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From the Ground Up

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... a total of 37 Events every semi-annual training cycle 49,506 training events every 6 months Mixture of clinical and aircrew ... replicates a task ... 2012 ... – PowerPoint PPT presentation

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Title: From the Ground Up


1
From the Ground Up Aeromedical Evacuation
Training System
  • Major Chad Corliss
  • 94 AES/DO
  • 2/12/2015

2
DISCLAMIER(s)
  • Reference to any specific commercial products,
    process, or service by trade name, trademark,
    manufacturer, or otherwise, does not necessarily
    constitute or imply its endorsement,
    recommendation, or favoring by the US Air Force,
    Department of Defense or the United States
    Government. The views and opinions of authors
    expressed herein do not necessarily state or
    reflect those of the US Air Force, Department of
    Defense or the United States Government
  • This presentation is UNCLASSIFIED and will not
    contain any discussion or information that may
    be subject to the International Traffic in Arms
    Regulations (ITAR).

3
Why Simulation
A Soldier lay dying in a distant land His
friends prayed for god to send an angel down from
the heavens to save him
4
ETA 2 Minutes
5
Objectives
  • Describe the Aeromedical Simulation Training and
    Education Center and its mission
  • Discuss the design, development and future
    opportunities of the Aeromedical Evacuation
    Training Device (AETD-1)
  • Discuss the importance of integrating realism and
    curriculum integration when implementing an
    immersive simulation environment

6
MISSION AIRLIFT THE WOUNDED WARRIOR MISSION AIRLIFT THE WOUNDED WARRIOR
Date ANYTIME Location ANYWHERE
7
Global Summary
  • Since combat operations began (10 October 2001)
  • Patient Movements Completed
  • 316,502
  • Since 1 Jan 2016 557 Patient Movements

8
What is the Survival Rate
  1. 66
  2. 75
  3. 89
  4. 98

9
Advances in Aeromedical Evacuation
Died of Wounds
1918
WWII 30
Korea 25
1950
Vietnam 24
1968
Combat Mortality Rate
Persian Gulf 24
1990
OEF/OIF lt10
2015
10
What is the Survival Rate
Todays conflictsThe survival rate from
wounding-- so if they're not killed instantly and
they actually receive medical care--
That survival rate is 98
11
Survival in a Combat Zone
People with major trauma, missing legs, missing
arms, massive body injuries--in the past that
used to cause death.
because we have the medical care so far forward
and improved care itself--not just its
availability, - that we have people surviving
that never would have survived.
12
The leading cause of death on the battlefield
  1. Uncontrolled Hemorrhage
  2. Head Injury
  3. Tension Pneumothorax
  4. Obstructed Airway

13
True or False
  • Of those killed in action/Died of Wounds 15 of
    those are potentially preventable

14
Total Force AE
  • Air Force Reserve Command
  • 18 Squadrons
  • 60 of the Force
  • Air National Guard (State)
  • 9 Squadrons
  • 28 of the Force
  • Regular AF
  • 4 Squadrons
  • 12 of the Force

15
The Evacuation Story
  • Point of Injury
  • Self-Aid Buddy Care
  • Combat Medic
  • 9 Line
  • Patient Evacuation Coordination Cell
  • Intelligent Tasking
  • Right Asset, Right Time, Right Place, Right Care

16
What we did
  • 64 Rotary Wing Assets
  • H60
  • USA DUSTOFF
  • USAF PJ Pedro
  • 4 Fixed Wing Assets
  • C-130 Bandage (US)
  • C-130 Trash (USMC)
  • C-130 Batman (UK)
  • C-160 ISAF71 (Ger)
  • 8 Tilt Rotary Assets
  • MV-22 Elvis
  • UK MERT
  • CH-47 Tricky
  • 6 AE Crews
  • 4 US (3 AFRC)
  • 1 UK AE
  • 1 German AE

710 Evacuation Missions 979 Patients
17
Now that the War is Over
US Level 1 Trauma Center Joint Theater Trauma System
5,000 evaluations per 2,000,000 population 8,000 evaluations per 200,000 population



Less the 30 penetrating trauma Greater than 90 penetrating trauma
Less than 10 require surgery Greater than 80 require surgery
Single procedure/Surgeon Multiple procedures/Specialists
How do we prepare for the Future?
18
Readiness Requirements
  • 579 Flight Nurses Authorized in the Reserve
    Command
  • 779 Aeromedical Technicians Authorized in AFRC
  • For a total of 1338 AE Crew Members in the
    Reserves alone
  • Each Crew member must complete a total of 37
    Events every semi-annual training cycle
  • 49,506 training events every 6 months
  • Mixture of clinical and aircrew operational events

19
True or False
  • The historic model of clinical training is See
    One, Do One, Teach One

20
What if the one you saw was done wrong?...
21
  • Retention
  • 5 - Lecture
  • 20 - Audio/Visual Death by PowerPoint
  • 30 - Demonstration
  • 75 - Learn by DOING Simulations
  • 90 - Teach Others Collaborative Simulations
  • Interaction is associated with Learning
    achievement and retention of knowledge
  • Source Andersen Consulting

22
AE SimulationA Better way to Train
  • There is a big difference
  • between seeing and understanding
  • between watching and doing
  • Thats what makes training and simulation so
    vital to operational success
  • Tell me and I'll forget show me and I may
    remember involve me and I'll understand.
  • Chinese Proverb

23
What is AE Simulation
  • Simulator
  • replicates a task environment with sufficient
    realism to serve the desired purpose.
  • Simulation
  • ..as a strategy not a technology to mirror,
    anticipate, or amplify real situations with
    guided experience in an immersive way.

