Like many other innovations in emergency medicine, the concept of air transport of wounded originates in the military. The first written reference to the term "air ambulance" is found in Jules Verne's Roman Robur of the Conquerors (1866), who was responsible for the rescue of shipwrecked ships by means of a "flying platform" Called Albatros. The first documented air rescue took place during the siege of Paris (1870-1871) in 1870, when more than 160 soldiers were evacuated by balloons from the besieged city.
The first real air rescue was carried out during the First World War, when a Serbian officer of French air forces was flown from the battlefield to a hospital. French records from the time document that the death rate of wounded fell from 60% to 10% when air rescue was carried out within six hours. The first recorded British wounded salvation took place in Turkey in 1917, when a soldier of the Imperial Camel Corps, shot in the ankle, was flown to the hospital within 45 minutes with a de Havilland DHH.
Until the end of the Second World War, continental Europe used mainly STOLs, such as the Fieseler Fi 156 or Piper J-3, for wounded rescue.
The first documented MedEvac deployment with helicopters took place in the Second World War. On April 21, 1944, during the Burma crusade, the Imperial Japanese Army shot an aircraft of the United States Air Force with three wounded British soldiers on board in the jungle near Mawlu behind Japanese forces. The pilot Lt. Carter Harman evacuated the wounded with a new helicopter of the United States Army of the type Sikorsky YR-4B in four flights from 25 to 26 April 1944 from the battle area.
The first dedicated use of helicopters by US armed forces took place during the Korean War (1950-53). The helicopters evacuated not only the wounded from the battlefield, but also transferred the more critical patients after the primary care provider from the field hospital to distant hospital ships. On August 4, 1950, just a month after the beginning of the Korean War, the first helicopter-assisted wounding was carried out by a Bell H-13. The wounded were transported in litter, which were fastened outside the small cabin of the H-13 above the country ridges.
The next major development step in air rescue took place during the Vietnam War when the multi-purpose helicopter Bell UH-1 went into operation. Commonly known as Huey, the cabin of the aircraft was sufficiently large to accommodate patients, and they could be treated by medical staff during transportation to the field hospital or hospital. The massive installation of this helicopter type for the wounded rescue reduced the average duration of the war up to the supply to an hour. The ability to transport patients inside the aircraft significantly reduced the mortality and morbidity of the wounded. Military paramedics carried on board treatments, which had previously been carried out only by physicians: they placed venenkatheders, introduced thoracic catheters, and sewed bleeding wounds.
Helicopters also play a key role in military wound rescue in the 21st century. The UH-60 Blackhawk rescue helicopter has been widely used in the Iraq war (2003), the occupation of Iraq in 2003-2011 and the war in Afghanistan since 2001. While both countries have extensive, desert-like topologies, which make the use of helicopters imperative, there are also up to 7,500-meter high mountain ranges in Afghanistan in the Hindukush, which make additional helicopter operations even more difficult.
The ambulance forces of the United States Army use the callsign DUSTOFF, which is a Backronym from Dedicated Unhesitating Service to Our Fighting Forces. The tactical call sign DUSTOFF for a medical evacuation mission was used for the first time in 1963 by Major Lloyd E. Spencer, the Commander of the United States Army 57th Medical Detachment (helicopter ambulance). The term established itself until the end of the Vietnam War.
As soon as a medic or doctor on the ground has the call sign for CASEVAC or an EMERGENCY AIR MEDEVAC REQUEST (9-liner), the nearest available (air) vehicle is requested for assistance, regardless of its medical facility.
The general principle behind CasEvac is the transport of wounded persons who are in urgent need of an evacuation from the battlefield and whose injuries no longer allow to wait for a MedEvac rescue helicopter with intensive medical equipment (patient monitoring monitor, respirator, pump injection injectors, ultrasound device, blood gas analyzer, shock shock) . Also an unfavorable danger or a missing or hot landing zone may require a CasEvac. Typically, air rescue transports a wounded wounded wounded from the location of the wound to a stationary medical facility within an hour ("Golden Hour").
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