Abstract
Introduction A retrospective analysis of aeromedical evacuation of casualties from OP TELIC contrasting the demand for evacuation and nature of injury during both war fighting and peace enforcement missions. The study was performed to address a perception of clinicians working within the operational theatre that service personnel outside of times of conflict were being evacuated with increasingly trivial or chronic injuries compared with those evacuated when war fighting was occurring.
Methods A comprehensive record of patients evacuated was retrospectively studied. Consecutive cases were classified by diagnosis. The period of study was 1st March 2003 to 30th June 2004.
Results In the sixteen month period a total of one thousand nine hundred and twenty four patients were evacuated by air to the United Kingdom. In the first three months (immediately before, during and post conflict) eight hundred and thirty patients were evacuated, an average of 280 per month. Of these, 2.8% were as a result of battle. During the conflict phase, an average of 60 patients a month were evacuated due to a chronic orthopaedic condition. This is in contrast to an average of 10 a month in the post conflict phase. In the three months following the conflict (incorporating the Iraqi summer) four hundred and seventy one troops were evacuated - an average of 157 per month. Of these, heat illness accounted for 28%. In the following ten months 621 troops were evacuated, averaging 62 per month. During the post conflict period, Battle injuries accounted for 5.6% of those evacuated, which is double that seen during conflict. Chronic general surgery maintained a similar percentage of total sent home throughout both phases. Other specialities were more sporadic with no particular pattern other than a decrease in raw figures compared to the war fighting phase.
Conclusion This pattern of aeromedical evacuation in a modern major deployment illustrates the paucity of battle injury at the time of fighting in relation to non battle injury. It also highlights the impact of chronic injury on a deployed force, especially injury related to back pain. The study has shown that contrary to perception by the clinicians in theatre, there was no obvious increase in evacuation of troops as a result of chronic or minor injuries in the post conflict period. Heat illness clearly places an important predictable strain on this method of evacuation.
Correspondence should be addressed to Major S A Adams, Orthopaedic Department, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA.
