Evacuation Considerations
Medical evacuation in the midst of a bioincident can be very challenging, and it is difficult to generalize recommendations for all potential scenarios and would need to be addressed in specific Concept of Operations Plans and Pandemic and Infectious Disease plans. The complexity of medical evacuation during a bioincident will depend upon the operational environment (Large Scale Combat Operations (LSCO) vs. humanitarian, for example), acuity of the patient, and specific biothreat implicated (contagious vs. non-contagious). The combatant commander (CCDR), with the advice of the command surgeon, is responsible for moving casualties within the theater and deciding the extent to which evacuation assets will be committed.26 The commander, U.S. Transportation Command (USTRANSCOM) is the DoD single manager for inter-theater patient movement.26
Understand that aeromedical evacuation capabilities for contaminated and contagious HCID casualties under high-level biosafety containment are very limited. However, current theater evacuation policy permits the air transport of patients ill with, exposed to, or potentially exposed to an identified/known infectious agent using a contract transport service.26 With the additional actions required beyond the traditional medical evacuation (MEDEVAC) process, pre-planning is essential to assure casualty movement occurs in a timely fashion: