Medical Return to Duty in Conflict
TOPIC SPONSOR: Surgeon General
In peer conflict with large-scale combat operations, how does the medical service shift to maintaining patients in the AOR and close to the front lines for assessment and treatment in order to expedite an Airman's return to duty?
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Bernaola, Maj. Marby M., "Beyond a Fellowship: Building a Foundation for PACU Nurses," AFGC thesis, 2025, 51 pgs.
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Bernaola explains that as the Air Force shifts to a more expeditionary force, forward-deployed medical teams will be smaller, and medical evacuation may be significantly delayed by contested environments. To successfully maintain surgical patients in the AOR, she argues the medical service must shift away from its current practice of using inexperienced nurses for post-surgical recovery and instead implement a formalized Post Anesthesia Care Unit (PACU) fellowship. By fully training PACU nurses to handle complex post-operative emergencies and basic life-sustaining needs, they will be equipped to execute prolonged field (or theater) care and serve as the sole nurse on Ground Surgical Teams. This ensures patients safely recover close to the front lines while allowing intensive care nurses to focus on their primary critical care duties.
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Jenkins, Maj. Phillip R., "War, Wounds and Strategy: Patient Movement Lessons from the World Wars for Great Power Competition." SAASS thesis, 2025, 113 pgs.
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Asks how the medical service will shift to maintaining patients in the area of responsibility (AOR) and close to the front lines for assessment and treatment in order to expedite their return to duty during LSCO. Jenkins addresses this by explaining that in future peer conflicts, strategic evacuation (STRATEVAC) routes will likely be heavily disrupted, forcing a doctrinal shift toward prolonged in-theater care at robust Role 2 and Role 3 medical facilities. Drawing on historical lessons from the World Wars, he illustrates how the military successfully utilized layered echelons of care—such as field hospitals, clearing stations, and convalescent camps—to stabilize and retain patients in-theater. By establishing adaptable, forward-deployed medical structures that can independently manage patient flow and perform damage-control surgery, medical personnel can effectively retain, treat, and return lightly wounded personnel to the front lines while compensating for degraded evacuation pipelines.
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Taylor, Capt. Isabel, "BBP on Telehealth Capabilities in the Deployed Environment," SOS AUA 2024, 3 pgs.
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Vernon, Col. Caryn, "Critical Care on the Battlefield in 2035," AWC Strategic Studies Paper, 2020, 34 pgs.