Measuring Critical Care Air Support Teams’ Performance During Extended Periods of Duty

The Royal Air Force (RAF) Critical Care Air Support Teams (CCASTs) aeromedically evacuate seriously injured service personnel. Long casualty evacuation chains create logistical constraints that must be considered when aeromedically evacuating patients. One constraint is the length of a CCAST mission and its potential effect on team member performance. Despite no evidence of patient care compromise, the RAF has commissioned a study to investigate whether CCAST mission length influences performance. Describing and understanding the role of a CCAST enabled fatigue to be defined. Factors essential to studying fatigue were then identified that were used to develop a theoretical model for designing a study to measure the effects of fatigue on CCAST performance. Relevant factors include the patient’s clinical condition, team members’ cognition and vigilance levels, and the occupational aviation environment. Further factors influencing overall performance include the duration and complexity of patient interventions, mission length, circadian influences, and fatigue countermeasures.