NATO/PfP UNCLASSIFIED RECORD OF AMENDMENTS EXPLANATORY NOTES

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3 RECORD OF AMENDMENTS N Reference/date of Amendment Date Entered Signature EXPLANATORY NOTES AGREEMENT 1. This NATO Standardization Agreement (STANAG) is promulgated by the Director NATO Standardization Agency under the authority vested in him by the NATO Standardization Organisation Charter. 2. No departure may be made from the agreement without informing the tasking authority in the form of a reservation. Nations may propose changes at any time to the tasking authority where they will be processed in the same manner as the original agreement. 3. Ratifying nations have agreed that national orders, manuals and instructions implementing this STANAG will include a reference to the STANAG number for purposes of identification. RATIFICATION, IMPLEMENTATION AND RESERVATIONS 4. Ratification, implementation and reservation details are available on request or through the NSA websites (internet NATO Secure WAN FEEDBACK 5. Any comments concerning this publication should be directed to NATO/NSA Bvd Leopold III Brussels - BEL. - ii -

4 STANAG 2087 (Edition 6) NATO STANDARDIZATION AGREEMENT (STANAG) MEDICAL EMPLOYMENT OF AIR TRANSPORT IN THE FORWARD AREA Related documents: STANAG 2132 MED DOCUMENTATION RELATIVE TO MEDICAL EVACUATION, TREATMENT AND CAUSES OF DEATH OF THE PATIENTS STANAG 3117 FS STANAG 3204 AMD AIRCRAFT MARSHALLING SIGNALS AEROMEDICAL EVACUATION STANAG 2128 MED MEDICAL AND DENTAL SUPPLY PROCEDURES STANAG 2454 M&T ROAD MOVEMENTS AND MOVEMENT CONTROL - AMovP-1(A) ATP-49(E) VOL.II USE OF HELICOPTERS IN LAND OPERATIONS - TACTICS, TECHNIQUES AND PROCEDURES (Ratification Draft 2) ACP STATE 136 INSTRUCTIONS-PANELS SIGNALLING AIM 1. The aim of this agreement is to standardize for the NATO forces the general principles governing the evacuation by air of the sick and wounded from the forward area of the theatre of operations. AGREEMENT 2. Participating nations agree that the NATO forces are to follow the principles outlined herein in planning and organizing the employment of air transport in medical missions related to ground operations, regardless of which force operates the air transport. DETAILS OF AGREEMENT 3. Control of operations is to be in accordance with local directives and the organization of the force concerned

5 4. Emergency aeromedical evacuation is concerned with the prompt movement of the sick and wounded, where rapid, evacuation or treatment will reduce morbidity, permanent disability and mortality. Such sick and wounded should be picked up as soon as possible after the request for aeromedical evacuation and directly evacuated to designated treatment facilities. 5. Routine aeromedical evacuation is used when surface means are either non-existent or inadequate, or when aeromedical evacuation is more effective. In these cases, time is not of the same essence as in the emergency category. If properly prepared prior to routine evacuation, evacuees may require only minimal in flight care. However, patients requiring critical care support also may be moved in a timescale consistent with routine aeromedical evacuation. 6. Forward aeromedical Evacuation is that phase of evacuation which provides airlift for patients between points within the battlefield, from the battlefield, to the initial point of treatment, and to subsequent points of treatment within the combat zone 1. Aeromedical evacuation is to be used as far forward as tactical situation will permit. If necessary, this may apply from enemy territory. REQUEST FOR AEROMEDICAL EVACUATION 7. The unit initiates medical missions by directly contacting the command concerned, e.g. the battle group/regiment, the division, the corps or the army. Requests for these missions may be processed through medical technical channels and/or command channels, according to local directives and the organization of the force concerned. There should be close liaison between the medical despatching unit and the aircraft tasking authority. 8. In order that the unit and the controlling agency may be able to evaluate properly and establish priorities for aeromedical evacuation, the request should contain the following information: a. Number, diagnosis and priority of wounded and sick 2 (1) Priority 1/URGENT Emergency cases which should be evacuated, within 2 hours in order to save life, to prevent complications or to avoid serious permanent disability. (2) Priority 2/PRIORITY Patients who require a specialized treatment not available locally and whose clinical condition is likely to deteriorate unless evacuated within 4 hours. (3) Priority 3/ROUTINE Patients whose immediate treatment is available locally but whose prognosis would benefit from aeromedical evacuation within 24 hours. 1 AAP-6 2 Priority assessments are to be initiated and readjusted on medical grounds only. Inability to respond to requests for aeromedical evacuation of the sick and wounded within the advisory time quoted above does not constitute, in itself, a reason for alteration of priorities

