Battlefield Advanced Trauma Life Support (BATLS).

The vast majority of casualties will only require a common sense approach to their preparation for evacuation, by asking simple questions, most problems can be identified and resolved prior to the evacuation. Ask? Are aeromed teams available to undertake this task? (Contact them). If aeromed teams are unavailable but can offer advice, talk to them. Where is the onward destination and are they expecting the casualty. (Check). Is the destination suitable for the casualty and the aircraft type? (Check). What level of training is required to transfer the casualty? (Cbt Med Tech/RGN/MO). Are the appropriate aeromed stretchers and harnesses available? (If not get them). Are all the casualty's documentation and X-rays available for transportation with the casualty? (Check). Does the casualty require a secure airway, intravenous access or fluid resuscitation prior to or during flight? (Ideally, the casualty must be as stable as possible prior to flight). Are all i.v. lines taped and secure. (Check them). Is there sufficient oxygen supply on board for the casualty's(ies) needs to complete the journey and cope with delays? This especially applies if the ventilator is air or oxygen driven. Has the electrical medical equipment required for transportation been cleared for use on the aircraft? (Talk to the aircrew). This equipment may be necessary for in-flight monitoring. Even simple tasks such as counting a pulse rate using the carotid artery, may be impossible in a vibrating airframe. How is the casualty going to be positioned on board the aircraft and does the escort have access? (Find out). If the flight is tactical and at night, the air-crew may be using night vision goggles, can any light be used in the cabin? (On chinooks the crew may be able to provide a blacked out area; in other aircraft torches with green filters will have to be used and monitoring undertaken by touch. Check the situation with the crew and be prepared to adapt). It is very difficult to care for a casualty in the air, particularly on a helicopter. It is extremely important to prepare the casualty properly prior to the flight. A few extra minutes on the ground preparing the casualty may ultimately save their life. However, the tactical situation or the condition of the casualty may dictate the scoop and scoot approach, rather than stay and play.