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November 28, 2003

Air Force surgeon general: Better OIF patient care, interoperability result of lessons learned in OEF

U.S. Air Force photo by Col. (Dr.) Allan Hancock

Lt. Gen. (Dr.) George "Peach" Taylor Jr., Air Force surgeon general, says, "No one on the planet can do what the [Air Force Medical Service] does."

by G.W. Pomeroy
Air Force Surgeon General Public Affairs

Lessons learned in Operation Enduring Freedom have resulted in better patient care and better interoperability with other services in Operation Iraqi Freedom, according to the Air Force Surgeon General from Bolling, who recently completed a 10-day visit to the OEF and OIF theaters.

"We learned a large number of lessons in OEF on how to better operate with special forces and with the Army and Navy, and all those have been turned into smoother actions during Operation Iraqi Freedom and the ongoing OEF," said Lt. Gen. (Dr.) George "Peach" Taylor Jr.

"So from the perspective of the patient, there are fewer seams in the system from point of injury or illness to definitive health care," said Taylor.

Additionally, there is a much better understanding in the Army of the Air Force's capability to move critical patients, and there is a much better understanding from special forces about how they fit into the conventional system, said Taylor.

The Air Force Medical Service's presence throughout the OIF theater currently includes five expeditionary medical systems, or EMEDS, two aeromedical evacuation squadrons with a substantial number of aeromedical evacuation assets, air evacuation liaison teams and aeromedical staging facilities, Taylor said.

"Air Force medics on the ground and those performing aeromedical evacuations have been, and will remain, major factors in Operations Iraqi and Enduring Freedom," said Taylor.

Taylor said there is little to change about the aeromedical evacuation system but its capability creates new opportunities balancing the medical "footprint" on the ground.

"At Army hospitals in Afghanistan and Iraq you don't find a large number of Army casualties because the aeromedical system is so good using back-haul aircraft and forward-positioned crews to move people -- after essential care is accomplished -- to higher levels of care.

"This, in turn, keeps the hospitals clear for more casualties if and when the need arises," Taylor said.

"However, as we convert from force entry and combat operations, and move to a longer-term presence, the AFMS's presence on the ground will require some modifications," said Taylor, who served as the Air Force's forward surgeon in Operation Allied Force in Kosovo. He also molded Air Combat Command's medical response in the aftermath of Sept. 11, 2001, including OEF.

A typical EMEDS includes 25 to 85 staff for support and can provide expanded in-patient care for at-risk populations ranging in size from 500 to 5,000 people. Specific response specialists can be added to the basic EMEDS capabilities. These include roughly a dozen specialties ranging from agent detection and patient decontamination to preventive medicine and critical incident stress management.

"A lot of the EMEDS is for combat, high-speed operations, whereas now we're in for a longer haul," he said. "You need surgeons for the emergency part, but it becomes more of a dental care, preventive medicine and primary care operation after major combat ends."

According to AFMS statistics, through mid-October, Air Force surgeons had performed 217 surgeries in Iraq, or 3 percent of the 8,908 total admissions up to that point.

"We need to make sure we have the right balance of staff, including surgeons, orthopedics and anesthesiologists," Taylor said. "They need one less of this and one more of that so we need to work ways to allow us to bring the capabilities they need for the longer term."

Taylor said that during his visit to the region he encountered a lot of happy and "justifiably proud" troops.

"We came right at the end of Air Expeditionary Force Silver, so people were pretty happy they were leaving in a few weeks," he said. "They had been there for a long period of time and they were pleased with their accomplishments.

"I let them know that all of us who aren't deployed over there are proud of their commitment and sacrifices, and we understand what it means to their families to be separated and in danger's way.

"They had worked in tough conditions and they'd seen those austere conditions become better over time. They were very proud of the work they had done. They made their deployed location 'home' and they made it good enough that they're proud to turn it over to their replacements as AEF Blue rolls in."

He said that AFMS troops told him that the training they received before they came was very important. "The people who didn't train -- through not having the opportunity or not taking the opportunity -- were in a much worse position than those who had the training, Taylor said. "EMEDS-trained folks were much more comfortable."

For the foreseeable future, Taylor believes, the AFMS will be faced with a significant expeditionary footprint forward. Emphasizing that role, he said, "There is no doubt that the AFMS is prepared, trained, and experienced in supporting expeditionary operations. There is no one on the planet that can do what we do."