Patient transfer, en route care, and Critical Care Air Transport Team (CCATT)

The effective movement of casualties through increasingly capable levels of care is a hallmark of the modern combat casualty care system. In contemporary military operations, surgical capabilities are positioned as far forward as possible in order to provide lifesaving trauma resuscitations and urgent operative hemorrhage control. While surgeons are generally not deployed as en route care providers, surgical judgment in the planning for and execution of patient transfers is paramount for patient safety and mission success. Transport is an extremely dangerous process for a critically injured casualty, and a heroic surgical save can be quickly negated by simple, unanticipated problems arising during transport. The three distinct categories of patient movement occurring in the operational environment are described in this chapter, CASEVAC (casualty evacuation), MEDEVAC (medical evacuation), and AE (aeromedical evacuation).