THE SPANISH AIREVAC UNIT (UMAER). HISTORY AND TODAYS STRUCTURE.CURRENT TRENDS?

INTRODUCTION AND HISTORICAL BACKGROUND

The first air evac missions of the Spanish Armed Forces took place in Campaign in the war of Morocco, with the Junkers F-13 airplane. Later on, during the Spanish Civil War the Junkers 52 became the used aircarft for this kind of missions. At that time, patients were transported by plane but no medical intervention other than confort, took place during these transports. 

The creation of a Spanish Air-Evac Teams as such, started in 1988 where specific flight surgeons and flight nurses based at the Air Force Hospital in Madrid perfomed specific medical evacuations fromdifferent sites to the Air Force Hospital, when required.

At that time, medical equipment was intensive care equipment or medical transport equipment that was used sporadically on different airplanes when needed and without flight certification. 

During the Spanish Air Force participation in the UN mission in Namibia (UNTAG in 1989- 1990), the first tactical Air Evac Unit was deployed in Windhoekand worked as needed from any of the sites where the Spanish Air Force planes were detached, mainly at Windhoek, Rundu and Oshakati. The airplanes were the CASA 212, that was used as a small multipurpose aircraft for transport of personnel, cargo and Medevac, when requiered.

In 1991 three tactical airevac teams from the Air Force were deployed for the Operation Desert Storm. Finally it was in 1993 when the Air Force Surgeon General created four Air-Evac teams that were stationed at Air Force Hospital in Madrid, from where they were activated for different missions. Their main mission was Air-Evac to Hospital transport missions. They also performed not only Medevac flights in support of the Air Force Units deployments but one of the Air-Evac teams remained with the deployed force to provide Role 1 and Flight Medicine capability .

The Air Force Air-Evac capability became the Armed Forces Air-Evac Tactical and Strategical Medevac Unit, also for Navy and Army. It served also as advanced Air-Evac and inmediate medical intervention Role 1 capacity for the Air Force. 

During the conflict of the old Yugoslavia the structures of the groups were reorganized in 5 teams. These teams consisted of one Flight Surgeon with medical and emergency medicine background, one intensivist or anesthesiologyst and three nurses. These nurses had either a medical, surgical or trauma background so in each mission all of theses areas were represented. 

From the start, given the limited resources the manpower and equipment had to be able to perform en route care for a variety of casualties, including injured patients thatranged from the critical unstable patients to stable injuries and secondary transfers. This structure would compare now a days to a joint critical care transport medevac team. The reason to stablish this capacities was based in the need to sometimes evacuate unstable patients from the different missions from remote areas. Tipically this remote areas had no appropiate care available and/or the surgical capabilities of the deployed medical assets where overhelmed.

There was always a team ready to deploy in two hours and a second team in fourhours. 

After 2003 the Spanish medical service was reorganished and only one Joint Central Military Hospital remained for all branches of service. Air Force Surgeon General Vicente Navarro, former commander of the Air-Evac and operational medicine groups of the Air Force Hospital stablished the new Air Force Medical structure. This new structure had three Operational Medical Units. One was the Air-Evac and Inmediate Intervention Unit (UMAER) and the other two were the Deployable Medical Support Units with a ROLE 2 capability now a days based in Madrid and Zaragoza. 

CURRENT CAPABILITIES, SIZE, STRUCTURE AND ORGANIZATION OF THE SPANISH AIR-EVAC UNIT (UMAER). 

TheAir Force defined in 2003 the main missions and goals of the Spanish Air Force Medevac Unit.

Defined goals

1.Provide aeromedical evacuation (elective, contingency, urgent and medevac).Advanced Air-Evac for the Air forcé and Tactical and Estrategical Air-Evac to all the Armed Forces and Spanish Goverment. 

2.Constitues the aeromedical inmediate intervention unit (can provide triage, stabilization and preparation for the air transports in accidents and emergencies).

3.Provides basic medical support flight medicine and aerovacation capability for deployed forces under friendly enviroment (existance of local medical support).

