A Descriptive Analysis of Casualty Evacuation Provided by the 160th Special Operations Aviation Regiment in Operation Enduring Freedom from 2008-2015

This thesis is the completion of a descriptive analysis of prehospital casualty evacuation operations performed by a non-medical, rotary-wing special operations aviation unit in Afghanistan. The epidemiology of combat wounded is a relatively new field and the subset of wounded personnel in special operations missions is even newer and a smaller subset. During prior wars, data was simply never recorded and studied in a scientific fashion. Treatments were often based on surgeon’s opinions and those surgeons may only be seeing the patient hours after injury. This analysis will lay the foundation for further work and study in order to improve wartime casualty outcomes. Methods: Written permission was obtained by the 160th Regimental Commander, who is the owner of the data. This is a single-source dataset compiled by the author. The original data was in narrative after action review (AAR) format and the unclassified, non-personally identifiable information was extracted and put in an Excel file. The University of Texas Institutional Review Board made the determination that this was a non-research based study and granted approval. The statistical data analysis was performed using JMP software, version 10 (SAS Institute, Cary, NC). Results: There were 129 separate casualty evacuations (CASEVACS) with a total of 227 patients transported. Of which three had unavailable data and 8 were military working dogs, for a total of 207 (96%) trauma patients, five (2%) medical patients, and 4 (2%) with unknown injuries. Most of the casualties were male US and coalition forces (n = 178, 86%). Most trauma casualties were caused by gunshot wounds (n = 89, 45%), followed by blast injuries (n = 82, 41%). Conclusion: Most casualties from special operations missions are wounded by direct fire, rather than explosive devices. This speaks to the close-quarters engagements that predominate in this mission set. Hemostatic agents are rarely used, necessitating further research into their utility on the battlefield. This dataset can also be used to evaluate adherence to tactical combat casualty guidelines and thus to direct training priorities