Page 311 - 2023 SMOG Digital

FORMS

STANDING ORDERS - Air Ambulance, Emergency Medicine Tasks
PURPOSE
The intended purpose of these guidelines is to serve as a baseline for the Aviation Medical
Company’s Aviation Medicine SOP (Standing Orders and Aeromedical Treatment Guidelines).
Practices in Aviation Medicine undergo constant scrutiny and change. As such, this guide should
not be considered an all-inclusive and always up-to-date source of the newest and most relevant
policies, procedures, and practices in Aviation Medicine. It will require continued monitoring for
relevant clinical and operational updates needed to reflect current aviation and clinical practice
standards.
Primarily, this guide should serve as a resource for tactical and non-tactical prehospital,
interfacility and post-surgical enroute medical care on an Army aeromedical platform. Initial
patient evacuation and prehospital trauma guidelines are written in a manner to support the
principles of Tactical Combat Casualty Care (TCCC). This assumes that a combat trauma patient
will respond to care most effectively when the order of care addresses circulation (stopping and
preventing hemorrhage) prior to addressing the patient’s airway and breathing. When these
guidelines are adapted for use within US Army civilian missions (noncombat), unit medical
directors should consider the necessity of writing and appending these guidelines, order of care,
and standard operating procedures to address the differences in initial interventions of the
civilian trauma patient verses the combat trauma patient.
SCOPE OF PRACTICE

This guide is intended for use by Aviation Medical Personnel to include: Critical Care Flight
Paramedics, Flight Surgeons, Aeromedical Physician Assistants (APAs), Aeromedical Nurse
Practitioners (ANPs), and En Route Critical Care Nurses performing MEDEVAC on an Army
Aviation platform. Preferably, only medical personnel trained in and holding certifications in the
National Registry of Paramedics (NRP), Emergency Medicine, or Critical Care should be eligible
to use all treatment guidelines within this book. However, local training programs may be
adopted that may enable individually trained physicians, Physician Assistants, and Non-NRP
Flight Medics a knowledge base sufficient to satisfy use of these treatment guidelines in an
austere/combat environment. Specific certifications of importance might include: TCMC, ATLS®,
ACLS/ALS, PALS, PHTLS, ITLS, and PEPP, among others. Any individual who is not fully trained,
has not demonstrated competency in each of these guidelines, or has not been approved
(credentialed) to use these guidelines by the local Aviation Medicine Medical Director should
not be authorized to perform the respective guideline(s) without direct (on-hand) oversight. All
personnel using these guidelines should adhere to the steps and standards as outlined in each of
the standard medical operating guidelines (SMOG) and procedures. Moreover, all unit medical
personnel providing care aboard US Army Air Ambulances (including Unit Flight Surgeons and
APAs) will, at a minimum, adhere to this standard of care unless superseded by theater and/or
regional clinical practice guidelines under the authorization of an appropriate local command
medical officer/surgeon.
Following the concept set forth in the National Emergency Medical Services (EMS) Scope of
Practice Model, an individual may only perform a skill or role for which that person is:

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