4.Acts in conjunction with the Deployable Medical Support Units in medical support spearhead concept.

Conceptual frame

a)Today´s reality: Needs to be kept in mind in order to define our scope of needs.

The Spanish Medevac Unit has been seized to be able to support Air-Evac needs within the equipment and personnel limitations dictated by today´s trend of down-sizing of all Armed Forces. 

The proximity of the Joint Central Military Hospital acts as a reservour for specialist in support of critical care transports or in cases of emergency needed augmentees.

The unit provides the mainframe for the inmediate Air-Evac teams and all the logistical support involved in these missions. This structure allows to expedite the response time for conversion of different airframes for Medevac missions and launching of the mission.

The Spanish Air Force has always kept in mind the importance of Air-Evac and because of this the advanced, tactical and strategic medevac missions have been emphasized over the last years. This emphasys is supported on the following evidenced based principles which are shared by most of health care personnel involved in Air-Evac. 

1. In Advanced Air-Evac.

a.The ability to get our wounded personnel to a higher echalon of care in shorter time has improved the outcome of our wounded.

b.Inmediate combat care or life saving techniques in the first minutes and additional medical care during the Air-Evac time are able to further improve casualties´ care.

1. In the tactical-strategic Air Evac field.

a.The ability to provide care similar to a an intensive care unit not only with transport and stabilization medicine but already stablishing therapeutic interventions, aimed at the patients´ problems before arriving to the next echalon or to definitive care, has made a significant diference.

b.This medevac capabilities has permitted smaller medical footprints in the operational areas with consequent saving of medical personnel and logistic support requirements such as food, lodging, security, transports…

c.This trend enhances the ability to implement standards of care sooner and more effective

d.Finally the effect not only on combatants´morale but the possibility of faster healing and recuperation of the combattants, further enphasizes the operational importance of these capabilities.

Characteristics of Mission needs

1. Required Capabilitiesfor Air-Evac:
2. Ability to deploy (fast and flexible).
3. Enough autonomy.
4. Adequate command & control authority.
5. Ability to adapt to unexpected requirements.
6. Ability to sustain the development and full operational capability.

b)Air-Evac characteristics needed to fulfill the operationalRequirements:

• Inmediate response capability. Fast development readiness.
• Mobility. Deployment without limitations.
• Deplyment in distance and with-speed.
• Flexibility. Able to adapt to incrents of threat.
• Specialized. Skilled personnel and specific material.
• Medical Intervention. Allows to recover casualties.
• Medical intrinsec value.
• Morale of contingent.

Structure

This structure allows the Unit to be able to perform its function in any organization. The three key elements are:

-Adequate organization.

-Human resources.

-Appropiate medical equipment.

Organization

The Unit depends directly from the Air Force Combat Command who also commands the airframe involved in our missions.

The location in an Air Base where the medical support equipment and inteface material is storaged in hangars that areat the Flightline, makes the airframe ready available and allows a continous contact between theAir Evacuation Unit and the Transport Wings. This fact empowers mutual knowledge, frecuent joined training and enhances operativity and much shorter readiness times.

Appropiate Medical Equipment: Material

An appropiate medical support material together with an adequate interfacebetween aircraftand medical equipment will allow the unit to extend personnel knowledge towards casualties to be treated. The logisitic section not only takes care of the maintenance but has an active program of evaluation and research of all this equipment.

Human Resources: Personnel

It is the most prescious systems of arms. Motivation and exquisite training are the bases of the professional excellency thatwill be able to fully exploit the organizational and material capabilities for the success of our endevour.

Current structure of the Spanish Air-Evac Unit.

1.Logistic Section.

The Research and Development section is responsable for certification of new equipment in our aircrafts as well as analyzing its operational use in the field.

2.Operations Section.

Responsable for the planning, preparedness and execution of the missions.

3.Traning and Education Section.

Responsable for the training of new personnel at the Medevac unit as well as keeping the knowlegde updated at all mediacal and logistic disciplines of the members of the unit. 

Responsable for the training of Air Force medical personnel involved in international operations.

Date: 06/19/2011

Source: MCIF 2/11