The Army organized a new experimental chain of evacuation
that saw its first use after the invasion.
Poor supply of medicines, equipment, deficient staff and skilled workers, inefficient chain of evacuation
and geographical problems were the major difficulties in that area.
March 4, New Orleans: "The Chain of Evacuation
: The Army Nurse Corps." Lunchbox Lecture by Lauren Handley on the role of nurses in keeping patient mortality rates low under fire and during evacuation.
Aeromedical evacuation has been a staple in the patient care pathway since the US Army Air Corps began evacuating patients from North Africa during World War II, when Army Nurses first began escorting patients through the "chain of evacuation." (1) By 1945, the Army Air Corps evacuated 1.25 million patients by aircraft and some Army Nurses earned their in-flight caregiver wings on a portion of these evacuation missions.
While indicators were present shortly after the first employment of forward surgical teams (FSTs) in Bosnia-Herzegovina and Kosovo in 1997, (1) the return of Army nurses to the chain of evacuation actually became a necessity as combat operations intensified in Operations Enduring Freedom and Iraqi Freedom.
Earlier surgical intervention (resuscitation and stabilization) in the chain of evacuation
of the wounded has markedly improved survivability, but has also introduced an increased level of complexity in the onward transportation of these wounded.
Within the "chain of evacuation
" established by the Army Medical Department during World War II, nurses served under fire in field hospitals and evacuation hospitals, on hospital trains and hospital ships, and on medical transport planes as flight nurses.