6 b. Lying or sitting patients. c. Exact location, by grid co-ordinates or other method as directed by the tactical field SOP. d. Specific identification of landing site. e. Time the sick and wounded will be ready for evacuation. f. Special requirements/arrangements and their availability from local resources concerning means to be used in terms of equipment, drugs and personnel. g. Radio frequency and call sign of the coordinating unit at the landing site or in contact with the personnel at the landing site. h. Tactical considerations at the landing site, to include friendly or enemy artillery or other weapons firing, recommended approach paths (e.g. direction, altitude), friendly or enemy aircraft activity, NBC conditions. i. Patient nationality and personnel status (military, POW, civilian). PRIMARY MEDICAL MISSION 9. The primary mission of the medical units and/or air transport made available for medical purposes is to provide aeromedical evacuation for selected sick and wounded, according to the criteria described into 8.a., according to a doctor s or responsible officer s decision. SECONDARY MISSIONS 10. Secondary missions of air transport made available for medical purposes should include: a. Airlift of critical medical supplies. b. Air movement of medical specialist personnel. c. Other medical evacuation missions as required. LOADING, SECURING AND OFF-LOADING 11. The captain of the aircraft: a. Is responsible for the final decision as to how many sick and wounded may be safely loaded and as to their location. However, the aeromedical evacuation crew should advise him in his decision. b. Is to ensure that the wounded and sick as well as equipment are loaded in the aircraft in accordance with the prescribed methods outlined in the applicable flight handbook

7 c. Is to ensure that all relevant documentation procedures are completed, when the aircraft is permanently allotted for medical evacuation missions. 12. Commanders of medical treatment facilities are responsible: a. For the movement of the sick and wounded to and from the loading sites. b. For loading and unloading of the sick and wounded. c. For providing personnel in the landing area to assist in loading and off-loading of the wounded and sick. Failing that, these personnel will be provided by the commander of the requesting unit or the local commander at the point of loading and unloading. d. For in-flight medical care. e. For medical personnel s training about: MISCELLANEOUS (1) The various types of aircraft used for aeromedical evacuation missions. (2) In flight medical care and special medical equipment necessary for this purpose. (3) The various types of safety devices used for air transport of the wounded and sick. 13. A reliable communication capability, which provides for direct or minimal relay of transmissions, between the authority controlling medical missions, the aircraft and the requesting unit is to be provided. Communications are to be minimized by relaying accurate information in the original request for aeromedical evacuation. A ground-to-air communications capability at the landing site is desirable. 14. Normally, helicopters and V/STOL aircraft will be used for forward aeromedical evacuation. Patients will frequently be untreated or inadequately stabilized prior to evacuation. Therefore, whenever possible, in-flight medical care should be available. To the maximum extent possible, the medical crew should consist of personnel specially trained in the aeromedical realm. Operational situations may preclude use of aeromedical escorts, but their use is in the best interests for the patients. 15. All electro medical equipment used in aeromedical evacuation aircraft must be cleared by the appropriate national or EU authority for use on aircraft. It must have been demonstrated both safe and effective in the airborne environment. Suggested minimum specifications of such equipment are included in STANAG 3204, Annex E, Appendix

8 AIRCRAFT IDENTIFICATION 16. Aircraft permanently used for evacuation missions will be marked with the emblem stipulated in Geneva Conventions and AMovP-1. PREPARATION AND MARKING OF LANDING SITES 17. For the preparation and the marking of temporary landing sites and of approach and take-off areas for helicopters, see STANAG 3597 and ACP-136. IMPLEMENTATION OF THE AGREEMENT 18. This STANAG is implemented when the necessary orders/instructions have been issued directing the forces concerned to put the content of this agreement into effect