protection --Quick release mechanism (Rubber retaining bands with scissors attached to the patient).

  • Tracheotomy -- Change 24-48 hrs prior to flight.

  • C-SpineFracture -- Stryker frame -- Collins traction.

  • Pregnancy -- OB records.  Medical officer with labor patient or if on Ritodrine.

  • TB -- New: on litter with mask.  Over 2 wks: chemotherapy no precautions.

  • Casts -- Dry 48- 72 hrs.  Bi-Valve all casts.

  • Post-op -- 5 days post major surgery, and must be stable.



Department of the Navy
Standard Subject Identification Codes

(SSIC)

 

SSIC's are designed to meet the needs of the entire Navy Department for a single standard subject scheme to be used for classifying (numbering), arranging and filing, and referencing various types of Navy and Marine Corps documents by subject matter. This is required on all Navy and Marine Corps letters, instructional forms and other official documents.



  • SSIC's provide for a convenient numerical classification outline consisting of 14 major numerical series.
        (1) May be broken into primary, secondary, and tertiary subjects.
        (2) A number to be assigned to any and all subject matters.

  • Correspondence files are always in SSIC order. This is universal among Navy and Marine Corps.

  • Correspondence files are always renewed at the beginning of each new calendar year.

  • Classified Documents will always have their SSIC numbers prefixed by a certain number of zeroes.
    a. Confidential documents' SSIC numbers are prefixed by 1 zero (I.E., CO1530)
    b. Secret documents' SSIC numbers are prefixed by 2 zeros (I.E., S001530)
    c. Top secret documents' SSIC numbers are prefixed by 3 zeros (I.E., TS0001530)

 

The 14 major subject groups are designated by either a 4 or 5 digit number:



1000-1999 Military Personnel

Includes subjects relating solely to the administration of military personnel. Civilian personnel subjects are included in the 12000 series. General personnel subjects relating to both civilian and military personnel are included in the 5000 series.



2000-2999 Telecommunications

Includes subjects relating to general communication matters and to communication systems and equipment.



3000-3999 Operations and Readiness

Includes subjects relating to such matters as operational plans, fleetoperations, operational training and readiness, warfare techniques, operational intelligence, research and development, geophysical and hydrographic support.



4000-4999 Logistics

Includes subjects relating to the logistical support of the Navy and Marine Corps, including procurement, supply control, property redistribution and disposal, travel and transportation, maintenance, construction and conversion, production and mobilization planning, and foreign military assistance.



5000-5999 General Administration and Management

Includes subjects relating to the administration, organization, and management of the Department of the Navy , including general personnel matters concerning both civilian and military personnel, records management programs, security, external and internal relations, audiovisual management, law and legal matters, office services, office automation, and publication and printing matters.



6000-6999 Medicine and Dentistry

Includes subjects relating to medical matters such as physical fitness, general medicine, special or preventive medicine, dentistry, medical equipment and supplies.



7000-7999 Financial Management

Includes subjects relating to the financial administration of the Department of the Navy, including budgeting, disbursing, accounting, auditing, contract auditing, industrial and other special financing matters, and statistical reporting.



8000-8999 Ordnance Material

Includes subjects relating to all types of ordnance material and weapons, including ammunition and explosives, guided missiles of all types, nuclear weapons, fire control and optics, combat vehicles, underwater ordnance materials, and miscellaneous ordnance equipment.



9000-9999 Ships Design and Material

Includes subjects relating to such matters as the design and characteristics of ships, and to ships material and equipment.



10000-10999 General Material

Includes subjects relating to general categories of materials not included in the specialized material groups. It includes audiovisual/graphic arts/photographic/television/video equipment and accessories, general machinery and tools, personnel (materials), and miscellaneous categories.



11000-11999 Facilities and Activities Ashore

Includes subjects relating to ashore structures and facilities, fleet facilities, transportation facilities, heavy equipment, utilities and services, and other similar subjects.



12000-12999 Civilian Personnel

Includes subjects relating solely to the administration of civilian personnel. Military personnel subjects are included in the 1000 series. General personnel subjects relating to both civilian and military personnel are included in the 5000 series.



13000-13999 Aeronautical and Astronautical Material

Includes subjects relating to aeronautical and astronautical material, including parts, accessories, and instruments; special devices; armament; aerological equipment, weapons systems, types of aircraft; and astronautic vehicles.



16000-16999 Coast Guard Missions

Includes subjects relating solely to administration and mission of the Coast Guard. NOT TO BE USED BY NAVY OR MARINE CORPS ACTIVITIES.

 

When looking for a specific instruction, you should use NAVPUBINST 5215.1 (Consolidated Subject Index). This publication includes: The Alphabetical Listing, Numerical Listing, Cancellation Listing, and the DOD Implementation Listing. A listing of instructions issued by Washington, DC Headquarters Organizations is issued twice each year. This numerically indexed, subject-categorized compilation will aid in identifying active naval instructions applicable to addressee's programs or subject matter interests.



REFERENCE TELEPHONE NUMBERS

 



TYCOMS

 


AIRLANT Force Medical Officer            

DSN  564-7028

AIRPAC Force Medical Officer                                      

DSN  735-1148

FMFLANT Force Surgeon

DSN  836-1684

FMFPAC Force Surgeon

DSN  477-8660*



*Call your local DSN operator to see if applicable geographical area voice codes are required. 