24
  • The Flight Industry established simulation as a
    basis for training
  • Flight Simulators improved pilot skills
  • Certification is required on simulator prior to
    ACTUAL flight
  • Re-certification on a simulator required yearly
  • Simulation training is shown to
  • Improve acquisition and retention of knowledge
  • Decrease unplanned errors
  • Improve correction of problems

25
Readiness to Practice
Beyond Simple Skills Training
26
Speed of Learning
Simulation Sophistication
27
Simulation Vs Operational
  • The use of simulation wherever feasible conveys
    a critical educational and ethical message to
    all patients are to be protected whenever
    possible and they are not commodities to be used
    as conveniences of training.
  • Ziv A, Wolpe PR, Small SD, Glick S.
    Simulation-Based Medical Education An Ethical
    Imperative. Simulation in Healthcare. Winter
    2006 4252-256

28
We Train to Chase Zero
  • 24 Hours a day/ 7 days a week
  • You never know when the call is going to come
  • We must be ready when it does
  • So we train constantly
  • We train hard because we have to be able to get
    it right the first time

29
When U.S. combat deaths drop to zero
March 2014, marked an extraordinary
milestone the first time in more than a decade
that there were zero U.S. fatalities among
American troops engaging in combat.
30
Why use simulation?
  • Limited access to clinical experiences
  • No more Air Force Medical Treatment Facilities to
    train the required medical skills
  • Increasing focus on Readiness to Practice
    Competency
  • Drawdown in OCO may reduce clinical readiness
  • Desire for access to On Demand learning
    opportunities
  • AE Enterprise (AMC, AFRC, PACAF, USAFE and ANG) -
    looking at the requirements for AE/ERC
    sustainment training will grow more complex as
    the AE System moves to the high-acuity, complex
    Med-Surg level care
  • Constrained fiscal environment
  • Reduced flying hour program pilots using
    increased simulation Less platform time
    available

31
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32
Do we Believe in Simulation?
  • Teaching using simulation needs to occur in a
    realistic environment
  • When the learners return to the workplace, they
    can easily apply what is learned.
  • The more realistic the environment is to the
    learners own area of work, the more successful
    the learning will be.
  • Simulation allows the creation of realistic
    simulations to allow greater retention of what is
    learned

Simulation is the suspension of disbelief.
(Oberndorf, 2012)
33
Becoming Reality
34
Second to None
Joint Project with HQ AFRC 6M training
system Ready for training 2016
  • 94 AW host to the Aeromedical Evacuation Training
    and Education Center
  • First Simulation Center to focus on the
    sustainment and development of AE for critical
    lifesaving mission
  • Home of the FIRST and ONLY full simulation device
    for AE training

35
The New Normal
  • Old Model
  • Simulation
  • See 1, Do 1, Teach 1
  • Low Fault Tolerance
  • Irregular Feedback
  • Subjective Assessment
  • Experience by Chance
  • Criteria Based (See One, Sim Some, Harm None)
  • Permission to Fail
  • Immediate Feedback
  • Objective Assessment
  • Library of Content

36
Challenges
  • Misconception that it will become a substitute
    for AECM training and patient care
  • Lack of awareness of simulation capabilities and
    technology
  • Bottom up vs. Top down integration of simulation
  • Cost of transition

37
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38
Litter Configuration
39
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40
Fuselage Fire
41
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42
Current Capabilities
  • 20 High Fidelity Patient Simulators
  • 8 iStan (Safe-To-Fly)
  • 6 MetiMan (3 PH/3NRS)
  • 1 Gaumard HAL
  • 1 Gaumard HAL 5 year old
  • 1 CAESAR (Point of Injury)
  • 1 Lucina Fidels (OB)
  • 1 Pediatric ECS
  • 1 Multiple Amputation Trainer (Point of Injury)
  • Fully equipped skills training lab
  • Simulation Management and Debrief System
  • Student Response System
  • Joint Use (AES/TPC) C-130 Trainer for load
    training
  • Video training/production studio
  • Simulated AE Staging Facility
  • C-17 EP Lab/SLC
  • KC-135 EP Lab/SLC

43
Future
  • Large full flight simulation with visual system
  • AETD-1 will be placed on 6 DOV Motion Platform
  • KC-135 and C-17 (AETD 2/3) are being developed
    for use at an AFRC location
  • Both will be on 4 DOV Motion bases

44
Questions ?
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