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identification of available specialty backup.  CENTAF was slow in making this
information available.
      Emergency response varied by location. At many sites, the response teani
was jointly staffed.   SME's had to rely on vehicles of opportunity, either
ambulances provided by the supporting ATH or rental vehicles provided by the
host nation. Since there were no designated supply packages many SME vehicles
were capable of nothing but simple patient transport.
      Communications problems required creative solutions.    Some SME's were
given Sable or Foxinike radios with or without base stations.   Others acquired
cellular phones or beepers.  Although the ATO Concept of Operations requires
SME's have communication with Base Survival Recovery Center, Emergency
response teams, the supporting ATH and aerevacuation source, and casualty
collection points, there was no system in place to guarantee this capability.
Medics were often given low priority by Comm Squadrons.     Message traffic was
only moderately reliable.    Even when collocated, communication with the
supporting ATH was not always dependable.

                        PATIENT                CARE

      SME's typically reported a predominance of gastroenteritis visits early in
the deployment which was later superceded by URI's.     For supporting locations
outside the theater, gastroenteritis was not among the top two DNIF complaints.
The most commonly seen non-battle injury was lacerations; second most common
was back or ankle strain.


       In theater:
           Most common DNIF complaint: URI (all locations ex. Riyadh)
           Second: Gastroenteritis (all locations ex. Sharjah)
           Most common NBI: lacerations
           Second: back or ankle sprain
       Supporting operating locations:
           Most common DNIF complaint:         URI
           Second: Bronchitis
           Most common NBI: lacerations
           Second: ankle strain


      At one location, conflicts arose over whether or not to do flight physicals.
ATC's are not equipped for that purpose, but local resources were used.
      Nearly afl flight surgeons saw patients with significant medical problems
such as insulin dependent diabetes and chronic pancreatitis, which were beyond
the capabilities of the ATC to care for them.   These patients should never have
been deployed.   Many thought this problem was more common among the Air
Reserve Component (ARC) personnel.    At least one location also had civilian
contractors who presented unique medical demands.       There were few backup
medical facilities, except for host nation, available in theater the first 30 days.
With the exception of the complicated patient who should not have deployed, the
SME's strongly felt the disadvantages of deploying medical records outweighed
the advantages.  A complete SF 1480 should suffice in most cases and the most
recent SF 88 could provide such other use~al information as blood type, spectacle

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