Naval Operational Medicine Institute (NOMI)

 

Commercial (850) 452-XXXX

 


 

DSN 922-XXXX

Commanding Officer

4554 / 4555 / 3679

Accounting Division

4655 / 8143

Management Support

8155 / 8144

Command Master Chief

4154

Data Analysis Department (Code 14)

2171 / 2444

Psychiatry Department (Code 21)

4238 / 3974

Otorhinolaryngology Department (Code 22)

2657 / 3938

Ophthalmology Department (Code 23)

4558 / 3938

Internal Medicine Department (Code 24)

4349 / 4293

Special Studies Department (Code 25)

2157 / 8645 / 4672

Physical Exams Department (Code 26)

2257 / 2258 / 9343 / 9344

Training Directorate (Code 03)

2741 / 4659 / 2457 / 2458

Library

2256 / 3517

Aviation Physiology Training Dept. (Code 81)

2141 / 2142 / 2143

Safety/Survival (NASTP) (Code 06)

2681 / 4705

Physical Qualifications Directorate (Code 42)

4501 / 4502 / 8744

Operational Psychology Department (Code 41)             

2544 / 2516 / 2187

 



Naval Safety Center

 

Commercial (757) 444-XXXX

 


DSN 564-XXXX

Commanding Officer

7005

Administration

3520

Duty Officer

3520

A/C Mishap Reports

2929

Fax

7205

Aviation Safety Dir.

7225

A/C Operations Specialist

7285

Air Operations

7281

Air Traffic Control

7282

Aeromedical Division

7228

FSR

7268

Physiology

7230

Human Factors Engineering                                                

7231

A/C Mishap Investigators

7240

 

 



Navy Environmental and Preventive Medicine Units





EPMU No. 2
Naval Station
Norfolk,VA  23511-6288
Com:  (757) 444-7671
DSN:  564-7671

EPMU No. 5
Naval Station
Box143
San Diego, CA  92136-5143
Com:  (619) 556-7070
DSN:  526-7070

EPMU No. 6
Box112
Pearl Harbor, HI  96860-5040
Com:  (808) 471-9505
DSN:  471-9505*

EPMU No. 7
(Sigonella, Italy)
PSC 824 Box 2780
Com 39-95-56-4099
FPO AE  09623-2760
DSN:  624-4099*



 

*Call your local DSN operator to see if applicable


geographical area voice codes are required.

 

Navy Disease Vector Ecology and Control Center



 


Naval Air Station Jacksonville                          
Jacksonville, FL 33212-0043

 


Com (904)542-2424
DSN 942-2424

Naval Submarine Base Bangor
Bangor, WA 98370-7405

Com (360)315-4450
DSN 322-4450

 

 



 

 

Navy Environmental Health Center





2510 Walmer Avenue
Norfolk,VA 23513-2617

Com:  (757) 363-5402


DSN:  864-5402

 

 



 

 

Armed Forces Medical Intelligence Command (AFMIC)

Com:  (301) 619-7511 DSN:  343-7511

 

 



 

 

BUPERS





Selection Board

DSN:  224-3105
Com:  (703) 614-3105

Officer Promotion

DSN:  224-2725
Com:  (703) 601-2725

Head, Officer Separations Branch      

DSN:  224-3674
Com:  (703) 614-3674

MC Detailer

DSN:  225-7960/7961
Com:  (703)695-7960

Officer Records

DSN:  224-1315
(Com:  (202) 685-1770
for corrections)

Fiche

DSN:  224-1315 

Subspecialty Code Assignment

(see MC Career Plans)

 

 



 

 

BUMED





Chief, Medical Corps
(Code 00MC)

DSN 762-3070

Deputy Chief, Medical Corps
(Code 00MCB)

DSN 762-3063

MC Career Plans Officer
(Code 00MCB4)

DSN 762-3069

Aerospace Medicine
(Code 23)

DSN 762-3453

Deputy Dir., Aerospace Medicine
(Code 23B)

DSN 762-3451

Preventive Medicine & Occup. Health
(Code 24)

DSN 762-3500

Medical Boards
(Code 311A)

DSN 762-3143

Medical Dept. Special Pays Program Mgr.
(Code 525)

DSN 762-3362

Assistant Special Pays
(Code 525A)

DSN 762-3363

Assistant Special Pays
(Code 525B)

DSN 762-3364

Deputy for Marine Corps Medical Matters
(Code 093M)

Com (703) 614-4478

Deputy Director, Medical Programs
(Code 093M1)

Com (703) 614-4478

 

Research & Development Command

R&D (CODE 026)       DSN:  295-0287

 

United States Air Force School of Aviation Medicine (USAFSAM)





Brooks AFB, San Antonio, TX
Com:  (210) 536-1110 / 3500
DSN:  240-1110 / 3500

 

United States Air Force Aeromedical Research Lab (USAFAMRL)





Wright-Patterson AFB, OH
Com:  (513) 225-4549
DSN:  785-4549

 

United States Army School of Aviation Medicine (USASAM)





Ft. Rucker, AL
Com:  (334) 255-7409 / 7467
DSN:  558-7409 / 7467


United States Army Aeromedical Research Lab (USAARL)



Ft. Rucker, AL
Com:  (334) 225-6920
DSN:  558-6920

 

Available Lines of Communication for ALSS Problems



Three Regional Coordinators:

Directory: milmed -> avitation

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