Page 195 - PJ MED OPS Handbook 8th Ed

4. Secure blankets and loose items (duct tape, Velcro-straps) prior to entering rotor wash.
5. Re-check ear and eye protection.
6. Pre-arrange direction of loading patients so it is coordinated with location of gear/workspace.
7. If prolonged ground time, perform comm check with helo, update crew on number of patients:
stretcher, ambulatory, category.

Communicating with aircrew:
1. Avoid unnecessary evasive maneuvers when possible with very sick patients.
2. Let the aircrew know that you are performing a critical procedure so they can try to fly steady.
3. If it is cold, or concerns for hypothermia, ask aircrew to put on heaters and if windows can be
closed depending on threat.
4. Direct pilots to hospital you want to go to from a medical perspective.
5. Provide in-flight updates to aircrew of patient status on regular basis.

NOTE: Ensure proper medical planning has been conducted to include identifying the theater
validating flight surgeon point of contact for any clarifying requirements for conducting pa-
tient movement throughout theater.

Fixed Wing Operations
1. Load gear first.
2. If present, load healthy evacuees first.
3. Category C patients second, closest to front, then Cat B. Load Category A last so they are closest
to ramp and will not be delayed in off-loading to ambulances on landing.
4. Load masters are responsible for securing litters to the floor. PJs are responsible for securing
the patients to the litters.
5. Make sure vents, monitors, O2, IV/IO lines, etc. are secured.
6. If one PJ is responsible for more than one Cat A patient, configurations while flying which keep
the patients head to head either long ways or sideways allow favorable management.
7. Set up monitors, etc. at the patient’s feet/lower extremities or along the side of the litter or
airframe to facilitate monitoring and to enable access to the patient’s head and torso.
8. When possible: load patients in shock feet first for take-off and head first for landing.
9. When possible: load patients with TBI head first for take-off and feet first for landing.
10. For trans-continental and long flights, refer to the extended flight pack outs for the C-130 to
provide sufficient comfort items for evacuation missions of large groups (10–30 personnel).
11. Plan on 8–14 hour flights and have gear and contingency plans if the plane has to land and stay
down unexpectedly. Have 3 days of emergency food and water.
12. Ensure all gear is charged and have power sources compatible with aircraft power sources.
13. Use sleeping pads or other padding on the stretchers.
14. Roll the patient on to their side every 30 minutes to prevent pressure ulcers.
15. Maintain personal hydration on long flights, ensure adequate urination. Use electrolyte drinks
for warm weather ops/flights when no air conditioning is present. This will replace potassium
and glucose lost with perspiration.
16. Manning permitted, assign work rest cycles.

Chapter 15. Flight Operations n 193